Variation of TTC Repeat Pattern in the Dna of Mycobacterium Leprae Isolates Obtained From Archeological Bones and Leprosy Patients From East Nusa Tenggara

The existence of leprosy or kusta or Morbus Hansen or Hansens disease has been known for years, including in Indonesia. Starting from the discovery of Mycobacterium leprae isolates from ancient bone (about 1.000 years B.C), the archaeological excavations results in East Nusa Tenggara, interesting questions arise about how the development of leprosy in eastern Indonesia is. Biology molecular study would become a powerful tool to investigate the presence of leprosy bacillary whether there are similarities between the genomes of M. leprae isolates in the primeval and the present. PCR examinations were performed on mandibular bone fragments from ancient human who lived 1000 years B.C. discovered in archaeological surveys on the island of Lembata and three leprosy patients from East Nusa Tenggara. The DNA extraction was performed using a kit from Qiagen products and its TTC repeating pattern was seen with the method of direct sequencing. It turned out that the TTC profile obtained from samples of archaeological was as many as 13 copies, while the repetition of TTC in three samples of leprosy patients were 15, 17 and 26 copies. The different number of TTC repetition shows the different isolates of M. leprae between in the ancient times and the present. Further studies are needed to verify the differences in the genome that occur, for example from the study of SNPs (single nucleotide polymorphisms)

A simpler diagnostic method using blood collection on filter paper to determine anti-natural octyl disaccharide-leprosy infectious disease research institute diagnostic in household contacts of leprosy patients

The high prevalence among children shows continued transmission from adult and lack of disease control by the health system. Detection of anti-NDO-LID-1 has been known to be more effective to predict the development of leprosy in household contacts than just detecting PGL-1 or LID- 1 alone. However, serodiagnosis is not available in poorer-settings area and the procedure (venepuncture) is still inconvenient to some people. These problems can be solved by using finger-prick blood sample on filter paper. This study aims to prove the effectiveness of using capillary blood samples on filter paper to detect the positivity of Ig G antibody against NDO-LID-1 antigen in asymptomatic household contacts. Seventeen samples of capillary blood on filter paper and sera were tested for IgG anti-NDO-LID-1 using ELISA. There was no significant difference between IgG level from filter paper and serum (p=0.754) and there was also a strong positive correlation (R=0.906) between the two procedures. These findings show that the use of filter paper and NDO-LID-1 is worthy of further investigations, especially for those with lower bacillary load or contacts of leprosy patients

Understanding leprosy reactions and the impact on the lives of people affected: An exploration in two leprosy endemic countries.

BACKGROUND: Leprosy reactions, Type-1 and erythema nodosum leprosum, are immune-mediated complications of leprosy, which play a significant role in the morbidity associated with the disease. A considerable amount of literature has been published on the impact of leprosy in general but few studies focus specifically on leprosy reactions. This study aimed to investigate the impact of leprosy reactions on physical, psychological, and social aspects of the lives of people affected by analysing their life experiences and perspectives about leprosy reactions. METHODS/PRINCIPAL FINDINGS: This qualitative study involved people affected by leprosy reactions and their family members in two leprosy endemic countries. The data were collected through 66 interviews and 9 focus group discussions (4-6 participants each) in Surabaya, Indonesia, and Purulia, India. Content analysis and conversational analysis were performed. This study found that both types of leprosy reactions were perceived as an unpredictable and painful condition. Leprosy reactions restricted physical activities of the participants, such as going to bathroom, sleeping, eating, and cooking. In the interviews, the respondents expressed a range of emotions and feelings including confusion, sadness, anxiety, and anger. Some recounted that they felt stigmatized and lost opportunities to socialise and earn money. Differences between the two settings were identified. The majority of Indonesian participants preferred to stay at home, and some concealed the diagnosis of leprosy, while most of the Indian respondents continued working up to the time of hospitalization. CONCLUSION: Leprosy reactions are a distressing complication of leprosy and adversely affect the lives of those affected. Individuals reported physical discomfort, distress, anxiety, stigma, and financial hardship and these negative impacts in the physical, psychological, and social spheres reinforced each other. These findings provide important information about a need for early detection and sustained commitment to follow-up care for people with a history of leprosy reactions. More research on new drugs for reactional episodes, tools to measure knowledge, attitude, and practice, and costing study on leprosy reactions treatment are needed. We recommend the development and testing of holistic strategies to improve the management of leprosy reactions

Understanding leprosy reactions and the impact on the lives of people affected: An exploration in two leprosy endemic countries. Socio-demographic data.

Questionnaire produced to collect socio-demographic data. S1 Appendix for the paper, "Understanding leprosy reactions and the impact on the lives of people affected: An exploration in two leprosy endemic countries"