8 research outputs found
Impact of PGL-I Seropositivity on the Protective Effect of BCG Vaccination among Leprosy Contacts: A Cohort Study
Although leprosy has become a neglected disease, it is an important cause of disability, and 250,000 new cases are still diagnosed worldwide every year. The current study was carried out in Brazil, where almost 40,000 new cases of leprosy are diagnosed every year. The study targeted contacts of leprosy patients, who are at the highest risk of contracting the disease. We studied 2,135 contacts who were diagnosed at the Leprosy Outpatient Clinic at the Oswaldo Cruz Foundation in Rio de Janeiro, RJ, Brazil, between 1987 and 2007. The presence of antibodies against a specific Mycobacterium leprae antigen (PGL-I) at the first examination and BCG vaccination status were evaluated. PGL-I-positive contacts had a higher risk of developing leprosy than PGL-I-negative contacts. Among the former, vaccinated contacts were at higher risk than unvaccinated contacts. Our results indicate that contact examination combined with PGL-I testing and BCG vaccination appears to justify the targeting of PGL-I-positive individuals for enhanced surveillance. Furthermore, it is highly recommended that PGL-I-positive contacts and contacts with a high familial bacterial index (i.e., the sum of results from index and co-prevalent cases), regardless of serological response, should be monitored. This group could be considered as a target for chemoprophylaxis
Leprosy among Patient Contacts: A Multilevel Study of Risk Factors
Leprosy is an infectious disease that can lead to physical disabilities, social stigma, and great hardship. Transmitted from person to person, it is still endemic in developing countries, like Brazil and India. Effective treatment has been available since 1960, but early diagnosis of the disease remains the most effective way to stop the transmission chain and avoid late diagnoses and subsequent disabilities. Knowledge of the risk factors for leprosy can facilitate early detection; therefore, our study aimed to investigate the factors presented by leprosy patients and their contacts, who are considered at highest risk of contracting the disease. We studied 6,158 contacts of 1,201 patients under surveillance from 1987 to 2007 in a Public Health Care Center in the City of Rio de Janeiro, Brazil. We evaluated the ways patient and contact demographics and epidemiological characteristics were associated with the detection of leprosy. Statistical analyses took into account both individual and group characteristics and their interrelationships. The main characteristics facilitating the contraction of leprosy among contacts were shown to be consanguinity and household association. Conversely, the bacillary load index of leprosy patients was the principle factor leading to disease among their contacts
Adjusted rate ratios among leprosy contacts, stratified by BCG vaccination after index case diagnosis.
1<p>Person years.</p>2<p>Adjustment for clustering and age, gender, presence of BCG scar, type of association with IC, length of time of close association with IC, and sum of family BIs.</p>3<p>Confidence interval.</p>*<p>Bacteriological indexes.</p
Leprosy cases by PGL-I result, BCG vaccination and clinical presentation in a cohort of contacts.
<p>Leprosy cases by PGL-I result, BCG vaccination and clinical presentation in a cohort of contacts.</p
Crude and adjusted measures of association of seropositivity and selected covariates among leprosy contacts.
<p>Notes:</p>1<p>Based on chi-squared tests.</p>2<p>Adjustment for clustering and age, gender, presence of BCG scar, type of association with IC, length of time of close association with IC, and sum of family BIs.</p>3<p>Confidence interval.</p>*<p>Bacteriological indexes.</p