RESUMO
Hansen's disease (HD) is an ancient disease, but more than 200,000 new cases were reported worldwide in 2019. Currently, there are not many satisfactory immunoassay methods for its diagnosis. We evaluated antibodies against Mce1A as a promising new serological biomarker. We collected plasma from new cases, contacts, and endemic controls in the city of Parnaíba and treated patients at Carpina, a former HD colony in Piauí state, northeastern Brazil. Receiver operating characteristic (ROC) curves were used to assess the assay thresholds, specificity and sensitivity of the IgA, IgM, and IgG antibodies against α-Mce1A by indirect ELISA and compared it with IgM anti-PGL-I and molecular diagnosis by quantitative polymerase chain reaction (qPCR). Venn diagrams were generated to represent the overlap in the antibody positivity pattern. Multivariate analysis was performed to assess the potential predictor of antibodies for the outcome of having an HD diagnosis. IgA and IgG were positive in 92.3 and 84% of patients, respectively. IgM was negative for all treated patients. IgG had a sensitivity and specificity of 94.7 and 100%, respectively. IgM-positive individuals had a 3.6 chance of being diagnosed with HD [OR = 3.6 (95% CI = 1.1-11.6); p = 0.028], while IgA-positive individuals had a 2.3 chance [OR = 2.3 (95% CI = 1.2-4.3); p = 0.005] compared to endemic controls. We found that the Mce1A antibody profile can be an excellent diagnostic method of HD. IgA is an ideal biomarker for confirming contact with the bacillus. IgM has potential in the detection of active disease. IgG antibodies confirm the performance of these serological markers in diagnosis and therapeutic follow-up.
RESUMO
Objective: To analyze leprosy epidemiological profile in the state of Piauí, Brazil. Methods: Cross-sectional epidemiological study with retrospective collection. It was used data from the SUS Notifiable Diseases Information System of leprosy patients, for the period from 2005 to 2014. We evaluated the detection rate, degree of disability in the diagnosis and cure, and the proportion of healing. Results: It was totaled 13,787 leprosy cases, the detection rate has decreased over the years, the degree of disability to be evaluated in the diagnosis and cure showed a downward trend assessment, the cure rate was regular (%?). Conclusion: The proportion of cases detected with degree of disability and the prevalence of passive forms of detection suggest late diagnosis and confirm the importance of integrating leprosy control actions in primary care.
Objetivo: Analisar o perfil epidemiológico da hanseníase no estado do Piauí. Métodos: Estudo epidemiológico transversal, com coleta retrospectiva. Utilizaram-se dados do Departamento de Informática do SUS, de pacientes com hanseníase, referentes ao período de 2005 a 2014. Foram avaliadas a taxa de detecção, grau de incapacidade física no diagnóstico e na cura e a proporção da cura. Resultados: Totalizaram 13.787 casos de hanseníase. O coeficiente de detecção diminuiu ao longo dos anos, o grau de incapacidade física a ser avaliado no diagnóstico e na cura apresentou uma tendência de redução de avaliação, o percentual de cura foi regular (%?). Conclusão: A proporção de casos detectados com grau de incapacidade e o predomínio de formas passivas de detecção sugerem diagnóstico tardio e corroboram a importância da integração das ações de controle da hanseníase na atenção básica.
Objetivo: Analizar el perfil epidemiológico de la lepra en el estado de Piauí. Métodos: Estudio epidemiológico transversal con recolección retrospectiva. Se utilizaron datos de las enfermedades de declaración obligatoria del Sistema de Información de los enfermos de lepra, para el período comprendido entre 2005 y 2014. Se evaluó la tasa de detección, grado de discapacidad en el diagnóstico y la cura y la proporción de curación. Resultados: Asciende a 13,787 casos de lepra, la tasa de detección ha disminuido con el paso de los años, el grado de incapacidad para ser evaluados en el diagnóstico y la cura mostró una tendencia a la baja de evaluación, la tasa de curación fue regular (%?). Conclusión: La proporción de casos detectados con el grado de discapacidad y la prevalencia de las formas pasivas de detección sugieren un diagnóstico tardío y confirmar la importancia de integrar las acciones de control de la lepra en atención primaria.