RESUMO
Chemoprophylaxis was carried out on high risk group of extended contacts of new leprosy cases in Nyaungdon Township, Ayeyarwaddy Division, Myanmar and serological response was followed up for two years. In September 2003, blood samples were collected from 829 contacts after getting informed consent and sera were tested for immunoglobulin M antibodies using NTP-BSA ELISA test. These 300 seropositives were randomized to treated and non-treated groups. In each group 102 each were enrolled in adults and 48 each in children. A single dose of ROM (rifampicin, ofloxacin and minocycline) and RMP (rifampicin) by body weight was administered to treated group of above 15 years and those below 15 years respectively. The vitamins were administered to non-treated group. The blood samples of all contacts were collected again in September 2004 and September 2005 and ELISA was carried out on paired samples on one plate. The mean optical density (OD) titers before vs after chemoprophylaxis were 0.24 vs 0.10 and 0.20 vs 0.09 in treated and non-treated group respectively in adults and 0.25 vs 0.11 and 0.22 vs 0.11 respectively in children after one year. These were 0.24 vs 0.17 and 0.20 vs 0.19 respectively in adults and 0.25 vs 0.19 and 0.22 vs 0.20 respectively in children after two years. The difference of mean antibody titers before and after chemoprophylaxis in treated group was significantly reduced compared to non-treated group in adults but was not significant in children. The findings show that there is a significant role of chemoprophylaxis on serological response in the form of decreasing antibody titer among the adult group of extended contacts.
Assuntos
Antibioticoprofilaxia , Anticorpos Antibacterianos/sangue , Imunoglobulina M/sangue , Hansenostáticos/administração & dosagem , Hanseníase/epidemiologia , Hanseníase/prevenção & controle , Mycobacterium leprae/imunologia , Adolescente , Adulto , Criança , Estudos de Coortes , Quimioterapia Combinada , Ensaio de Imunoadsorção Enzimática , Seguimentos , Humanos , Hanseníase/transmissão , Minociclina/administração & dosagem , Mianmar/epidemiologia , Ofloxacino/administração & dosagem , Rifampina/administração & dosagem , Risco , Estudos Soroepidemiológicos , Fatores de TempoRESUMO
The value of BCG vaccination in preventing leprosy among children was studied in an area of high leprosy endemicity in Burma through a controlled trial; one group of 13066 children received BCG and another group of 13176 served as controls. The overall protective effect of BCG, which was only about 20% over the 14-year period, was found to vary with the batch of vaccine, as well as age, sex, and contacts status the children. The protective effect of BCG against the lepromatous type of leprosy could not be measured because of the low incidence. Protection was observed throught the fourteen years of the study except for the firts year. The results are compared with those of three other major BCG trials in leprosy. The trial has shown that BCG provides only a very modest level of protection and that BCG vaccination is not likely to be an important solution for leprosy control.