Leprosy in Colombian children and adolescents.

While leprosy is not considered a public health problem in Colombia, affected children are an important warning sign, demonstrating the challenge of controlling the disease. Herein, we report 12 cases of leprosy in patients 5-17 years of age, summarizing our clinical, micro biological and treatment findings.

Mycobacterium leprae in Colombia described by SNP7614 in gyrA, two minisatellites and geography.

New cases of leprosy are still being detected in Colombia after the country declared achievement of the WHO defined 'elimination' status. To study the ecology of leprosy in endemic regions, a combination of geographic and molecular tools were applied for a group of 201 multibacillary patients including six multi-case families from eleven departments. The location (latitude and longitude) of patient residences were mapped. Slit skin smears and/or skin biopsies were collected and DNA was extracted. Standard agarose gel electrophoresis following a multiplex PCR-was developed for rapid and inexpensive strain typing of Mycobacterium leprae based on copy numbers of two VNTR minisatellite loci 27-5 and 12-5. A SNP (C/T) in gyrA (SNP7614) was mapped by introducing a novel PCR-RFLP into an ongoing drug resistance surveillance effort. Multiple genotypes were detected combining the three molecular markers. The two frequent genotypes in Colombia were SNP7614(C)/27-5(5)/12-5(4) [C54] predominantly distributed in the Atlantic departments and SNP7614 (T)/27-5(4)/12-5(5) [T45] associated with the Andean departments. A novel genotype SNP7614 (C)/27-5(6)/12-5(4) [C64] was detected in cities along the Magdalena river which separates the Andean from Atlantic departments; a subset was further characterized showing association with a rare allele of minisatellite 23-3 and the SNP type 1 of M. leprae. The genotypes within intra-family cases were conserved. Overall, this is the first large scale study that utilized simple and rapid assay formats for identification of major strain types and their distribution in Colombia. It provides the framework for further strain type discrimination and geographic information systems as tools for tracing transmission of leprosy.

Identification and comparison of Mycobacterium leprae genotypes in two geographical regions of Colombia.

OBJECTIVE: To evaluate and establish genomic strain typing markers suitable for the identification of transmission patterns of leprosy in different regions of Colombia. DESIGN: Patients from Agua de Dios, Barranquilla and Cartagena cities and neighbouring towns were enrolled during 2006-2007. Slit skin smears or biopsies were obtained from newly detected untreated patients, and those undergoing multidrug therapy. DNA was extracted from the clinical samples and tested using 15 different short tandem repeat and three SNP polymorphic markers. RESULTS AND CONCLUSION: Differences or similarities between strain types from the northeast (n = 20) and central regions of Colombia (n = 18) were noted. The alleles at two loci, 27-5 and 12-5 were different in the M. leprae in the two regions. The other microsatellite loci may be useful for further intra-population differentiation. There was strong association of 27-5 and 12-5 alleles with the SNP types. The 4-5 combination of alleles was associated with SNP type 3, while the 5-4 combination was mostly associated with SNP type 1, 2 or 4. The SNP type 4 m. leprae isolates were seen in patients in the northeast, but not in the central part.