Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 22.948
Filtrar
1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48539

RESUMEN

Durante esta semana, a Fiocruz se unirá a outras instituições e iniciativas para a mobilização e o debate sobre uma doença negligenciada que tem tido seu quadro agravado pelo impacto da pandemia: a hanseníase. Segundo dados do Boletim do Ministério da Saúde, o diagnóstico de novos casos da doença no país foi reduzido à metade entre 2019 e 2020


Asunto(s)
Lepra/prevención & control ,
2.
Artículo en Portugués | PAHO-IRIS | ID: phr-55176

RESUMEN

[RESUMO]. Objetivo. Avaliar o uso combinado de marcadores sorológicos e análise espacial para ampliar a sensibilidade da vigilância epidemiológica da hanseníase. Método. Este estudo transversal foi realizado com vizinhos de casos de hanseníase e familiares e vizinhos de escolares com sorologia positiva anti-glicolipídeo fenólico I (PGL-I) em Diamantina, Minas Gerais, Brasil. Definiram- se como vizinhos as pessoas que residiam em um raio de até 100 metros de escolares e de casos de hanseníase. Para a coleta de dados, foram realizados entrevista semiestruturada, exame dermatoneurológico e teste sorológico rápido ML Flow. Todos os endereços foram georreferenciados. Foram realizadas regressão multivariada e análise espacial, tendo a sororreatividade anti-PGL-I como variável dependente. Resultados. Foram estudadas 1 491 pessoas: 1 009 (67,7%) familiares e vizinhos dos escolares com sorologia positiva e 482 (32,3%) vizinhos dos casos de hanseníase. Do total, 421 (28,2%) apresentaram soropositividade anti-PGL-I. A chance de soropositividade foi maior entre familiares e vizinhos dos escolares soropositivos (P < 0,001), entre pessoas com renda familiar de 1 salário-mínimo (P < 0,001), entre os mais jovens (P < 0,001) e entre os que residiam em domicílios com um a cinco cômodos (P = 0,007). A taxa de soropositividade foi maior em área geográfica correspondente aos escolares soropositivos (P < 0,001), ou seja, houve divergência entre o foco de maior concentração de casos e o de maior soropositividade. Conclusões. O uso combinado de marcadores sorológicos e análise espacial possibilitou identificar fragilidades operacionais dos serviços e uma possível endemia oculta de hanseníase nos setores censitários urbanos do município. Atividades de rastreamento de contatos sociais e vizinhos, busca ativa, campanhas educativas, inquéritos escolares e análise do território facilitam o diagnóstico precoce da hanseníase.


ABSTRACT Objective. To evaluate the combined use of serologic markers and spatial analysis to increase the sensitivity of leprosy epidemiological surveillance. Method. This cross-sectional study was performed with neighbors of leprosy cases and neighbors and family members of schoolchildren with a positive anti-phenolic glycolipid I (PGL-I) test in Diamantina, state of Minas Gerais, Brazil. Neighbors were those living within a 100-m radius of schoolchildren or leprosy cases. Data collection included a semi-structured interview, dermatologic examination, and rapid ML Flow test. All residential addresses were georeferenced. Multivariate regression and spatial analysis were performed with anti-PGL-I seropositivity as the dependent variable. Results. The study included 1 491 individuals: 1 009 (67.7%) family members and neighbors of schoolchildren with positive serology test and 482 (32.3%) neighbors of leprosy cases. Of the total, 421 (28.2%) were positive for anti-PGL-I. Seropositivity was higher among family members and neighbors of seropositive schoolers (P < 0.001), among people with family income of 1 minimum wage (P < 0.001), among the youngest participants (P < 0.001), and among those living in homes with one to five rooms (P = 0.007). The seropositivity rate was higher in the geographic area corresponding to seropositive schoolchildren (P < 0.001), that is, the spot with the highest number of cases was different from the spot with the highest rate of seropositivity. Conclusions. The combined use of serologic markers and spatial analysis allowed us to easily identify operational weaknesses of services and a possible occult leprosy endemism in the municipality’s urban census tracts. Tracing of social contact and neighbors, active search, educational campaigns, school surveys, and territorial analyses facilitate the early diagnosis of leprosy.


[RESUMEN]. Objetivo. Evaluar el uso conjunto de los marcadores serológicos y del análisis espacial para ampliar la sensibilidad de la vigilancia epidemiológica de la lepra. Método. Este estudio transversal se realizó con vecinos de personas con casos de lepra y con familiares y vecinos de escolares con resultados positivos en las pruebas serológicas del antígeno glicolípido fenólico I (PGL-I) en Diamantina (Minas Gerais, Brasil). Se definieron como vecinos las personas residentes en un radio de hasta 100 metros de distancia de los escolares y de las personas con casos de lepra. Para la recopilación de datos se realizaron entrevistas semiestructuradas, exámenes dermatoneurológicos y pruebas serológicas rápidas ML Flow. Todas las direcciones se ubicaron por georreferencia. Se realizó una regresión multivariante y un análisis espacial, y se empleó la reactividad serológica anti-PGL-I como variable dependiente. Resultados. Se estudiaron 1 491 personas: 1 009 (67,7%) familiares y vecinos de escolares con resultados positivos en las pruebas serológicas y 482 (32,3%) vecinos de las personas con casos de lepra. Del total, 421 (28,2%) presentaron seropositividad anti-PGL-I. La posibilidad de presentar seropositividad fue mayor en los familiares y vecinos de los escolares seropositivos (P < 0,001), en las personas con ingresos familiares de un salario mínimo (P < 0,001), en las personas más jóvenes (P < 0,001) y en los residentes en domicilios con una a cinco habitaciones (P = 0,007). La tasa de seropositividad fue mayor en la zona geográfica correspondiente a los escolares seropositivos (P < 0,001), por lo que hubo divergencia entre el foco de mayor concentración de casos y el de mayor seropositividad. Conclusiones. El uso conjunto de los marcadores serológicos y del análisis espacial permitió determinar las fragilidades operativas de los servicios y una posible endemia oculta de lepra en los sectores urbanos del municipio incluidos en el censo correspondiente. Las actividades de rastreo de contactos sociales y cercanos, la búsqueda activa de casos, las campañas educativas, las encuestas escolares y el análisis del territorio facilitan el diagnóstico temprano de la lepra.


Asunto(s)
Lepra , Mycobacterium leprae , Monitoreo Epidemiológico , Serología , Análisis Espacial , Brasil , Lepra , Monitoreo Epidemiológico , Serología , Análisis Espacial , Brasil , Lepra , Monitoreo Epidemiológico , Serología , Análisis Espacial
3.
Neurol India ; 69(5): 1349-1353, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34747810

RESUMEN

Background: Central nervous system (CNS) involvement in leprosy is sparsely documented. Neurophysiological tests and magnetic resonance imaging (MRI) helps in demonstrating CNS involvement in the patient of pure neuritic leprosy. Objectives: To demonstrate CNS involvement in pure neuritic leprosy. Methods: Detailed clinical presentation and skin lesions were evaluated. Sural nerve biopsy, MRI diffusion tensor imaging of spinal cord and optic nerve were performed. Visual evoked potential and tibial somatosensory evoked potential were done. Their clinical, electrophysiological, and MRI were done at follow-up visits. Results: We report three patients of pure neuritic leprosy with bilateral foot drop as the initial presentation. MRI T2W sequence of cervico dorsal cord showed dorsal column hyperintensity in two patients. Diffusion-weighted MR revealed decrease fractional anisotropy and an increase in the apparent diffusion coefficient. Similar findings were also noted in the optic nerves. The patients were managed with multidrug therapy multibacillary regimen and steroid in tapering dose. At follow-up, they showed clinical improvement in vision and power of ankle dorsiflexor. Conclusions: Patients of pure neuritic leprosy may manifest with bilateral foot drop with the involvement of posterior column and cranial nerves.


Asunto(s)
Lepra , Neuropatías Peroneas , Imagen de Difusión Tensora , Quimioterapia Combinada , Potenciales Evocados Visuales , Humanos , Leprostáticos/uso terapéutico , Lepra/complicaciones , Lepra/diagnóstico por imagen , Lepra/tratamiento farmacológico , Imagen por Resonancia Magnética , Neuropatías Peroneas/tratamiento farmacológico
4.
Indian J Med Res ; 154(1): 121-131, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34782538

RESUMEN

Background & objectives: The elimination goal for leprosy as a public health problem at the national level was achieved in 2005 in India. However, the number of new cases reporting annually remained nearly the same during the last 10-15 years. Moreover, a substantial number of these new cases reported disabilities for the first time. Therefore, besides multidrug therapy (MDT), newer strategies with focus on effectively decreasing the number of new cases, optimizing the treatment of detected cases, averting disabilities and arresting the transmission of the disease are required. So the objective of this study was to assess the cost-effectiveness of Mycobacterium indicus pranii (MIP) vaccine implementation in National Leprosy Eradication Programme (NLEP) for newly diagnosed leprosy patients as well as their contacts to arrest/decrease the transmission and occurrence of new cases. Methods: This was a model-based estimation of incremental costs, total quality-adjusted life years (QALYs) gained, new cases averted, deaths averted, incremental cost-effectiveness ratio (ICER) and budget impact of the vaccination intervention. This model included the addition of MIP treatment intervention to the newly detected leprosy patients as well as vaccination with MIP to their contacts. Results: Using the societal perspective, discounted ICER was estimated to be ₹73,790 per QALY gained over a five-year time period. Probabilistic sensitivity analysis (PSA) was assessed by varying the values of input parameters. Majority (96%) of simulations fell in North East quadrant of cost-effectiveness plane, which were all below the willingness to pay threshold. Interpretation & conclusions: Introduction of MIP vaccination in the NLEP appears to be a cost-effective strategy for India. Significant health gains were reduction in the number of new leprosy cases, decreased incidence and severity of reactions during treatment, and after release from treatment, prevention of disabilities, thus reducing the cost as well as stigma of the disease.


Asunto(s)
Lepra , Vacunas , Análisis Costo-Beneficio , Quimioterapia Combinada , Humanos , India/epidemiología , Leprostáticos/uso terapéutico , Lepra/tratamiento farmacológico , Lepra/epidemiología , Lepra/prevención & control , Mycobacterium , Años de Vida Ajustados por Calidad de Vida , Resultado del Tratamiento
5.
BMC Infect Dis ; 21(1): 1155, 2021 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-34774006

RESUMEN

BACKGROUND: Individuals with relapses of leprosy should be monitored carefully, however, with respect to paucibacillary (PB) leprosy, it is sometimes difficult to make a definitive diagnosis of relapse, because the bacillary index is often negative. To evaluate the usefulness of cytokine profiling in a patient with relapsed PB leprosy who tested negative for anti-phenolic glycolipid-I antibodies, we analyzed the Mycobacterium leprae protein-induced cytokine expression in peripheral blood mononuclear cells of the patient. CASE PRESENTATION: An 89-year-old-male relapsed PB patient, first treated for leprosy over 50 years prior, was examined. In April 2012, he noticed three skin lesions consisting of annular erythema in the thighs. Slit skin smear tests were negative, and skin biopsies revealed a pathology of indeterminate-to-borderline tuberculoid leprosy. He received 600 mg of rifampicin once per month and 75 mg of dapsone daily for 12 months. The annular erythemas disappeared after starting treatment. Before treatment, and 6 and 12 months after starting treatment, the Th1/Th2 cytokine profiles in the supernatant of mononuclear cells from the patient before and after stimulation with Mycobacterium leprae soluble protein (MLS) were examined using a Cytometric Bead Array (CBA) Human Th1/Th2 Cytokine Kit II. The CBA Enhanced Sensitivity Flex Set system was applied to detect small amounts of cytokines in the serum just before treatment and one year before relapse. In the culture supernatant, just before treatment, increases in IFN-γ level and the IFN-γ/IL-10 ratio and a decreased IL-6 level were observed without stimulation. Upon stimulation with MLS, just before treatment, both the IFN-γ and TNF levels increased markedly, and twelve months after starting treatment, the IFN-γ and TNF levels decreased greatly. In the serum, just before treatment, increases in IFN-γ and TNF levels and the IFN-γ/IL-10 ratio were evident compared with those measured one year before relapse. CONCLUSIONS: Cytokine profiling using culture supernatants and serum samples may be useful for the diagnosis of relapsed PB leprosy.


Asunto(s)
Lepra Paucibacilar , Lepra , Anciano de 80 o más Años , Citocinas , Humanos , Lepra Paucibacilar/diagnóstico , Lepra Paucibacilar/tratamiento farmacológico , Leucocitos Mononucleares , Masculino , Mycobacterium leprae
7.
Western Pac Surveill Response J ; 12(3): 34-46, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34703634

RESUMEN

Background: Leprosy elimination was achieved in the Western Pacific Region of the World Health Organization (WHO) in the late 1980s. However, cases continue to be reported within the Region. This paper analyses leprosy cases in the Region reported to WHO during 1991-2019. Methods: Descriptive analyses were conducted of data from leprosy surveillance reported in the Region. Key indicators included prevalence, the number and rate of new cases detected, proportions of cases with multibacillary leprosy or grade 2 disability, and the numbers and proportions of cases among children and cases by sex. Results: From 1991 to 2019, the number of registered cases detected in the Region decreased by 94% (from 68 313 in 1991 to 4381 in 2019), and the number of new cases detected decreased by 72.1% (from 15 002 in 1991 to 4004 in 2019). The proportion of cases of multibacillary leprosy increased from 67.4% (8045/11 943) in 1995 to 85.6% (3428/4004) in 2019, and between 1997 and 2019 the number of leprosy cases occurring in children decreased from 1240 to 424. The proportion of new cases with grade 2 disability decreased from 15.4% in 1997 to 6.6% in 2019. With few exceptions, nearly two thirds of reported cases occurred in males. Conclusion: Most countries and areas in the Region have successfully eliminated leprosy, although some pockets remain in countries with hard-to-reach areas. The introduction of multidrug therapy and WHO's 1991 elimination goals may have prompted the initial decline in leprosy cases. Continued efforts are required in case-finding, care and prevention in areas with a high burden of disease.


Asunto(s)
Leprostáticos , Lepra , Niño , Quimioterapia Combinada , Humanos , Lepra/epidemiología , Lepra/prevención & control , Masculino , Prevalencia , Organización Mundial de la Salud
8.
Rev Chilena Infectol ; 38(4): 532-539, 2021 Aug.
Artículo en Español | MEDLINE | ID: mdl-34652399

RESUMEN

BACKGROUND: Leprosy, a chronic infectious disease, is one of the major causes of preventable disability. Early treatment prevents neurological damage and disability. AIM: To identify prognostic factors of disability in individuals with multibacillary and paucibacillary leprosy who completed a drug treatment between 2011 and 2017 in Paraguay. METHODS: A case-control study was carried out on 34 patients, of them 9 were cases and 25 controls. Cases were those patients with Grade 1, presented lack of sensation in lower or upper limbs, and those of Grade 2 lagophthalmos, rigidity, visible deformity ulcerations, passive claw, active claw. Controls had no disabilities. RESULTS: Mean age of the patients was 53 ± 15.2 years, 55.9% were male, and 58.9% had primary education or no formal education. Multibacillary leprosy was found in 58.8% of patients; and 64.7% were diagnosed after consulting with two or more physicians. Diagnosis delay of more than one year was significantly (p = 0.047) greater in the cases than in the controls (77.8% vs 12%; OR: 7.44; 95% CI: 1.02-67.86). CONCLUSION: In this study, a diagnosis delay of more than one year is a prognostic factor for disability.


Asunto(s)
Lepra , Adulto , Anciano , Estudios de Casos y Controles , Humanos , Lepra/diagnóstico , Lepra/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Paraguay/epidemiología , Pronóstico
9.
BMC Infect Dis ; 21(1): 1050, 2021 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-34627197

RESUMEN

BACKGROUND: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Patients have distinct clinical forms, and the host´s immunological response regulate those manifestations. In this work, the presence of the myeloid-derived suppressor cell and the regulatory protein annexin A1 is described in patients with multibacillary leprosy and with type 1 and 2 reactions. METHODS: Patients were submitted to skin biopsy for histopathological analysis to obtain a bacilloscopic index. Immunofluorescence was used to detect myeloid-derived suppressor cells and annexin A1. RESULTS: The data demonstrated that the presence of granulocytic and monocytic myeloid-derived suppressor cells in leprosy patients. A high number of monocytic myeloid-derived suppressor cells were observed in lepromatous leprosy and type 2 reactional patients. The presence of annexin A1 was observed in all myeloid-derived suppressor cells. In particular, the monocytic myeloid-derived suppressor cell in the lepromatous patients has higher levels of this protein when compared to the reactional patients. This data suggest that the higher expression of this protein may be related to regulatory response against a severe infection, contributing to anergic response. In type 1 reactional patients, the expression of annexin A1 was reduced. CONCLUSIONS: Myeloid-derived suppressor cell are present in leprosy patients and annexin A1 might be regulated the host response against Mycobacterium leprae.


Asunto(s)
Anexina A1 , Lepra Lepromatosa , Lepra , Células Supresoras de Origen Mieloide , Anexina A1/genética , Humanos , Mycobacterium leprae
10.
Adv Exp Med Biol ; 1313: 155-177, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34661895

RESUMEN

Leprosy is an ancient insidious disease caused by Mycobacterium leprae, where the skin and peripheral nerves undergo chronic granulomatous infections, leading to sensory and motor impairment with characteristic deformities. Susceptibility to leprosy and its disease state are determined by the manifestation of innate immune resistance mediated by cells of monocyte lineage. Due to insufficient innate resistance, granulomatous infection is established, influencing the specific cellular immunity. The clinical presentation of leprosy ranges between two stable polar forms (tuberculoid to lepromatous) and three unstable borderline forms. The tuberculoid form involves Th1 response, characterized by a well demarcated granuloma, infiltrated by CD4+ T lymphocytes, containing epitheloid and multinucleated giant cells. In the lepromatous leprosy, there is no characteristic granuloma but only unstructured accumulation of ineffective macrophages containing engulfed pathogens. Th1 response, characterised by IFN-γ and IL-2 production, activates macrophages in order to kill intracellular pathogens. Conversely, a Th2 response, characterized by the production of IL-4, IL-5 and IL-10, helps in antibody production and consequently downregulates the cell-mediated immunity induced by the Th1 response. M. lepare has a long generation time and its inability to grow in culture under laboratory conditions makes its study challenging. The nine-banded armadillo still remains the best clinical and immunological model to study host-pathogen interaction in leprosy. In this chapter, we present cellular morphology and the genomic uniqueness of M. leprae, and how the pathogen shows tropism for Schwann cells, macrophages and dendritic cells.


Asunto(s)
Lepra , Humanos , Inmunidad Celular , Mycobacterium leprae , Piel , Linfocitos T
11.
Braz J Infect Dis ; 25(5): 101634, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34648742

RESUMEN

Leprosy can be considered a dissimulated disease, mainly when presented as atypical cases leading to mistaken diagnosis at the emergency setting. Herein we report six patients referred to the emergence room with hypotheses of acute myocardial infarction and arterial and venous thrombosis, although with chronic neurological symptoms; the seventh patient was referred with a wrong suspicion of infected skin ulcer. Positive findings included hypo-anesthetic skin lesions and thickened nerves; 100% were negative for IgM anti-phenolic glycolipid-I, while 71.4%, 100% and 42.8% were positive for IgA, IgM and IgG Mce1A. RLEP-PCR was positive in all patients. Ultrasound of peripheral nerves showed asymmetric and focal multiple mononeuropathy for all patients. Unfortunately, in many patients leprosy is often misdiagnosed as other medical conditions for long periods thus delaying initiation of specific treatment. This paper is intended to increase physicians' awareness to recognize leprosy cases presented as both classical and unusual forms, including in emergency department.


Asunto(s)
Lepra , Servicio de Urgencia en Hospital , Glucolípidos , Humanos , Mycobacterium leprae
12.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48447

RESUMEN

Um novo teste de diagnóstico desenvolvido por pesquisadores da Fundação Oswaldo Cruz (Fiocruz) pode contribuir para o enfrentamento da hanseníase


Asunto(s)
Lepra/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Brasil
13.
Arq Neuropsiquiatr ; 79(8): 716-723, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-34550184

RESUMEN

BACKGROUND: Peripheral neural surgical decompression (PNSD) is used as a complementary therapy to the clinical treatment of neuritis to preserve neural function. OBJECTIVE: To evaluate the long-term (≥ 1 year) clinical and functional results for PNSD in leprosy neuritis. METHODS: This cross-sectional study included leprosy patients who were in late postoperative period (LPO) of surgical decompression of ulnar, median, tibial, and fibular nerves. Socioeconomic, epidemiological, and clinical data were collected. The following instruments were used in this evaluation: visual analogue pain scale (VAS), Douleur Neuropathique en 4 Questions (DN4), SALSA scale, and simplified neurological assessment protocol. The preoperative (PrO) and 180-day postoperative (PO180) results were compared. RESULTS: We evaluated 246 nerves from 90 patients: 56.6% were on multidrug therapy (MDT) and 43.3% discharged from MDT. Motor scores and pain intensity showed statistically significant improvement (p<0.01). There was an increase in sensory scores only for bilateral ulnar nerves (p<0.05). Of the operated cases, 26.0% of patients were referred for surgery of ulnar neuritis and 23.6% of tibial neuritis. Neuropathic pain was reported in 41% of cases. Daily dose of prednisone reduced from 39.6 mg (±3.0) in PrO, 16.3 mg (±5.2) in PO180, to 1.7 mg (±0.8) in LPO. The SALSA scale results showed mild activity limitation in 51% and moderate in 34% of patients. Eighty percent of individuals reported that the results reached their expectations. CONCLUSIONS: PNSD in leprosy was effective in the long term to decrease the prevalence and intensity of pain, improve motor function, and reduce the dose of corticosteroids, which is reflected in the patients' satisfaction.


Asunto(s)
Leprostáticos , Lepra , Estudios Transversales , Descompresión , Quimioterapia Combinada , Estudios de Seguimiento , Humanos , Leprostáticos/uso terapéutico , Lepra/complicaciones , Lepra/tratamiento farmacológico
14.
15.
Int J Mycobacteriol ; 10(3): 330-334, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34494576

RESUMEN

Tuberculosis (TB) and leprosy are two chronic mycobacterial infections caused by intracellular Gram-positive aerobic acid-fast bacilli. Both have highly variable presentations depending on immunological milieu of the host and account for significant disease morbidity. The burden of these age-old infections of humanity still remains high in India. Regardless of the same geographical endemicity of the two, coinfections are sparsely reported. Indeed, studies have revealed an antagonism between them. Of the few coinfections reported in the past, majority were diagnosed over a temporal sequence, with one occurring after the other, and most of these were localized forms of TB associated with leprosy. Only a single case of disseminated TB and lepromatous leprosy has been reported in the medical literature till date. Here, we report another rare case of disseminated TB and lepromatous leprosy that ultimately proved fatal for the patient. The diagnosis of the two diseases was made simultaneously which is again infrequent in the reported literature.


Asunto(s)
Coinfección , Lepra Lepromatosa , Lepra , Tuberculosis Miliar , Granuloma , Humanos , Lepra Lepromatosa/complicaciones , Lepra Lepromatosa/diagnóstico , Masculino
16.
Int J Mycobacteriol ; 10(2): 155-161, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34558467

RESUMEN

Background: Mycobacterium leprae was considered the only causal agent of leprosy until Mycobacterium lepromatosis was identified' which it has been suggested has greater pathogenicity and is linked to diffuse lepromatous leprosy (DLL) and Lucio's phenomenon (LPh). Our objective is to identify Mycobacterium spp. in an endemic area of leprosy in Colombia. Methods: The study included cases with a diagnosis of leprosy by clinical and histopathological analysis. DNA extraction and two specific rounds of semi-nested polymerase chain reaction (PCR) were performed in paraffin biopsies skin to identify M. leprae and M. lepromatosis. Demographic, clinical, and histopathological data were extracted and tabulated for analysis. Results: Forty-one cases of leprosy were analyzed. The most frequent clinical diagnosis was lepromatous leprosy (36.6%); there was one case with DLL and two with LPh. The most common histopathological finding was tuberculoid leprosy (36.59%); three cases had negative histopathology. M. lepromatosis was not detected; all cases corresponded to M. leprae including cases with negative histopathology' DLL, and LPh. Conclusion: In this study, M. leprae was the causative agent of leprosy, encompassing even its most severe phenotypic forms. It is appropriate to consider PCR as an indispensable tool for the diagnosis of leprosy and to continue to carry out the active search for M. lepromatosis.


Asunto(s)
Lepra Lepromatosa , Lepra , Mycobacterium , Región del Caribe , Colombia/epidemiología , Humanos , Lepra/diagnóstico , Lepra/epidemiología , Lepra Lepromatosa/diagnóstico , Lepra Lepromatosa/epidemiología , Mycobacterium leprae/genética
17.
Int J Mycobacteriol ; 10(2): 199-201, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34558475

RESUMEN

Hansen's disease is one of the ancient skin diseases known to humankind, still foxes even trained physician leading to delay in its diagnosis and unusual health burden. India followed by Brazil constitutes the highest number in newly diagnosed cases. Even though the World Health Organization and individual country have done much to contain the spread of leprosy, the findings of systemic complications, grade 2 deformity, and childhood leprosy reflect some shortcomings of the worldwide public health program. Renal involvement, particularly glomerulonephritis, is a known common systemic complication of the leprosy, but introduction of multidrug therapy and early case detection have reduced the chances of systemic complication significantly over the last three decades. Here, we report a case who presented in the emergency department with rapidly progressive swelling of the body, on evaluation found to have leprosy and glomerulonephritis having tubuloreticular inclusions in glomerular endothelial cell cytoplasm on electron microscopy.


Asunto(s)
Glomerulonefritis , Lepra , Enfermedades de la Piel , Niño , Quimioterapia Combinada , Glomerulonefritis/diagnóstico , Glomerulonefritis/tratamiento farmacológico , Glomerulonefritis/etiología , Humanos , Leprostáticos/uso terapéutico , Lepra/complicaciones , Lepra/diagnóstico , Lepra/tratamiento farmacológico , Úlcera
18.
Codas ; 33(5): e20200058, 2021.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-34524350

RESUMEN

PURPOSE: Verifying the association between clinical-functional vulnerability and vocal and auditory self-perception in seniors presenting a history of leprosy. METHODS: Cross-sectional study encompassing 117 elderly people from an old leprosy colony in southeastern Brazil. The research analyzed sociodemographic information and the following protocols: Clinical-Functional Vulnerability Index-20 (IVCF-20), Hearing Handicap Inventory for the Elderly Screening Version (HHIE-S), Screening for Vocal Change in the Elderly (RAVI) and Vocal Handicap Index 10 (IDV-10). For data analysis, the ordinal logistic regression model of proportional odds was used. RESULTS: 37.6% of the elderly were classified as robust, 35.0% at risk of fragility and 27.4% as frail. Vocal alteration (RAVI), vocal handicap (IDV-10) and restriction to auditory participation (HHIE-S) were observed in 65.8%, 24.8% and 48.7% respectively, in the studied population. In the multivariate analysis, it was found the oldest group (OR = 1.11; CI: 1.05-1.16) and those with vocal handicap (OR = 4.11; 95% CI: 1.77-9.56) were more likely to be classified as at risk of fragility or already fragile. The simultaneous presence of vocal handicap and restriction of auditory participation (46.9%) was larger among frail elderly people. CONCLUSION: The increasing age of the elderly and the presence of vocal handicap is associated with greater clinical-functional vulnerability. The high prevalence of both voice and hearing disorders reinforces the need for the speech therapist to be included in public policies, directed towards caring for people with a history of leprosy.


Asunto(s)
Audición , Lepra , Anciano , Brasil , Estudios Transversales , Humanos , Lepra/complicaciones , Autoimagen , Encuestas y Cuestionarios
19.
Int J Infect Dis ; 111: 360-362, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34492393

RESUMEN

A routine mammogram identified changes thought to be due to a lymph node, which was confirmed on biopsy. The lymph node was infiltrated with macrophages and showed fragmented acid-fast bacilli. The patient had been treated for leprosy some years before and was still taking thalidomide for erythema nodosum leprosum. Leprosy-associated lymphadenopathy may be identified on routine breast screening.


Asunto(s)
Eritema Nudoso , Lepra Multibacilar , Lepra , Biopsia , Eritema Nudoso/diagnóstico , Eritema Nudoso/tratamiento farmacológico , Humanos , Mamografía
20.
BMC Infect Dis ; 21(1): 916, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488660

RESUMEN

BACKGROUND: Leprosy is a treatable disease; however, the release from treatment after completion of multidrug therapy (MDT) often does not equal absence of health problems. Consequently, sequelae interfere with the patient's perception of cure. The objective of this study was to analyze the factors associated with the perception of not being healed among people treated for leprosy in a highly endemic area in Brazil. METHOD: A cross-sectional study of perceived cure of leprosy in the post-release from treatment period was conducted in Cáceres in the state of Mato Grosso, Brazil. The study included a total of 390 leprosy patients treated with MDT and released after completion of treatment from 1 January 2000 to 31 December 2017. The dependent variable was self-reported cure of leprosy; the independent variables included clinical, operational and socioeconomic variables. RESULTS: Out of the 390 former leprosy patients, 304 (77.9%) perceived themselves as cured and 86 (22.1%) considered themselves unhealed. Among the latter, 49 (57.0%) reported muscle weakness and joint pains. Individuals with complaints related to leprosy post-release from treatment had a 4.6 times higher chance to self-report as unhealed (OR 4.6; 95% CI 2.5-8.5). Patients with physical disabilities (PD) grade 1 and 2 at the time of the study had a 3.1 (OR 3.1; 95% CI 1.3-7.4) and 8.8 (OR 7.7; 95% CI 3.5-21.9) times higher likelihood to self-identify as unhealed, respectively. CONCLUSION: Among successfully treated leprosy patients, a quarter self-report as unhealed of the disease. The factors associated with the perception of being unhealed are PD and complaints related to leprosy in the post-release from treatment phase.


Asunto(s)
Leprostáticos , Lepra , Brasil , Estudios Transversales , Quimioterapia Combinada , Humanos , Leprostáticos/uso terapéutico , Lepra/complicaciones , Lepra/tratamiento farmacológico , Percepción
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...