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1.
Pan Afr Med J ; 42: 324, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36451977
2.
PLoS One ; 17(11): e0276977, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36417347

RESUMEN

OBJECTIVE: The aim was to analyze the spatial association and relative risk (RR) of leprosy cases diagnosed in southern Brazil and in the Argentinean province of Misiones during 2010 to 2016. METHODS: This ecological-type epidemiological study analyzed data from the Health Ministries of both countries. The analysis included frequency measures, spatial autocorrelation, RR cluster analysis and map construction. RESULTS: A hyperendemic occurrence was identified in all study regions, in the state of Paraná 71.2% of the municipalities were hyperendemic and in Misiones, Argentina 41.2%. The GI* statistical analysis showed clusters of high incidence rates in the state of Paraná and low-risk clusters in much of the state of Rio Grande do Sul, both in Brazil. The analysis indicated an area with RR equal to 3.87 - (p < .0001) when considering the entire territory and an RR of 2.80 - (p < .0001) excluding the state of Paraná, with the number of departments of Misiones, Argentina included in the risk clusters increasing significantly. CONCLUSIONS: The findings indicate a high probability of similar illness in adjacent areas, according to their relative position in space, as the occurrence of the disease is influenced by neighboring clusters.


Asunto(s)
Lepra , Mariposas Nocturnas , Animales , Brasil/epidemiología , Argentina/epidemiología , Lepra/epidemiología , Análisis Espacial
3.
BMJ Open ; 12(11): e062372, 2022 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-36450432

RESUMEN

OBJECTIVE: To provide knowledge about the domains of life affected by stigma towards leprosy in Indonesia, including its manifestations, driving factors and consequences. DESIGN: Qualitative systematic review. STUDY SELECTION: PubMed, CINAHL, ProQuest, Taylor&Francis and Google Scholar were used to systematically search studies with qualitative component that were conducted in Indonesia and published from January 2000 to December 2020 in English or Indonesian language. The search was started in November 2020 and reran in April 2021. Quality assessment and thematic synthesis were applied. DATA EXTRACTION: Of the 3184 studies, 37 manuscripts were reviewed. Information relating to study characteristics, stigma domains and types following Weiss Extended Scambler's Hidden Stress Model, stigma consequences and drivers were extracted. RESULTS: Seven themes were identified. Three themes-community, domestic and intimate relationships-impacted private domains. Four themes-health, economics, education and public entitlements-concerned public domains. Studies mainly discussed enacted stigma rather than anticipated and internalised stigma. Ten stigma-driving factors were found, ranging from negative and positive concepts linked with the condition to aspects not related to the disease process. Five areas of consequences were shown. Impact on public rights, such as education, was very minimally explored, although school absence was often mentioned. Stigma manifestation, drivers and consequences in most public domains were least explored. CONCLUSION: Leprosy-affected persons in Indonesia experienced and felt stigma in private and public domains. Disease-related aspects, the culture and history of a particular region are linked with stigma manifestations. Approaches in one domain can affect another domain. More exploratory studies are needed in the endemic areas outside Java, especially considering both the lack of studies there and the unique culture of each Indonesian region.


Asunto(s)
Lepra , Humanos , Indonesia/epidemiología , Lepra/epidemiología , Estigma Social , Escolaridad , Lenguaje
6.
Cell Rep Med ; 3(11): 100822, 2022 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-36384098

RESUMEN

Extensive work has revealed well-coordinated mechanisms that underlie liver regeneration, albeit with a focus on intrinsic interactions within hepatic cells. Here, Hess et al.1 demonstrate that Mycobacterium leprae infection can induce liver growth of nine-banded armadillo without obvious side effects.


Asunto(s)
Lepra , Microbiota , Humanos , Animales , Mycobacterium leprae , Regeneración Hepática , Armadillos/microbiología , Lepra/microbiología
8.
Rev Assoc Med Bras (1992) ; 68(10): 1389-1393, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36417641

RESUMEN

OBJECTIVE: Leprosy is a disabling infectious disease caused by Mycobacterium leprae. This study aimed to investigate the prevalence of leprosy among household contacts of leprosy patients. METHODS: This study is a serological survey in household contacts of leprosy patients who had been treated or were undergoing treatment in the city of Presidente Prudente, São Paulo, Brazil, from 2006-2016, using clinical examination and screening for anti- Phenolic glycolipid-I antibodies with Mycobacterium leprae-flow serology. RESULTS: A total of 263 index cases of leprosy were identified during the study period. Of these, 53 were approached, and among their household contacts, 108 were examined. The ML-flow test was positive in 2 (1.85%) individuals, but clinical examination revealed no signs or symptoms of leprosy in them. Therefore, they were considered to have a subclinical infection. Leprosy was not confirmed in any household contacts. In this study, a lower percentage of household contacts, when compared to that in the literature, had a positive Mycobacterium leprae-flow test result. CONCLUSION: The use of Mycobacterium leprae-flow should be encouraged during the follow-up of at-risk populations, such as the household contacts of leprosy patients.


Asunto(s)
Antígenos Bacterianos , Lepra , Humanos , Estudios Seroepidemiológicos , Brasil/epidemiología , Mycobacterium leprae , Lepra/epidemiología , Lepra/diagnóstico
9.
Virulence ; 13(1): 1985-2011, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-36326715

RESUMEN

Leprosy is caused by Mycobacterium leprae (M. leprae) and M. lepromatosis, an obligate intracellular organism, and over 200,000 new cases occur every year. M. leprae parasitizes histiocytes (skin macrophages) and Schwann cells in the peripheral nerves. Although leprosy can be treated by multidrug therapy, some patients relapse or have a prolonged clinical course and/or experience leprosy reaction. These varying outcomes depend on host factors such as immune responses against bacterial components that determine a range of symptoms. To understand these host responses, knowledge of the mechanisms by which M. leprae parasitizes host cells is important. This article describes the characteristics of leprosy through bacteriology, genetics, epidemiology, immunology, animal models, routes of infection, and clinical findings. It also discusses recent diagnostic methods, treatment, and measures according to the World Health Organization (WHO), including prevention. Recently, the antibacterial activities of anti-hyperlipidaemia agents against other pathogens, such as M. tuberculosis and Staphylococcus aureus have been investigated. Our laboratory has been focused on the metabolism of lipids which constitute the cell wall of M. leprae. Our findings may be useful for the development of future treatments.


Asunto(s)
Lepra , Mycobacterium leprae , Animales , Mycobacterium leprae/genética , Virulencia , Quimioterapia Combinada , Leprostáticos , Lepra/tratamiento farmacológico , Lepra/epidemiología
10.
Front Immunol ; 13: 961405, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36389696

RESUMEN

Mycobacterium leprae is a kind of disease-causing bacteria and results in leprosy in human. Gamma delta (γδ) T cell is a T-cell subset that is presented in both human dermis and epidermis. These cells bridge innate and adaptive immune responses and play critical roles in regulating anti-microbial defense, wound healing, and skin inflammation. Here, we investigated skin resident γδ T cells in patients with leprosy. Our data showed that γδ T cells significantly accumulated in skin lesions of leprosy patients with tuberculoid (TT) form. IL-23 can predominantly stimulate dermal γδ T cells to produce interleukin 17 (IL-17), a cytokine which may lead to disease protection. These γδ T cells expressed a specific set of surface molecules, and majority of these cells were Vδ1+. Also, IL-23 can stimulate the expansion of dermal γδ T cells expansion. Moreover, our results revealed that the transcription factor RORγt was responsible for IL-17A expression in leprosy lesion. Therefore, these data indicated that IL-23-responsive dermal γδ T cells were the major resource of IL-17A production in the skin and could be a potential target in the treatment of leprosy.


Asunto(s)
Linfocitos Intraepiteliales , Lepra , Humanos , Interleucina-17/metabolismo , Mycobacterium leprae , Linfocitos Intraepiteliales/metabolismo , Interleucina-23
11.
Cien Saude Colet ; 27(12): 4485-4492, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36383862

RESUMEN

To estimate the prevalence of leprosy among Brazilian female prisoners and identify factors associated with the disease. Cross-sectional study conducted between 2014 and 2015 in 15 Brazilian female prisons. The data of 1,327 women were collected using Audio Computer-Assisted Self-Interviewing and dermatological and neurological examination to identify suspicious lesions of leprosy. The average age was 33.4 years. Suspicion of leprosy was identified in 5.1% of women in prison, and lifetime self-reported prevalence was 7.5%. The variables that were associated with lifetime self-reported leprosy were: women in prison once being twice as likely to have leprosy; white women were 1.4 time more likely to have leprosy than non-white women; women who knew someone with leprosy was 1.9 time more likely to have leprosy; and women who shared a cell with 11 or more women were 2.5 times more likely to have leprosy than women who shared a cell with two or fewer people. The leprosy prevalence among female prisoners in Brazil were greater than that found in a Brazilian woman of the general population and show the extremely high vulnerability of this population generated through pre-incarceration poverty, as well as potential transmission in prison.


Asunto(s)
Lepra , Prisioneros , Femenino , Humanos , Adulto , Brasil/epidemiología , Estudios Transversales , Prisiones , Prevalencia , Lepra/epidemiología
12.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-49198

RESUMEN

O mapa apresenta uma visão geral das evidências sobre intervenções de profilaxia pós-exposição à hanseníase. A partir de uma ampla busca bibliográfica (PubMed, BVS, Embase, Cochrane, Web of Science e SCOPUS) foram incluídos no mapa 7 estudos de revisão (4 revisões sistemáticas e 3 metanálises). Todos os estudos foram avaliados, caracterizados e categorizados por tipo de intervenção e desfechos em relação à exposição pós-hanseníase, resultando em 45 associações entre 9 tipos de intervenção, 7 desfechos e efeito reportado. Principais Achados: ● A evidência reportada nos estudos aponta que a grande maioria das associações teve efeito positivo (32 associações). Foi reportado como potencial positivo da intervenção em 13 associações. ● As revisões avaliaram efetividade, eficácia, segurança e custo-efetividade das intervenções profiláticas pós-exposição à hanseníase, organizadas em 3 grupos: quimioprofilaxia, imunoprofilaxia e quimioprofilaxia associada a imunoprofilaxia. ● Os estudos primários incluídos nas revisões estão concentrados principalmente em países como Bangladesh, Índia, Brasil e Myanmar. ● Para avaliar o nível de confiabilidade das 7 revisões, se aplicou a ferramenta AMSTAR2 (Measurement Tool to Assess Systematic Reviews) resultando em 1 revisão de nível baixo de confiabilidade para a evidência reportada e 6 revisões de nível criticamente baixo.


Asunto(s)
Lepra/prevención & control , Profilaxis Pre-Exposición , Profilaxis Posexposición
13.
Am J Clin Pathol ; 158(6): 678-686, 2022 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-36200553

RESUMEN

OBJECTIVES: Leprosy is caused by Mycobacterium leprae or Mycobacterium lepromatosis. This study reviews literature on M lepromatosis and reports on a Mexican family with this infection. METHODS: The review included all primary studies. Family history and surveys were used to uncover the infection cluster. Genome-based differential polymerase chain reactions were designed to detect etiologic agents. RESULTS: Since the discovery of M lepromatosis in 2008, 154 cases of M lepromatosis infection from 11 countries in the Americas and Asia have been reported, with most cases coming from Mexico. These cases included diffuse lepromatous leprosy (DLL) and other leprosy forms. Genomes of M lepromatosis strains have lately been sequenced, revealing 3,271,694 nucleotides and approximately 15% mismatches with M leprae. The Mexican family with leprosy involved the grandfather, mother, and 2 grandsons. The index was the oldest grandson, who manifested DLL and likely contracted the infection from his maternal grandfather approximately 13 years earlier. Family surveys diagnosed DLL in the index patient's mother and borderline leprosy in his brother; both were likely infected by the index patient. M lepromatosis was identified from archived biopsies from the index patient and his mother, while M leprae was excluded. CONCLUSIONS: M lepromatosis is a significant cause of leprosy in Mexico and requires better surveillance and control.


Asunto(s)
Lepra Lepromatosa , Lepra , Mycobacterium , Masculino , Humanos , Lepra/diagnóstico , Lepra/microbiología , Mycobacterium/genética , Mycobacterium leprae/genética , Lepra Lepromatosa/diagnóstico , Lepra Lepromatosa/microbiología , Lepra Lepromatosa/patología
15.
Goiânia; SES-GO; 27 out. 2022. 1-11 p. mapas.(Boletim epidemiológico: análise descritiva da taxa de prevalência da hanseníase em dois cenários territoriais no estado de Goiás, 18, 4).
Monografía en Portugués | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1396876

RESUMEN

A hanseníase é uma doença infecto contagiosa causada pelo Mycobacterium leprae (bacilo de Hansen), manifestada por lesões na pele e comprometimento dos nervos periféricos, tendo as vias aéreas superiores como a principal via de eliminação do bacilo e a mais provável porta de entrada


Leprosy is a contagious infectious disease caused by Mycobacterium leprae (Hansen's bacillus), manifested by skin lesions and impairment of peripheral nerves, with the upper airways as the main route of elimination of the bacillus and the most likely gateway


Asunto(s)
Humanos , Lepra/epidemiología , Lepra/transmisión
16.
PLoS Negl Trop Dis ; 16(10): e0010792, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36251696

RESUMEN

BACKGROUND: In the past 15 years, the decline in annually detected leprosy patients has stagnated. To reduce the transmission of Mycobacterium leprae, the World Health Organization recommends single-dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for contacts of leprosy patients. Various approaches to administer SDR-PEP have been piloted. However, requirements and criteria to select the most suitable approach were missing. The aims of this study were to develop an evidence-informed decision tool to support leprosy programme managers in selecting an SDR-PEP implementation approach, and to assess its user-friendliness among stakeholders without SDR-PEP experience. METHODOLOGY: The development process comprised two phases. First, a draft tool was developed based on a literature review and semi-structured interviews with experts from various countries, organisations and institutes. This led to: an overview of existing SDR-PEP approaches and their characteristics; understanding the requirements and best circumstances for these approaches; and, identification of relevant criteria to select an approach. In the second phase the tool's usability and applicability was assessed, through interviews and a focus group discussion with intended, inexperienced users; leprosy programme managers and non-governmental organization (NGO) staff. PRINCIPAL FINDINGS: Five SDR-PEP implementation approaches were identified. The levels of endemicity and stigma, and the accessibility of an area were identified as most relevant criteria to select an approach. There was an information gap on cost-effectiveness, while successful implementation depends on availability of resources. Five basic requirements, irrespective of the approach, were identified: stakeholder support; availability of medication; compliant health system; trained health staff; and health education. Two added benefits of the tool were identified: its potential value for advocacy and for training. CONCLUSION: An evidence-informed SDR-PEP decision tool to support the selection of implementation approaches for leprosy prevention was developed. While the tool was evaluated by potential users, more research is needed to further improve the tool, especially health-economic studies, to ensure efficient and cost-effective implementation of SDR-PEP.


Asunto(s)
Lepra , Rifampin , Humanos , Rifampin/uso terapéutico , Leprostáticos/uso terapéutico , Lepra/tratamiento farmacológico , Lepra/prevención & control , Lepra/microbiología , Mycobacterium leprae , Toma de Decisiones
17.
PLoS Negl Trop Dis ; 16(10): e0010799, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-36264976

RESUMEN

BACKGROUND: Leprosy is rare in the United Kingdom (UK), but migration from endemic countries results in new cases being diagnosed each year. We documented the clinical presentation of leprosy in a non-endemic setting. METHODS: Demographic and clinical data on all new cases of leprosy managed in the Leprosy Clinic at the Hospital for Tropical Diseases, London between 1995 and 2018 were analysed. RESULTS: 157 individuals with a median age of 34 (range 13-85) years were included. 67.5% were male. Patients came from 34 different countries and most contracted leprosy before migrating to the UK. Eighty-two (51.6%) acquired the infection in India, Sri Lanka, Bangladesh, Nepal and Pakistan. 30 patients (19.1%) acquired leprosy in Africa, including 11 from Nigeria. Seven patients were born in Europe; three acquired their leprosy infection in Africa, three in South East Asia, and one in Europe. The mean interval between arrival in the UK and symptom onset was 5.87 years (SD 10.33), the longest time to diagnosis was 20 years. Borderline tuberculoid leprosy (n = 71, 42.0%), and lepromatous leprosy (n =, 53 33.1%) were the commonest Ridley Jopling types. Dermatologists were the specialists diagnosing leprosy most often. Individuals were treated with World Health Organization recommended drug regimens (rifampicin, dapsone and clofazimine). CONCLUSION: Leprosy is not a disease of travellers but develops after residence in an leprosy endemic area. The number of individuals from a leprosy endemic country reflect both the leprosy prevalence and the migration rates to the United Kingdom. There are challenges in diagnosing leprosy in non-endemic areas and clinicians need to recognise the symptoms and signs of leprosy.


Asunto(s)
Lepra Dimorfa , Lepra Lepromatosa , Lepra , Humanos , Masculino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Femenino , Londres , Lepra/epidemiología , Lepra Lepromatosa/tratamiento farmacológico , Lepra Dimorfa/tratamiento farmacológico , Nigeria
18.
Arq. ciências saúde UNIPAR ; 26(3): 569-579, set-dez. 2022.
Artículo en Portugués | LILACS | ID: biblio-1399248

RESUMEN

hanseníase no Brasil ainda apresenta como um problema de saúde pública. A posição epidemiológica da doença no país é considerada diversificada devido ao alto coeficiente e variação de prevalência nas diversas regiões do país. O objetivo desse estudo é conhecer o perfil epidemiológico da população acometida pela hanseníase na cidade de General Carneiro, no interior do Mato Grosso, durante os anos de 2006 e 2021. A coleta de dados foi realizada nos meses de julho e agosto do ano de 2021. Trata-se de uma pesquisa retrospectiva, documental do tipo descritiva, com abordagem quantitativa. No período em estudo notificou-se 50 casos, sendo 62% do sexo masculino, com faixa etária entre 48 a 69 anos de idade, de cor branca, com predominância da forma dimorfa. Os resultados demonstram que a cidade de General Carneiro, está com o número de casos de hanseníase na média do preconizado pela Organização Mundial de Saúde e também, inferior à média brasileira.


Leprosy in Brazil still presents as a public health problem. The epidemiological position of the disease in the country is considered diversified due to the high coefficient and variation in prevalence in different regions of the country. The aim of this study is to know the epidemiological profile of the population affected by leprosy in the city of General Carneiro, in the interior of Mato Grosso, during the years 2006 and 2021. Data collection was carried out in July and August of 2021 This is a retrospective, descriptive documentary research with a quantitative approach. During the study period, 50 cases were reported, 62% male, aged between 48 and 69 years old, white, with a predominance of the borderline form. The results show that the city of General Carneiro has the number of cases of leprosy in the average recommended by the World Health Organization and also below the Brazilian average.


La lepra en Brasil sigue siendo un problema de salud pública. La posición epidemiológica de la enfermedad en el país se considera diversificada debido al alto coeficiente y a la variación de la prevalencia en diferentes regiones del país. El objetivo de este estudio es conocer el perfil epidemiológico de la población afectada por la lepra en la ciudad de General Carneiro, en el interior de Mato Grosso, durante los años 2006 y 2021. La recogida de datos se realizó en julio y agosto del año 2021. Se trata de una investigación retrospectiva, documental y descriptiva, con un enfoque cuantitativo. En el período de estudio se notificaron 50 casos, siendo el 62% de sexo masculino, con una edad entre 48 y 69 años, de color blanco, con predominio de la forma dimorfa. Los resultados muestran que la ciudad de General Carneiro, está con el número de casos de lepra en la media recomendada por la Organización Mundial de la Salud y también por debajo de la media brasileña.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Perfil de Salud , Lepra/diagnóstico , Lepra/etiología , Lepra/epidemiología , Pacientes/estadística & datos numéricos , Organización Mundial de la Salud/organización & administración , Vigilancia de la Población , Salud Pública , Prevalencia , Estudios Retrospectivos , Estudios Poblacionales en Salud Pública
20.
Artículo en Inglés | MEDLINE | ID: mdl-36197417

RESUMEN

People who interact with leprosy patients in their environment, neighborhood, family, or social relationships are at risk to develop the disease. This systematic review investigated the risk and protective factors associated with the development of leprosy in Brazilian contacts. The studies were found in Cochrane Library, PubMed (MEDLINE), Embase, Virtual Health Library, grey literature and hand search until July 2021. The study selection, data extraction and quality assessment were independently performed by two investigators. The quality assessment was performed using the Newcastle-Ottawa Scale (NOS). This review was registered in PROSPERO (CRD42020160680). Seventeen articles fulfilled the inclusion criteria (n=544). The immunological and molecular factors, such as Anti-phenolic Glycolipid Antibodies (Anti-PGL-1) seropositivity, negative Mitsuda test, absence of Bacillus Calmette-Guérin (BCG) scar, positive Polymerase Chain Reaction (PCR) in blood; age and race; conviviality, education, contact time and type of contact, as well as elements related to the index case (bacilloscopic index; genetic conditions, family relationships), and some combined factors were shown to be relevant risk factors associated with the development of the disease in Brazilian leprosy contacts. The protective factors reported were the presence of one or more BCG scars, positive Mitsuda test, and education level. All selected studies were considered of high quality according to NOS. The knowledge of disease-related risk and protective factors provides the scientific basis for decision-making in the management of the disease in leprosy contacts.


Asunto(s)
Vacuna BCG , Lepra , Anticuerpos Antibacterianos , Antígenos Bacterianos , Brasil , Glucolípidos , Humanos , Mycobacterium leprae , Factores de Riesgo
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