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1.
Rev Inst Med Trop Sao Paulo ; 61: e44, 2019 Sep 12.
Artículo en Inglés | MEDLINE | ID: mdl-31531622

RESUMEN

Mycobacterium leprae is the primary causative agent of Hansen's disease or leprosy. Besides human beings, natural infection has been described in animals such as mangabey monkeys and armadillos. Leprosy is considered a global health problem and its complete pathogenesis is still unknown. As M. leprae does not grow in artificial media, armadillos have become the primary experimental model for leprosy, mimicking human disease including involvement of the peripheral nervous system. Leprosy transmission occurs through continuous and close contact of susceptible people with untreated infected people. However, unknown leprosy contact has been reported in leprosy-affected people, and contact with armadillos is a risk factor for leprosy. In the USA, leprosy is considered a zoonosis and this classification has recently been accepted in Brazil. This review presents information regarding the role of wild armadillos as a source of M. leprae for human infections, as well as the pathogenesis of leprosy.


Asunto(s)
Armadillos/microbiología , Reservorios de Enfermedades/microbiología , Lepra/veterinaria , Mycobacterium leprae , Animales , Modelos Animales de Enfermedad , Humanos , Lepra/microbiología , Lepra/transmisión
2.
Rev Saude Publica ; 53: 61, 2019 Aug 01.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31390430

RESUMEN

OBJECTIVE: To analyze the temporal trend of leprosy indicators in a hyperendemic state of Brazil, from 2001-2015. METHODS: This is a time-series study of leprosy indicators in the state of Maranhão, Northeastern region of Brazil. The study used data from the Brazilian National System of Reportable Diseases, for the period between 2001 and 2015. The following indicators were evaluated: (i) detection coefficient in the general population; (ii) detection coefficient in people under 15 years old; (iii) rate of cases with grade 2 physical disability in the diagnosis; (iv) rate of examined contacts, and (v) proportion of healing . The Prais-Winsten regression model was used for trend analysis. Analyses were performed for the state and by each health region. RESULTS: 77,697 leprosy cases were analyzed in the general population and 7,599 in individuals under 15 years old. The detection coefficient in the general population ranged from 80.7/100 thousand inhabitants in 2001 to 51.2/100 thousand inhabitants in 2015. The coefficient in the general population presented a downward trend (annual percentage variation [APV] = -2.98; 95%CI -4.15- -1.79). For the population under 15 years old, the rate was 24.9/100 thousand inhabitants in 2001, and 19.9/100 thousand inhabitants in 2015, with downward trend (APV = -3.07; 95%CI -4.95- -1.15). It was observed upward trend in rate of contacts examined (APV = 2.35; 95%CI 0.58-4.15) and rate of cases with grade 2 disability (APV = 2.19; 95%CI 0.23-4.19). Stationary trend was observed in the proportion of healing (APV = -0.10; 95%CI -0.50-0.30). Regional differences were found in the performance of the indicators. CONCLUSIONS: A downward trend for the detection coefficients in the general population and in individuals under 15 years old was found in Maranhão. Despite this result, the rates are still very high, demanding efforts from all spheres of public administration and health professionals to reduce the burden of the disease in the state.


Asunto(s)
Enfermedades Endémicas/estadística & datos numéricos , Indicadores de Salud , Lepra/epidemiología , Enfermedades Desatendidas/epidemiología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Femenino , Geografía , Humanos , Lepra/diagnóstico , Lepra/prevención & control , Lepra/transmisión , Modelos Lineales , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Factores de Tiempo , Adulto Joven
3.
EBioMedicine ; 47: 301-308, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31422044

RESUMEN

BACKGROUND: Transmission of Mycobacterium leprae, the pathogen causing leprosy, is still persistent. To facilitate timely (prophylactic) treatment and reduce transmission it is vital to both early diagnose leprosy, and identify infected individuals lacking clinical symptoms. However, leprosy-specific biomarkers are limited, particularly for paucibacillary disease. Therefore, our objective was to identify new biomarkers for leprosy and assess their applicability in point-of-care (POC) tests. METHODS: Using multiplex-bead-arrays, 60 host-proteins were measured in a cross-sectional approach in 24-h whole blood assays (WBAs) collected in Bangladesh (79 patients; 54 contacts; 51 endemic controls (EC)). Next, 17 promising biomarkers were validated in WBAs of a separate cohort (55 patients; 27 EC). Finally, in a third cohort (36 patients; 20 EC), five candidate markers detectable in plasma were assessed for application in POC tests. FINDINGS: This study identified three new biomarkers for leprosy (ApoA1, IL-1Ra, S100A12), and confirmed five previously described biomarkers (CCL4, CRP, IL-10, IP-10, αPGL-I IgM). Overnight stimulation in WBAs provided increased specificity for leprosy and was required for IL-10, IL-1Ra and CCL4. The remaining five biomarkers were directly detectable in plasma, hence suitable for rapid POC tests. Indeed, lateral flow assays (LFAs) utilizing this five-marker profile detected both multi- and paucibacillary leprosy patients with variable immune responses. INTERPRETATION: Application of novel host-biomarker profiles to rapid, quantitative LFAs improves leprosy diagnosis and allows POC testing in low-resource settings. This platform can thus aid diagnosis and classification of leprosy and also provides a tool to detect M.leprae infection in large-scale contact screening in the field.


Asunto(s)
Biomarcadores , Interacciones Huésped-Patógeno , Lepra/sangre , Lepra/diagnóstico , Pruebas en el Punto de Atención , Adolescente , Adulto , Biomarcadores/sangre , Niño , Preescolar , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Lactante , Recién Nacido , Lepra/microbiología , Lepra/transmisión , Masculino , Pruebas en el Punto de Atención/normas , Curva ROC , Sensibilidad y Especificidad , Flujo de Trabajo , Adulto Joven
4.
Fontilles, Rev. leprol ; 32(2): 87-104, mayo-ago. 2019. tab
Artículo en Español | IBECS | ID: ibc-187212

RESUMEN

Se realizó una investigación observacional descriptiva prospectiva con el objetivo de determinar la eficacia del uso de la rifampicina como tratamiento profiláctico en los contactos de primer orden de los casos de lepra en el municipio Camagüey, durante los años 2000 al 2010. Predomino el grupo de 40 a 49 años, sin diferencias significativas en cuanto al sexo. En más de la mitad de los contactos el per cápita familiar fue malo y tenían hacinamiento. La madre resultó ser la fuente de infección más probable, con más de 10 años de convivencia con los contactos en la mayoría de los casos. Un mínimo por ciento de los contactos desarrolló lepra, con serología UMELISA HANSEN reactiva y examen dermato-neurológico con lesiones sugestivas de la enfermedad y uno solo con baciloscopia positiva. Los enfermos presentaron lepra paucibacilar, dentro de esta, la indeterminada. Se concluyó que la quimioprofilaxis con rifampicina en dosis única no fue totalmente efectiva


A prospective, descriptive, observational investigation was carried out with the aim of determining the effectiveness of the use of the rifampicin as a preventive treatment in household contacts of leprosy in Camagüey city, from 2000 to 2010. The majority of the contacts were in the age group from 40 to 49 years, without significant gender differences. In more than half of the contacts, the family income rate was poor and they lived in harsh conditions. In the majority of cases, the mother turned out to be the source of infection. A very small percent of the contacts developed leprosy, with positive ELISA serology and dermal - neurological examination with suggestive lesions of the illness and only one case with positive skin smear. The affected individuals presented indeterminate leprosy a form of paucibacillary leprosy. The study concluded that Chemoprophylaxis with only one dose of rifampicin was not totally effective


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Trazado de Contacto/estadística & datos numéricos , Leprostáticos/uso terapéutico , Rifampin/uso terapéutico , Lepra/transmisión , Factores Socioeconómicos , Profilaxis Posexposición , Estudios Prospectivos , Lepra/prevención & control , Cuba
5.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 873-879, jul.-set. 2019. tab, graf
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1005618

RESUMEN

Objetivo: Avaliar a situação dos contatos intradomiciliares dos casos de hanseníase notificados no ano de 2012 em São Luís/Maranhão. Métodos: Estudo quantitativo-descritivo-transversal, com coleta de dados utilizando-se instrumento estruturado. Resultados: A maioria dos contatos intradomiciliares eram mulheres (51,87%), idade entre 0 e 20 anos (40,29%), parentesco consanguíneo de 1º grau (54,92%), forma dimorfa (59,78%) e multibacilares (75,53%). Do total, 1880 (67,96%) não realizaram o exame dermatoneurológico. Entre os examinados, houve maior frequência no distrito Bequimão (28,48%), no qual 59,82% eram mulheres, idade entre 0 a 20 anos (44,77%). Ao exame, 91,27% apresentou-se normal. Dentre os suspeitos, 36,73% tinham hanseníase, 58,21% possuíam cicatriz da 1ª dose da BCG e 59,98% foram encaminhados a vacinação. A prevalência da doença entre os contatos foi de 1,62%. As ações da vigilância de contatos classificaram-se como precárias em São Luís. Conclusão: A maioria dos contatos registrados não foi examinada, evidenciando necessidade de fortificação das ações da vigilância no município


Objective: To evaluate the situation of in-house contacts of the cases of leprosy reported in 2012 in São Luis, Maranhão. Methods: Quantitative cross-sectional descriptive study, with data collection using a structured instrument. Results: The majority of in-house contacts were women (51.87%), from 0 to 20 years of age (40.29%), first-degree kinship (54.92%), dimorphic shape (59.78) and multibacillary (75.53%). In total, 1880 (67.96%) did not take the dermato-neurological exam. Among those tested, there was a greater frequency in the Bequimão district (2.48%), 59.82% were women, from 0 to 20 years of age (44.77%). On the exam, 91.27% were normal. Among those suspected of carrying the disease, 36.73% had leprosy, 58.21% had scars from the first dose of BCG and 59.98% were sent to receive vaccination. The prevalence of the disease among the contacts was 1.62%. The actions of contact monitoring were classified as precarious in São Luis. Conclusion: The majority of registered contacts were not examined, highlighting the need for strengthening of monitoring efforts in the city


Objetivo: Evaluar la situación de los contactos intradomiciliares de los casos de hanseniasis notificados en el año 2012 en São Luis - MA. Métodos: Estudio cuantitativo-descriptivo-transversal, con recolección de datos utilizando instrumento estructurado. Resultados: La mayoría de los contactos intradomiciliares eran mujeres (51,87%), edad entre 0 y 20 años (40,29%), parentesco consanguíneo de primer grado (54,92%), forma dimorfa (59,78%), multibacilares (75,53%). Del total, 1880 (67,96%) no realizaron el examen dermatoneurológico. Entre los examinados, hubo mayor frecuencia en el distrito de Bequimão (28,48%), el 59,82% eran mujeres, entre 0 a 20 años (44,77%). En el examen, el 91,27% se presentó normal. Entre los sospechosos, el 36,73% tenían hanseniasis, el 58,21% tenía cicatriz de la 1ª dosis de BCG y el 59,98% fueron encaminados a la vacunación. La prevalencia de la enfermedad entre los contactos fue del 1,62%. Las acciones de la vigilancia de contactos se clasificaron como precarias en San Luis. Conclusión: La mayoría de los contactos registrados no fueron examinados, evidenciando necesidad de fortificación de las acciones de la vigilancia en el municipio


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Notificación de Enfermedades/estadística & datos numéricos , Lepra/transmisión , Lepra/epidemiología , Contaminación Ambiental/prevención & control , Registros Electrónicos de Salud/estadística & datos numéricos , Monitoreo Epidemiológico
6.
BMC Infect Dis ; 19(1): 520, 2019 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-31196008

RESUMEN

BACKGROUND: Leprosy is is still considered a public health issue and in Colombia 7-10% of new cases are found in children, indicating both active transmission and social inequality. We hypothesized that circulating antibodies against Natural Octyl Disaccharide-Leprosy IDRI Diagnostic (NDO-LID) (a combination of Mycobacterium leprae antigens) could reveal the social and environmental aspects associated with higher frequencies of M. leprae infection among children and adolescents in Colombia. METHODS: An observational cross-sectional study was conducted involving sampling from 82 children and adolescents (younger than 18 years of age) who had household contact with index leprosy patients diagnosed in the last 5 years. Data were analyzed through bivariate analysis made by applying a Pearson x2 test for qualitative variables, while quantitative variables, depending on their distribution, were analyzed using either a Student's t-test or Mann-Whitney U test. Multivariate analysis was performed using a multiple regression and binomial logistic approach. RESULTS: A bivariate analysis demonstrated that antibody titers against NDO-LID were significantly greater in children and adolescents with a low socioeconomic status that had: lived in vulnerable areas of the UAChR shared region; eaten armadillo meat; exposure of over 10 years to an index case and; not received BCG immunization. Moreover, a multivariate analysis showed that residing in the UAChR region has a strong association with a greater possibility of M. leprae infection. CONCLUSIONS: M. leprae transmission persists among young Colombians, and this is associated with social and environmental conditions. An intensification of efforts to identify new leprosy cases in vulnerable and forgotten populations where M. leprae transmission continues therefore appears necessary.


Asunto(s)
Lepra/diagnóstico , Mycobacterium leprae/aislamiento & purificación , Adolescente , Animales , Anticuerpos Antibacterianos/sangre , Armadillos , Vacuna BCG/inmunología , Niño , Preescolar , Colombia/epidemiología , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Lactante , Lepra/epidemiología , Lepra/transmisión , Modelos Logísticos , Masculino , Carne/análisis , Carne/microbiología , Mycobacterium leprae/inmunología , Clase Social , Estadísticas no Paramétricas
9.
Immunobiology ; 224(4): 518-525, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31109749

RESUMEN

Hansen's disease (or leprosy) still persists as a serious public health issue. Its diagnosis is based primarily on the detection of clinical signs that are characteristic of the disease. Studies have pointed to the selection of a set of serological and cellular biomarkers of subclinical infection that result in an efficient diagnosis. The aim of this study was compare index cases and their household contacts to identify differentially expressed biomarkers of immune response in leprosy that could provide reliable evidence of subclinical infection in household contacts. The study population consisted of index cases with multibacillary form (IC, n = 13) and their household contacts (HC, n = 14). Serum cytokines and chemokines were quantified using the cytometric beads array (CBA) system. The humoral response was assessed by ELISA test. Flow cytometry was used to characterize the cellular immune response. Monocyte and CD4 + T lymphocytes frequency was significantly higher in IC. Both CD4+ and CD8 + T lymphocytes had a reduced CD25 expression in HC. The immunoglobulin (Ig)M profile anti- NDO-HSA, LID-1, and NDOLID antigens was significantly higher in IC. This study points to the monocyte and CD4+ lymphocyte frequency, as well as specific IgM profile, as predictors of subclinical infection in the household contacts.


Asunto(s)
Biomarcadores , Familia , Lepra/diagnóstico , Lepra/inmunología , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Citocinas/sangre , Femenino , Humanos , Inmunoglobulina M/inmunología , Lactante , Lepra/microbiología , Lepra/transmisión , Leucocitos/inmunología , Leucocitos/metabolismo , Masculino , Persona de Mediana Edad , Mycobacterium leprae/inmunología , Índice de Severidad de la Enfermedad
10.
Epidemiol Serv Saude ; 28(1): e2018065, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-30970070

RESUMEN

OBJECTIVE: to describe the trend and the spatial distribution of leprosy in the state of Bahia, Brazil, 2001-2015. METHODS: this was a mixed ecological study of epidemiological indicators of leprosy; Jointpoint regression was used for the temporal analysis, while spatial scan statistics were used to identify clusters of the disease; the trend was classified as stationary, increasing or decreasing; we calculated the annual percent change (APC) and average annual percent change (AAPC). RESULTS: there was a reduction in prevalence (AAPC = -5.6; p<0,001), treatment dropout (AAPC = -13.7; p<0.001), and females with leprosy (AAPC = -0.6; p<0.001); the new grade II case coefficient (AAPC = 2.7; p<0.001) and the proportion of multibacillary cases (AAPC = 2,2; p<0.001) showed a growing trend; spatial distribution was heterogeneous and concentrated in three regions in particular (north, west and south of the state), with variation between the indicators. CONCLUSION: persisting leprosy transmission in the state, late diagnosis and high hidden prevalence is suggested.


Asunto(s)
Lepra/transmisión , Modelos Estadísticos , Análisis Espacial , Adolescente , Brasil/epidemiología , Análisis por Conglomerados , Diagnóstico Tardío , Femenino , Humanos , Lepra/diagnóstico , Lepra/epidemiología , Masculino , Prevalencia , Análisis de Regresión
13.
Rev. cuba. pediatr ; 91(1): e594, ene.-mar. 2019. graf
Artículo en Español | LILACS | ID: biblio-985590

RESUMEN

Introducción: Los niños contactos de pacientes con lepra se consideran las personas con mayores posibilidades de desarrollar la enfermedad. Objetivo: Valorar la utilidad del seguimiento serológico de anticuerpos contra el glicolípido fenólico I para el diagnóstico de lepra en niños. Métodos: Investigación prospectiva. Se incluyeron todos los niños contactos de pacientes diagnosticados con lepra en las provincias de La Habana, Santiago de Cuba y Guantánamo entre enero 2013-junio 2015. Los menores se evaluaron clínicamente mediante examen dermatoneurológico y se determinó la presencia de anticuerpos contra el glicolípido fenólico I de Mycobacterium leprae para el estudio serológico. Los niños con serología positiva se siguieron, con estos dos métodos, cada seis meses durante dos años. La confirmación de un caso nuevo de lepra se realizó mediante baciloscopía y biología molecular. Resultados: Se estudiaron 151 niños, de ellos 44 (29,13 por ciento) resultaron positivos al glicolípido fenólico I. Se diagnosticaron durante el período 12 casos, de los cuales 11 tuvieron serología positiva. Presentaron sospecha clínica 10 niños de los estudiados, solo se confirmó un caso nuevo, el cual tuvo serología negativa. En ocho de los niños diagnosticados se detectó presencia de bacilos ácido alcohol resistente en la lámina de baciloscopía. En los restantes cuatro niños el diagnóstico se confirmó por la reacción en cadena de la polimerasa. Conclusiones: Los resultados de esta investigación denotan la utilidad del seguimiento serológico de anticuerpos contra el glicolípido fenólico I en el diagnóstico de lepra en niños, en apoyo a la vigilancia clínica(AU)


Introduction: Children having contact with leprosy patients are considered the contacts with greater possibilities of developing the disease. Objective: To assess the usefulness of antibodies´ serologic follow up against the phenolic glycolipid I (PGL-1) for the diagnosis of leprosy in children. Methods: Prospective study in which were included all children contacts of patients diagnosed with leprosy in Havana, Santiago de Cuba and Guantanamo provinces between January 2013 and June 2015. They were evaluated clinically by the dermato-neurological examination and the presence of antibodies against the PGL-1 of M. leprae was determined. Children with positive serology were followed up using these same two methods every six months for two years. The confirmation of a new case of leprosy was made by smear microscopy and molecular biology / PCR-Rlep. Results: A total of 151 children were studied. Of these, 44 children (29.13 percent) were positive for phenolic glycolipid I. A total of 12 children were diagnosed during this period, of which 11 had positive serology. Only 10 children of the studied ones presented clinical suspicion and of these only one new case was confirmed, which had negative serology. In eight of the diagnosed children, the presence of acid-fast bacilli was detected in the smear microscopy. In the remaining four children, the diagnosis was confirmed by the PCR result. Conclusion: The results of this investigation show the usefulness of the antibodies´ serologic follow up against the phenolic glycolipid I in the diagnosis of leprosy in children as a support to clinical surveillance(AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Trazado de Contacto/métodos , Compuestos Fenólicos/métodos , Lepra/prevención & control , Lepra/transmisión , Reacción en Cadena de la Polimerasa/métodos , Estudios Prospectivos , Diagnóstico Precoz
14.
Rev. cuba. pediatr ; 91(1)ene.-mar. 2019. graf
Artículo en Español | CUMED | ID: cum-73693

RESUMEN

Introducción: Los niños contactos de pacientes con lepra se consideran las personas con mayores posibilidades de desarrollar la enfermedad. Objetivo: Valorar la utilidad del seguimiento serológico de anticuerpos contra el glicolípido fenólico I para el diagnóstico de lepra en niños. Métodos: Investigación prospectiva. Se incluyeron todos los niños contactos de pacientes diagnosticados con lepra en las provincias de La Habana, Santiago de Cuba y Guantánamo entre enero 2013-junio 2015. Los menores se evaluaron clínicamente mediante examen dermatoneurológico y se determinó la presencia de anticuerpos contra el glicolípido fenólico I de Mycobacterium leprae para el estudio serológico. Los niños con serología positiva se siguieron, con estos dos métodos, cada seis meses durante dos años. La confirmación de un caso nuevo de lepra se realizó mediante baciloscopía y biología molecular. Resultados: Se estudiaron 151 niños, de ellos 44 (29,13 por ciento) resultaron positivos al glicolípido fenólico I. Se diagnosticaron durante el período 12 casos, de los cuales 11 tuvieron serología positiva. Presentaron sospecha clínica 10 niños de los estudiados, solo se confirmó un caso nuevo, el cual tuvo serología negativa. En ocho de los niños diagnosticados se detectó presencia de bacilos ácido alcohol resistente en la lámina de baciloscopía. En los restantes cuatro niños el diagnóstico se confirmó por la reacción en cadena de la polimerasa. Conclusiones: Los resultados de esta investigación denotan la utilidad del seguimiento serológico de anticuerpos contra el glicolípido fenólico I en el diagnóstico de lepra en niños, en apoyo a la vigilancia clínica(AU)


Introduction: Children having contact with leprosy patients are considered the contacts with greater possibilities of developing the disease. Objective: To assess the usefulness of antibodies´ serologic follow up against the phenolic glycolipid I (PGL-1) for the diagnosis of leprosy in children. Methods: Prospective study in which were included all children contacts of patients diagnosed with leprosy in Havana, Santiago de Cuba and Guantanamo provinces between January 2013 and June 2015. They were evaluated clinically by the dermato-neurological examination and the presence of antibodies against the PGL-1 of M. leprae was determined. Children with positive serology were followed up using these same two methods every six months for two years. The confirmation of a new case of leprosy was made by smear microscopy and molecular biology / PCR-Rlep. Results: A total of 151 children were studied. Of these, 44 children (29.13 percent) were positive for phenolic glycolipid I. A total of 12 children were diagnosed during this period, of which 11 had positive serology. Only 10 children of the studied ones presented clinical suspicion and of these only one new case was confirmed, which had negative serology. In eight of the diagnosed children, the presence of acid-fast bacilli was detected in the smear microscopy. In the remaining four children, the diagnosis was confirmed by the PCR result. Conclusion: The results of this investigation show the usefulness of the antibodies´ serologic follow up against the phenolic glycolipid I in the diagnosis of leprosy in children as a support to clinical surveillance(AU)


Asunto(s)
Humanos , Masculino , Femenino , Niño , Lepra/prevención & control , Lepra/transmisión , Trazado de Contacto/métodos , Compuestos Fenólicos/métodos , Diagnóstico Precoz , Estudios Prospectivos
15.
Cad Saude Publica ; 35(2): e00105318, 2019 02 18.
Artículo en Portugués | MEDLINE | ID: mdl-30785488

RESUMEN

The study sought to analyze the magnitude of occurrence and the sociodemographic, economic and clinical profiles of leprosy associated with household social networks (HSN), with disease overlap in cities from the states of Bahia, Piauí and Rondônia, Brazil, from 2001 to 2014. This is a cross-sectional study using primary and secondary data regarding new cases of leprosy notified to the Brazilian Information System for Notifiable Diseases (SINAN, in Portuguese) residing in the cities. We applied a standardized instrument to the new cases and reviewed data from charts and from SINAN. Of a total of 1,032 (29.6%) assessed cases, 538 (52.1%) had more than one case in their HSN. There were larger frequencies of female sex (292; 54.3%), age between 41 and 60 years (240; 44.6%), primary education (272; 50.6%), income lower than the minimum wage (265; 49.3%) and living with 5 or more people (265; 49.3%). The overlap of cases in the HSN was associated in the multivariate analysis with residing in cities in the state of Rondônia (PR = 1.23; 95%CI: 1.07-1.43; p = 0.003), as well as living with 3 to 4 people in the same household (PR = 1.66; 95%CI: 1.11-2.49; p = 0.014) and having leprosy reaction (PR = 1.31; 95%CI: 0.99-1.70; p = 0.050). Case repetition within the same HSN is a frequent event in the situations we studied. Its occurrence must be considered as a sentinel indicator of greater epidemiological severity in primary health care surveillance. We highlight the vulnerability of affected families.


Asunto(s)
Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Composición Familiar , Lepra/transmisión , Adolescente , Adulto , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Enfermedades Endémicas/estadística & datos numéricos , Monitoreo Epidemiológico , Femenino , Humanos , Lactante , Recién Nacido , Sistemas de Información , Lepra/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Características de la Residencia , Factores Sexuales , Determinantes Sociales de la Salud , Red Social , Factores Socioeconómicos , Adulto Joven
16.
Rev Inst Med Trop Sao Paulo ; 61: e5, 2019 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-30785559

RESUMEN

The Mitsuda test is a skin test based on the individual's immune response through late and highly specific hypersensitivity reaction to the Mycobacterium leprae bacillus. A negative reaction identifies individuals who present a higher risk of becoming ill if exposed to M. leprae and, if they become ill, to develop the virchowian form of disease. The Mitsuda test reading is performed by means of a millimeter ruler. The dermatoscopy is a method that has not been used in the evaluation of cutaneous tests, although its use has increased in several areas. The study aimed to compare the results between the standardized reading and the total area of the Mitsuda test obtained by a computerized method which was structured by the association of digital dermatoscopy, the Dermatology Web system and the Image Tool 3.0 software. Data collection was performed at the Dermatology Outpatient Clinic of the Eduardo de Menezes Hospital, in Belo Horizonte, from November 2015 to August 2016. The sample consisted of 100 leprosy domiciliary contacts. There was an excellent agreement between the Mitsuda test (diameter and area), with a coefficient greater than 80%, and an excellent correlation with the Spearman's correlation coefficient (0.936). The intraclass correlation coefficient indicated a low (0.219) but significant agreement between the two measurements. In conclusion, there is a significant correlation between the standardized reading and the total area of the Mitsuda test. Digital dermoscopy can be an alternative instrument of evaluation, allowing the computerization and recording of the Mitsuda test.


Asunto(s)
Trazado de Contacto , Dermoscopía , Procesamiento de Imagen Asistido por Computador , Pruebas Intradérmicas/métodos , Lepra/transmisión , Atención Ambulatoria , Diagnóstico por Computador , Humanos , Lepra/diagnóstico , Estadísticas no Paramétricas
17.
Cad. Saúde Pública (Online) ; 35(2): e00105318, 2019. tab, graf
Artículo en Portugués | LILACS | ID: biblio-984132

RESUMEN

O estudo tem como objetivo analisar a magnitude da ocorrência e os perfis sociodemográfico, econômico e clínico de casos de hanseníase vinculados à redes de convívio domiciliar (RCD) com sobreposição da doença em municípios dos estados da Bahia, do Piauí e de Rondônia, Brasil, no período de 2001 a 2014. Trata-se de estudo transversal, com dados primários e secundários de casos novos de hanseníase, notificados no Sistema de Informação de Agravos de Notificação (SINAN) e residentes nos municípios. Foram realizadas a aplicação de instrumento padronizado aos casos novos e a revisão de dados em prontuários e na base do SINAN. De um total de 1.032 (29,6%) casos de hanseníase abordados, 538 (52,1%) tinham mais de um caso em sua RCD. Maior frequência de pessoas do sexo feminino (292; 54,3%), com idade entre 41 a 60 anos (240; 44,6%), ensino fundamental (272; 50,6%), renda menor que um salário mínimo (265; 49,3%) e residindo com cinco pessoas ou mais (265; 49,3%). A ocorrência de sobreposição de casos na RCD foi associada, na análise multivariada, a residir em municípios do Estado de Rondônia (RP = 1,23; IC95%: 1,07-1,43; p = 0,003), assim como morar com três a quatro pessoas no mesmo domicílio (RP = 1,66; IC95%: 1,11-2,49; p = 0,014) e ter reação hansênica (RP = 1,31; IC95%: 0,99-1,70; p = 0,050). A repetição de casos de hanseníase em uma mesma RCD representa um evento frequente nos cenários abordados. Sua ocorrência deve ser considerada como indicador sentinela de maior gravidade epidemiológica para a vigilância na rede de atenção básica à saúde. Ressalta-se o caráter de vulnerabilidade das famílias acometidas.


The study sought to analyze the magnitude of occurrence and the sociodemographic, economic and clinical profiles of leprosy associated with household social networks (HSN), with disease overlap in cities from the states of Bahia, Piauí and Rondônia, Brazil, from 2001 to 2014. This is a cross-sectional study using primary and secondary data regarding new cases of leprosy notified to the Brazilian Information System for Notifiable Diseases (SINAN, in Portuguese) residing in the cities. We applied a standardized instrument to the new cases and reviewed data from charts and from SINAN. Of a total of 1,032 (29.6%) assessed cases, 538 (52.1%) had more than one case in their HSN. There were larger frequencies of female sex (292; 54.3%), age between 41 and 60 years (240; 44.6%), primary education (272; 50.6%), income lower than the minimum wage (265; 49.3%) and living with 5 or more people (265; 49.3%). The overlap of cases in the HSN was associated in the multivariate analysis with residing in cities in the state of Rondônia (PR = 1.23; 95%CI: 1.07-1.43; p = 0.003), as well as living with 3 to 4 people in the same household (PR = 1.66; 95%CI: 1.11-2.49; p = 0.014) and having leprosy reaction (PR = 1.31; 95%CI: 0.99-1.70; p = 0.050). Case repetition within the same HSN is a frequent event in the situations we studied. Its occurrence must be considered as a sentinel indicator of greater epidemiological severity in primary health care surveillance. We highlight the vulnerability of affected families.


El objetivo de este estudio fue analizar la magnitud de la ocurrencia y los perfiles sociodemográficos, económicos y clínicos de casos de lepra, vinculados a las redes de convivencia domiciliaria (RCD), con sobreposición de la enfermedad, en municipios de los estados de Bahía, Piauí y Rondônia, Brasil, durante el período de 2001 a 2014. Se trata de un estudio transversal, con datos primarios y secundarios de casos nuevos de lepra, notificados en el Sistema de Información de Enfermedades de Obligada Notificación (SINAN, por su sigla en portugués) y residentes en los municipios. Se procedió a la aplicación de un instrumento estandarizado a los casos nuevos y a la revisión de datos en prontuarios y base de datos del SINAN. De un total de 1.032 (29,6%) casos de lepra abordados, 538 (52,1%) tenían más de un caso en su RCD. Existía una mayor frecuencia de personas del sexo femenino (292; 54,3%), con edades comprendidas entre 41 y 60 años (240; 44,6%), enseñanza fundamental (272; 50,6%), renta menor a un salario mínimo (265; 49,3%) y residiendo con 5 personas o más (265; 49,3%). La ocurrencia de sobreposición de casos en la RCD se asoció en el análisis multivariado a residir en municipios del estado de Rondônia (RP = 1,23; IC95%: 1,07-1,43; p = 0,003), así como vivir con de 3 a 4 personas en el mismo domicilio (RP = 1,66; IC95%: 1,11-2,49; p = 0,014) y sufrir reacción leprótica (RP = 1,31; IC95%: 0,99-1,70; p = 0,050). La repetición de casos de lepra en una misma RCD representa un evento frecuente en los escenarios abordados. Su ocurrencia debe ser considerada como un indicador centinela de mayor gravedad epidemiológica para la vigilancia en la red de atención básica en la salud. Se resalta el carácter de vulnerabilidad de las familias participantes.


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Composición Familiar , Transmisión de Enfermedad Infecciosa/estadística & datos numéricos , Lepra/transmisión , Factores Socioeconómicos , Brasil/epidemiología , Sistemas de Información , Características de la Residencia , Factores Sexuales , Estudios Transversales , Análisis Multivariante , Enfermedades Endémicas/estadística & datos numéricos , Red Social , Monitoreo Epidemiológico , Determinantes Sociales de la Salud , Lepra/epidemiología
18.
Rev. enferm. UFPE on line ; 13: [1-10], 2019. ilus, tab
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1050779

RESUMEN

Objetivo: descrever o perfil dos domicílios e dos contatos intradomiciliares que apresentaram um ou mais casos da doença após a primeira notificação. Método: trata-se de um estudo quantitativo, descritivo, transversal, retrospectivo. Estudaram-se 52 pacientes que apresentaram a doença após a notificação do caso índice no SINAN. Coletaram-se os dados em prontuário e realizaram-se entrevistas por meio de formulário. Analisaram-se os dados no programa estatístico EPI INFO 7.1.1.0, realizando-se a análise estatística descritiva. Resultados: notificaram-se, nos anos de 2013 e 2014, 101 casos de hanseníase. Revela-se que a média de contatos foi de 3,6 por domicílio, sendo que 46 conviviam há mais de dez anos com o caso índice; em relação aos contatos desses domicílios, a escolaridade é baixa; 65,4% deles não receberam a vacina BCG; 61,5% não foram avaliados clinicamente e 21,2% dos contatos ainda sofreram algum tipo de discriminação/preconceito. Conclusão: acredita-se que o controle dos contatos é um dos pilares estratégicos para a quebra da cadeia de transmissão da doença no domicílio, associado ao diagnóstico precoce, tratamento e prevenção de incapacidades físicas.(AU)


Objective: to describe the profile of households and household contacts who presented one or more cases of the disease after the first notification. Method: this is a quantitative, descriptive, cross-sectional, retrospective study. Fifty-two patients who presented the disease after notification of the index case in SINAN were studied. Data was collected from medical records and interviews were conducted using a form. Data were analyzed using the statistical program EPI INFO 7.1.1.0, and descriptive statistical analysis was performed. Results: in 2013 and 2014, 101 cases of leprosy were reported. The average number of contacts was 3.6 per household, and 46 had been living with the index case for over ten years; Regarding the contacts of these households, the education level is low; 65.4% of them did not receive the BCG vaccine; 61.5% were not clinically evaluated and 21.2% of contacts still suffered some kind of discrimination/prejudice. Conclusion: it is believed that contact control is one of the strategic pillars for breaking the disease transmission chain at home, associated with early diagnosis, treatment and prevention of physical disabilities.(AU)


Objetivo: describir el perfil de los hogares y contactos familiares que presentaron uno o más casos de la enfermedad después de la primera notificación. Método: este es un estudio cuantitativo, descriptivo, transversal, retrospectivo. Se estudiaron 52 pacientes que presentaron la enfermedad después de la notificación del caso índice en SINAN. Los datos se recopilaron de los registros médicos y las entrevistas se realizaron mediante un formulario. Los datos se analizaron utilizando el programa estadístico EPI INFO 7.1.1.0 y se realizó un análisis estadístico descriptivo. Resultados: en 2013 y 2014, se informaron 101 casos de lepra. El número promedio de contactos fue de 3.6 por hogar, y 46 habían estado viviendo con el caso índice por más de diez años; con respecto a los contactos de estos hogares, el nivel educativo es bajo; el 65,4% de ellos no recibieron la vacuna BCG; el 61.5% no fueron evaluados clínicamente y el 21.2% de los contactos aún sufrieron algún tipo de discriminación/prejuicio. Conclusión: se cree que el control de contacto es uno de los pilares estratégicos para romper la cadena de transmisión de enfermedades en el hogar, asociado con el diagnóstico temprano, el tratamiento y la prevención de discapacidades físicas.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Trazado de Contacto , Vigilancia en Salud Pública , Vivienda , Lepra , Lepra/transmisión , Lepra/epidemiología , Registros Médicos , Salud Pública , Epidemiología Descriptiva , Estudios Transversales , Estudios Retrospectivos , Sistemas de Información en Salud
19.
PLoS Negl Trop Dis ; 12(12): e0007001, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-30566440

RESUMEN

Leprosy is an infectious disease caused by Mycobacterium leprae and frequently resulting in irreversible deformities and disabilities. Ticks play an important role in infectious disease transmission due to their low host specificity, worldwide distribution, and the biological ability to support transovarial transmission of a wide spectrum of pathogens, including viruses, bacteria and protozoa. To investigate a possible role for ticks as vectors of leprosy, we assessed transovarial transmission of M. leprae in artificially-fed adult female Amblyomma sculptum ticks, and infection and growth of M. leprae in tick cell lines. Our results revealed M. leprae RNA and antigens persisting in the midgut and present in the ovaries of adult female A. sculptum at least 2 days after oral infection, and present in their progeny (eggs and larvae), which demonstrates the occurrence of transovarial transmission of this pathogen. Infected tick larvae were able to inoculate viable bacilli during blood-feeding on a rabbit. Moreover, following inoculation with M. leprae, the Ixodes scapularis embryo-derived tick cell line IDE8 supported a detectable increase in the number of bacilli for at least 20 days, presenting a doubling time of approximately 12 days. As far as we know, this is the first in vitro cellular system able to promote growth of M. leprae. Finally, we successfully transformed a clinical M. leprae isolate by inserting the reporter plasmid pCHERRY3; transformed bacteria infected and grew in IDE8 cells over a 2-month period. Taken together, our data not only support the hypothesis that ticks may have the potential to act as a reservoir and/or vector of leprosy, but also suggest the feasibility of technological development of tick cell lines as a tool for large-scale production of M. leprae bacteria, as well as describing for the first time a method for their transformation.


Asunto(s)
Vectores Arácnidos/fisiología , Ixodes/microbiología , Ixodidae/microbiología , Lepra/transmisión , Mycobacterium leprae/fisiología , Animales , Vectores Arácnidos/microbiología , Línea Celular , Femenino , Humanos , Ixodes/fisiología , Ixodidae/fisiología , Lepra/microbiología , Masculino , Mycobacterium leprae/genética , Conejos
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