Association between NDO-LID and PGL-1 for leprosy and class I and II human leukocyte antigen alleles in an indigenous community in Southwest Amazon

The frequencies of the Human leukocyte antigen (HLA) alleles in the Puyanawa indigenous reserve population and their association with the NDO-LID and ELISA PGL-1 rapid serological test was assessed. This was a cross-sectional study with an epidemiological clinical design conducted in two indigenous communities in the state of Acre, Brazil. Blood was collected in a tube with EDTA to identify HLA alleles and perform serological tests. DNA was obtained using the salting out procedure. The LabType™ technique (One-Lambda-USA) was used for HLA class I (loci A*, B* and C*) and II (loci DRB1*, DQA1* and DQB1*) typing. Allele frequency was obtained by direct count, and the chi-square test was used to assess the association with the NDO-LID and PGL-1 tests. The most frequent alleles in the two communities were: HLA-A*02:01, HLA-B*40:02, HLA-DRB1*16:02, HLA-DQA1*05:05 and HLA-DQB1*03:01. The allele HLA-C*04:01 was the most common in the Barão community, and the allele HLA-C*07:01 in Ipiranga. Among individuals who presented seropositivity to the NDO-LID test, the association with alleles HLA-A*02 (43.18% vs 24.8%, p = 0.03, OR = 2.35) and HLA-B*53 (6.83% vs 0.0%, p = 0.03, OR = 8.95) was observed in the Barão community. HLA-B*15 was associated with non-seroconversion to the NDO-LID test in Ipiranga. In both communities, HLA-B*40 and HLA-C*03 were associated with positive serological response to ELISA PGL-1. The HLA class I and II alleles most frequently found in this study have already been described among Terena indigenous groups, and HLA class I contributes to seroconversion to NDO-LID and PGL-1 tests in inhabitants of the Barão and Ipiranga communities(AU).

Association between NDO-LID and PGL-1 for leprosy and class I and II human leukocyte antigen alleles in an indigenous community in Southwest Amazon.

The frequencies of the Human leukocyte antigen (HLA) alleles in the Puyanawa indigenous reserve population and their association with the NDO-LID and ELISA PGL-1 rapid serological test was assessed. This was a cross-sectional study with an epidemiological clinical design conducted in two indigenous communities in the state of Acre, Brazil. Blood was collected in a tube with EDTA to identify HLA alleles and perform serological tests. DNA was obtained using the salting out procedure. The LabType™ technique (One-Lambda-USA) was used for HLA class I (loci A*, B* and C*) and II (loci DRB1*, DQA1* and DQB1*) typing. Allele frequency was obtained by direct count, and the chi-square test was used to assess the association with the NDO-LID and PGL-1 tests. The most frequent alleles in the two communities were: HLA-A*02:01, HLA-B*40:02, HLA-DRB1*16:02, HLA-DQA1*05:05 and HLA-DQB1*03:01. The allele HLA-C*04:01 was the most common in the Barão community, and the allele HLA-C*07:01 in Ipiranga. Among individuals who presented seropositivity to the NDO-LID test, the association with alleles HLA-A*02 (43.18% vs 24.8%, p=0.03, OR=2.35) and HLA-B*53 (6.83% vs 0.0%, p=0.03, OR=8.95) was observed in the Barão community. HLA-B*15 was associated with non-seroconversion to the NDO-LID test in Ipiranga. In both communities, HLA-B*40 and HLA-C*03 were associated with positive serological response to ELISA PGL-1. The HLA class I and II alleles most frequently found in this study have already been described among Terena indigenous groups, and HLA class I contributes to seroconversion to NDO-LID and PGL-1 tests in inhabitants of the Barão and Ipiranga communities.

Aspectos clínicos, epidemiológicos e sociais da hanseníase em indígenas na região do Alto Rio Juruá/Acre, Brasil / Clinical, epidemiological and social aspects of leprosy among the Indians from the Alto Juruá River/ State of Acre, Brazil

Este estudo investigou os casos de hanseníase na população indígena da microrregião do Alto Rio Juruá/Acre notificados pelo Sistema de Informação e Notificação de Agravos (SINAN), bem como avaliou seus respectivos contatos no período de 2009 a 2012. Foram identificados três casos em indígenas, sendo dois do sexo masculino com 69 e 27 anos, do povo Puyanawa,classificados como multibacilares com forma clínica dimorfa e virchowiana e grau de incapacidade I e II, respectivamente. O caso do povo Nawa foi do sexo feminino com 15 anos de idade, classificado como paucibacilar. Doze contactantes foram avaliados para investigação da doença, que foi afastada em todos. Os indígenas estudados estão inseridos em condições ambientais, esgotamento sanitário e condições sociais favoráveis ao desenvolvimento da hanseníase. Há possível persistência de foco na aldeia Ipiranga,além do indicativo de alta endemicidade pela detecção da doença em indivíduo menor de 15 anos,apontando necessidade de avaliação epidemiológica e busca ativa de casos para o diagnóstico da doença nestes povos.

This study investigated cases of leprosy among indigenous population of the micro-region of AltoJurua River/State of Acre. We evaluated leprosy cases reported by the Information System for Notifiable Diseases (SINAN) as well as their contacts among indigenous population from 2009 to 2012. Three leprosy cases were identified. Two Puyanawa men, 69 and 27 years old, classified as borderline and lepromatous forms, with disability grade I and II, respectively. The third case was detected in Nawaethnicity and was a female, under 15 years. Thediagnosis was not confirmed in twelve contacts that were evaluated for suspicion of the disease. The studied Indians are embedded in environmental and social conditions favorable to development of leprosy. Probably, there is a focus in Ipiranga village and an indication of high endemicity area, once leprosy was detected in an under 15 year-old girl. The epidemiological assessment and diagnostic accuracy for the diagnosis of disease in this population are priorities.