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Widespread nasal carriage of Mycobacterium lepraeamong a healthy population in a hyperendemic region of northeastern Brazil.

Lima LN, Frota CC, Mota RM, Almeida RL, Pontes MA, Gonçalves Hde S, Rodrigues LC, Kendall C, Kerr L - Mem. Inst. Oswaldo Cruz (2015)

Bottom Line: To augment the spatial analysis of M. leprae specific repetitive element (RLEP) positive prevalence, an external group (EG) (n = 121), a convenience sample of healthy students, were included.Prevalence of RLEP positivity for cases and Co were 69.2% and 66.9%, respectively, significantly higher than for EG (28.1%), and reported elsewhere.Our geographical analysis demonstrated that the bacillus is widespread among the healthy population, with clusters of RLEP positive multibacillary cases concentrated in distinct areas of the city.

View Article: PubMed Central - PubMed

Affiliation: Seção de Bacteriologia e Micologia, Instituto Evandro Chagas, Belém, PA, Brasil.

ABSTRACT
A case-control study was conducted to determine the presence ofMycobacterium lepraeDNA in nasal secretions of leprosy cases and nonleprosy individuals in Fortaleza, Brazil. It included 185 cases identified by physicians at the Dona Libânia National Reference Centre for Sanitary Dermatology (CDERM). A control group (Co) (n = 136) was identified among individuals from CDERM not diagnosed as leprosy cases. To augment the spatial analysis of M. leprae specific repetitive element (RLEP) positive prevalence, an external group (EG) (n = 121), a convenience sample of healthy students, were included. Polymerase chain reaction for the RLEP sequence was conducted for all participants. Prevalence of RLEP positivity for cases and Co were 69.2% and 66.9%, respectively, significantly higher than for EG (28.1%), and reported elsewhere. Male sex, belonging to a lower socioeconomic status (D/E), history of a previous contact with a case and being older, were associated with being a leprosy case. Our geographical analysis demonstrated that the bacillus is widespread among the healthy population, with clusters of RLEP positive multibacillary cases concentrated in distinct areas of the city. Our results suggest that in endemic areas, as in Fortaleza, surveillance for both nonhousehold leprosy contacts and members of the general population living in cluster areas should be implemented.

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Related in: MedlinePlus

map of the city of Fortaleza, state of Ceará, Brazil, showing leprosy caseswith bacilloscopy index positive and specific repetitive element (RLEP)polymerase chain reaction (PCR) from nasal samples. ●: leprosy cases withpositive RLEP PCR; +: leprosy cases with negative RLEP PCR.
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f02: map of the city of Fortaleza, state of Ceará, Brazil, showing leprosy caseswith bacilloscopy index positive and specific repetitive element (RLEP)polymerase chain reaction (PCR) from nasal samples. ●: leprosy cases withpositive RLEP PCR; +: leprosy cases with negative RLEP PCR.

Mentions: The geographical kernel density distribution of all members with M.leprae DNA positive in nasal secretion in Fortaleza is illustrated inFig. 1A. We observed that the groups C and Co wereconcentrated in the southwest and western side of Fortaleza (Fig. 1B, C), areas of lowerSES, while group EG is concentrated in clusters in the northeast region of the map(Fig. 1D), representing wealthier areas of thecity. In addition, cases with a positive bacilloscopy and RLEP positive are alsoclustered (Fig. 2). The distance between the casesthat comprised each cluster varied from 121-1,000 m.


Widespread nasal carriage of Mycobacterium lepraeamong a healthy population in a hyperendemic region of northeastern Brazil.

Lima LN, Frota CC, Mota RM, Almeida RL, Pontes MA, Gonçalves Hde S, Rodrigues LC, Kendall C, Kerr L - Mem. Inst. Oswaldo Cruz (2015)

map of the city of Fortaleza, state of Ceará, Brazil, showing leprosy caseswith bacilloscopy index positive and specific repetitive element (RLEP)polymerase chain reaction (PCR) from nasal samples. ●: leprosy cases withpositive RLEP PCR; +: leprosy cases with negative RLEP PCR.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660619&req=5

f02: map of the city of Fortaleza, state of Ceará, Brazil, showing leprosy caseswith bacilloscopy index positive and specific repetitive element (RLEP)polymerase chain reaction (PCR) from nasal samples. ●: leprosy cases withpositive RLEP PCR; +: leprosy cases with negative RLEP PCR.
Mentions: The geographical kernel density distribution of all members with M.leprae DNA positive in nasal secretion in Fortaleza is illustrated inFig. 1A. We observed that the groups C and Co wereconcentrated in the southwest and western side of Fortaleza (Fig. 1B, C), areas of lowerSES, while group EG is concentrated in clusters in the northeast region of the map(Fig. 1D), representing wealthier areas of thecity. In addition, cases with a positive bacilloscopy and RLEP positive are alsoclustered (Fig. 2). The distance between the casesthat comprised each cluster varied from 121-1,000 m.

Bottom Line: To augment the spatial analysis of M. leprae specific repetitive element (RLEP) positive prevalence, an external group (EG) (n = 121), a convenience sample of healthy students, were included.Prevalence of RLEP positivity for cases and Co were 69.2% and 66.9%, respectively, significantly higher than for EG (28.1%), and reported elsewhere.Our geographical analysis demonstrated that the bacillus is widespread among the healthy population, with clusters of RLEP positive multibacillary cases concentrated in distinct areas of the city.

View Article: PubMed Central - PubMed

Affiliation: Seção de Bacteriologia e Micologia, Instituto Evandro Chagas, Belém, PA, Brasil.

ABSTRACT
A case-control study was conducted to determine the presence ofMycobacterium lepraeDNA in nasal secretions of leprosy cases and nonleprosy individuals in Fortaleza, Brazil. It included 185 cases identified by physicians at the Dona Libânia National Reference Centre for Sanitary Dermatology (CDERM). A control group (Co) (n = 136) was identified among individuals from CDERM not diagnosed as leprosy cases. To augment the spatial analysis of M. leprae specific repetitive element (RLEP) positive prevalence, an external group (EG) (n = 121), a convenience sample of healthy students, were included. Polymerase chain reaction for the RLEP sequence was conducted for all participants. Prevalence of RLEP positivity for cases and Co were 69.2% and 66.9%, respectively, significantly higher than for EG (28.1%), and reported elsewhere. Male sex, belonging to a lower socioeconomic status (D/E), history of a previous contact with a case and being older, were associated with being a leprosy case. Our geographical analysis demonstrated that the bacillus is widespread among the healthy population, with clusters of RLEP positive multibacillary cases concentrated in distinct areas of the city. Our results suggest that in endemic areas, as in Fortaleza, surveillance for both nonhousehold leprosy contacts and members of the general population living in cluster areas should be implemented.

Show MeSH
Related in: MedlinePlus