Early detection of leprosy by examination of household contacts, determination of serum anti-PGL-1 antibodies and consanguinity

Bazan-Furini, Renata; Motta, Ana Carolina Fragoso; Simão, João Carlos Lopes; Tarquínio, Daniela Chaves; Marques, Wilson; Barbosa, Marcello Henrique Nogueira; Foss, Norma Tiraboschi

doi:10.1590/s0074-02762011000500003

Cited by 32 publications

(39 citation statements)

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“…leprae [5, 29]. Individuals in close contact with untreated MB patients have a 10% lifetime risk of eventually succumbing to leprosy [2, 9, 29–31], particularly when they are consanguineous relatives [29]. Although a positive titre to anti-PGL-I is an infection biomarker, it is not an absolute indicator of disease.…”

Section: Discussionmentioning

confidence: 99%

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Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test

Frade

Gomes

et al. 2017

PLoS Negl Trop Dis

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BackgroundLeprosy diagnosis is mainly based on clinical evaluation, although this approach is difficult, especially for untrained physicians. We conducted a temporary campaign to detect previously unknown leprosy cases in midwestern Brazil and to compare the performance of different serological tests.MethodsA mobile clinic was stationed at the main bus terminal in Brasília, Brazil. Volunteers were quizzed and given a clinical exam to allow categorization as either patients, known contacts of patients or non-contacts, and blood was collected to determine anti-PGL-I and anti-LID-1 antibody titers by ELISA and by the NDO-LID rapid test. New cases of leprosy and the impact of performing this broad random surveillance strategy were evaluated. Accuracy values and concordance between the test results were evaluated among all groups.ResultsFour hundred thirty-four individuals were evaluated, and 44 (10.1%) were diagnosed with leprosy. Borderline forms were the most frequent presentation. Both tests presented higher positivity in those individuals with multibacillary disease. Serological tests demonstrated specificities arround 70% for anti-PGL-1 and anti-LID ELISA; and arround 40% for NDO-LID. Sensitivities ranged from 48 to 62%. A substantial agreement between NDO-LID and ELISA with concomitant positive results was found within leprosy patients (Kappa index = 0.79 CI95% 0.36–1.22).ConclusionsThe unexpectedly high leprosy prevalence in this population indicates ongoing community-based exposure to Mycobacterium leprae antigens and high rates of subclinical infection. All tests showed low specificity and sensitivity values and therefore cannot be considered for use as stand-alone diagnostics. Rather, considering their positivity among MB patients and non-patients, these tests can be considered effective tools for screening and identifying individuals at high risk who might benefit from regular monitoring.

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Section: Discussionmentioning

confidence: 99%

“…In healthy subjects, a high anti-PGL-I and anti-LID-1 titre suggests that there is a hidden bacillary load driving the response to this antigen. Household contacts demonstrating substantial increases in titre against LID-1 and/or PGL-I should be closely monitored [29, 31]. …”

Section: Discussionmentioning

confidence: 99%

Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test

Frade

Gomes

et al. 2017

PLoS Negl Trop Dis

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“…29,30 In highly endemic areas, distribution of PGL1 positivity in leprosy cases is similar between household contacts and non-household contacts, but there is a significant difference between contacts and non-contacts in areas of low endemicity. 31 However, there is no cutoff point for anti-PGL-1 levels to distinguish between subclinical infection and disease, both in the healthy population and in leprosy patients.…”

Section: Laboratory Diagnosismentioning

confidence: 99%

Leprosy: a review of laboratory and therapeutic aspects - Part 2

Lastória

Abreu

2014

An. Bras. Dermatol.

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Leprosy is a chronic infectious condition caused by Mycobacterium leprae(M. leprae). It is endemic in many regions of the world and a public health problem in Brazil. Additionally, it presents a wide spectrum of clinical manifestations, which are dependent on the interaction between M. leprae and host, and are related to the degree of immunity to the bacillus. The diagnosis of this disease is a clinical one. However, in some situations laboratory exams are necessary to confirm the diagnosis of leprosy or classify its clinical form. This article aims to update dermatologists on leprosy, through a review of complementary laboratory techniques that can be employed for the diagnosis of leprosy, including Mitsuda intradermal reaction, skin smear microscopy, histopathology, serology, immunohistochemistry, polymerase chain reaction, imaging tests, electromyography, and blood tests. It also aims to explain standard multidrug therapy regimens, the treatment of reactions and resistant cases, immunotherapy with bacillus Calmette-Guérin (BCG) vaccine and chemoprophylaxis.

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“…We found that the anti-PGL-I antibody can be detected in saliva and serum and its determination may be useful for the evaluation of antigen exposure and response to MDT and for distinguishing MB from paucibacillary (PB) patients (Bonfitto et al 2009). Another application of the detection of this antibody was studied in the evaluation of household contacts (HHC) of LPs, where we observed that the serum anti-PGL-I IgM antibody may be useful for evaluating antigen exposure and as a tool for an early leprosy diagnosis in HHC (Bazan-Furini et al 2011).…”

Section: Immunopathological Mechanisms In Leprosy -mentioning

confidence: 99%

Leprosy, a neglected disease that causes a wide variety of clinical conditions in tropical countries

Foss

Motta

2012

Mem. Inst. Oswaldo Cruz

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Early detection of leprosy by examination of household contacts, determination of serum anti-PGL-1 antibodies and consanguinity

Cited by 32 publications

References 16 publications

Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test

Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test

Leprosy: a review of laboratory and therapeutic aspects - Part 2

Leprosy, a neglected disease that causes a wide variety of clinical conditions in tropical countries

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