Epidemiological characteristics and trends of leprosy in children and adolescents under 15 years old in a low-endemic State in Southern Brazil

Abstract

Leprosy is an infectious and contagious disease affecting skin and nerves. The number of cases in individuals under 15 years old is one of the parameters used in Brazil as an indicator of endemic permanence of the disease and its continuous transmission. Rio Grande do Sul State, in Southern Brazil, is low-endemic to leprosy. However, the disease remains a public health problem. This is a retrospective, observational and analytical study of a historical series of new cases of leprosy in children under 15 years old diagnosed in the period from 2000 to 2019, in all health units in Rio Grande do Sul State. Seventy-seven new cases were notified. The male gender was predominant in 53.2% of the cases (n=41). The average age was 10.4 years (standard deviation of 2.9), with predominance of the age group between 10 and 15 incomplete years old. The most frequent operational classification was multibacillary, in 62.3% of cases (n=48), and the most common clinical form was borderline, in 38.9% of cases (n=28). The predominant disability degree in the sample was grade zero, in 80.0% of the cases (n=60), but in 4.0% (n=3) the grade assessed was 2. In 54.0% of cases (n=27), bacilloscopy was performed, with positive results in 36.0% (n=9) of the exams. Multibacillary cases, with physical disability and/or positive bacilloscopy, draws attention that that the diagnosis is frequently not made in early stages.

Serum Levels of Ficolin-3 and Mannose-Binding Lectin in Patients with Leprosy and Their Family Contacts in a Hyperendemic Region in Northeastern Brazil

“…The leprosy cases that were investigated in the present study were more likely to occur in patients younger than 15 years old. When leprosy is detected in childhood, it indicates that family contacts have not been treated, were treated late, or have not been identified and indicates the active and recent transmission of leprosy in the community [ 27 , 28 ].…”

Leprosy bacilloscopy notifications in the Brazilian Unified Health System and COVID-19 pandemic: an ecological investigation

“…Moreover, leprosy bacilloscopy can be considered invasive, especially for younger age groups. Recent evidence has sought to clarify which laboratory methods can contribute more assertively to the diagnosis of leprosy, considering the method to collect biological material and the technique of analysis, seeking to overcome these limitations 14,15 .…”

Leprosy: A Review of Epidemiology, Clinical Diagnosis, and Management

“…In particular, cases still appear in various countries in Southeast Asia, America, Africa, the Eastern Pacific, and the Western Mediterranean [4,9]. Moreover, the high incidence rate in children under 15 years of age is important, indicating that there is early exposure of the population to the bacillus, which is associated with an elevated prevalence in the general population and is a good indicator of high transmission and poor quality of control programs [10][11][12][13][14][15][16]. In the absence of an effective vaccine, early diagnosis and treatment of the disease are important to stop the transmission of M. leprae, reduce the risk of physical disability and deformity, and reduce the physical, psychosocial, and economic burden of the disease [17][18][19].…”