Leprosy on Anjouan (Comoros): persistent hyper-endemicity despite decades of solid control efforts

Hasker, Epco; Baco, Abdallah; Younoussa, Assoumani; Mzembaba, Aboubacar; Grillone, Saverio; Demeulenaere, Tine; Groenen, Guido; Suffys, Philip Noël; Jong, Bouke C. de

doi:10.47276/lr.88.3.334

Cited by 11 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After the full-text analysis, we included 47 articles. 23 from Brazil [ 11 – 33 ], 6 from India [ 34 – 39 ], 3 from China [ 40 – 42 ], 2 from Bangladesh [ 2 , 43 ] and Comoros [ 44 , 45 ]. One from Cambodia [ 46 ], Sri-Lanka [ 47 ], Cameroon [ 48 ], Venezuela [ 49 ], Bangladesh and Thailand [ 50 ], Indonesia [ 51 ], Argentina [ 52 ], and Uganda [ 53 ].…”

Section: Resultsmentioning

confidence: 99%

Measuring endemicity and burden of leprosy across countries and regions: A systematic review and Delphi survey

et al. 2021

View full text Add to dashboard Cite

Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae, the annual new case detection in 2019 was 202,189 globally. Measuring endemicity levels and burden in leprosy lacks a uniform approach. As a result, the assessment of leprosy endemicity or burden are not comparable over time and across countries and regions. This can make program planning and evaluation difficult. This study aims to identify relevant metrics and methods for measuring and classifying leprosy endemicity and burden at (sub)national level. Methods We used a mixed-method approach combining findings from a systematic literature review and a Delphi survey. The literature search was conducted in seven databases, searching for endemicity, burden and leprosy. We reviewed the available evidence on the usage of indicators, classification levels, and scoring methods to measure and classify endemicity and burden. A two round Delphi survey was conducted to ask experts to rank and weigh indicators, classification levels, and scoring methods. Results The literature review showed variation of indicators, levels, and cut-off values to measure leprosy endemicity and/or burden. The most used indicators for endemicity include new case detection rate (NCDR), new cases among children and new cases with grade 2 disability. For burden these include NCDR, MB cases, and prevalence. The classification levels ‘high’ and ‘low’ were most important. It was considered most relevant to use separate scoring methods for endemicity and burden. The scores would be derived by use of multiple indicators. Conclusion There is great variation in the existing method for measuring endemicity and burden across countries and regions. Our findings contribute to establishing a standardized uniform approach to measure and classify leprosy endemicity and burden at (sub)national level, which would allow effective communication and planning of intervention strategies.

show abstract

Section: Resultsmentioning

confidence: 99%

Measuring endemicity and burden of leprosy across countries and regions: A systematic review and Delphi survey

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Editor Arteriovenous malformations(AVMs) are fast-flow vascular anomalies consisting of an abnormal artery-vein bypass with no intervening capillary network, which are progressive and prone to steal blood, resulting in haemorrhage, ulcers, deformities and even heart failure. [1][2][3] Conventional treatments such as embolization and excision achieve transient benefits, but the recurrence rate is greater than 90%. 3 A recent study showed that AVMs were caused by mutations in KRAS and MAP2K1.…”

Section: Genotype-guided Targeted Treatment Of Kras-mutated Arteriove...mentioning

confidence: 99%

Leprosy in Mayotte: persistent hyper‐endemicity in a French overseas territory

Maillard

Tabard²,

Mohand-Oussaid³

et al. 2022

Acad Dermatol Venereol

View full text Add to dashboard Cite

“…These persistently high incidence areas also occur in settings with solid leprosy control programs, where patients are diagnosed early and treated appropriately with highly effective multidrug therapy. Moreover, in some regions 30% of the leprosy patients occur in children [ 2 ], which supports that transmission continues unabatedly. Although transmission pathways of Mycobacterium leprae ( M .…”

Section: Introductionmentioning

confidence: 95%

Minimally invasive sampling to identify leprosy patients with a high bacterial burden in the Union of the Comoros

et al. 2021

Self Cite

View full text Add to dashboard Cite

The World Health Organization (WHO) endorsed diagnosis of leprosy (also known as Hansen’s disease) entirely based on clinical cardinal signs, without microbiological confirmation, which may lead to late or misdiagnosis. The use of slit skin smears is variable, but lacks sensitivity. In 2017–2018 during the ComLep study, on the island of Anjouan (Union of the Comoros; High priority country according to WHO, 310 patients were diagnosed with leprosy (paucibacillary = 159; multibacillary = 151), of whom 263 were sampled for a skin biopsy and fingerstick blood, and 260 for a minimally-invasive nasal swab. In 74.5% of all skin biopsies and in 15.4% of all nasal swabs, M. leprae DNA was detected. In 63.1% of fingerstick blood samples, M. leprae specific antibodies were detected with the quantitative αPGL-I test. Results show a strong correlation of αPGL-I IgM levels in fingerstick blood and RLEP-qPCR positivity of nasal swabs, with the M. leprae bacterial load measured by RLEP-qPCR of skin biopsies. Patients with a high bacterial load (≥50,000 bacilli in a skin biopsy) can be identified with combination of counting lesions and the αPGL-I test. To our knowledge, this is the first study that compared αPGL-I IgM levels in fingerstick blood with the bacterial load determined by RLEP-qPCR in skin biopsies of leprosy patients. The demonstrated potential of minimally invasive sampling such as fingerstick blood samples to identify high bacterial load persons likely to be accountable for the ongoing transmission, merits further evaluation in follow-up studies.

show abstract

Leprosy on Anjouan (Comoros): persistent hyper-endemicity despite decades of solid control efforts

Cited by 11 publications

References 0 publications

Measuring endemicity and burden of leprosy across countries and regions: A systematic review and Delphi survey

Measuring endemicity and burden of leprosy across countries and regions: A systematic review and Delphi survey

Leprosy in Mayotte: persistent hyper‐endemicity in a French overseas territory

Minimally invasive sampling to identify leprosy patients with a high bacterial burden in the Union of the Comoros

Contact Info

Product

Resources

About