Methods for the Classification of Leprosy for Treatment Purposes

Pardillo, Fe Eleanor F.; Fajardo, T. T.; Abalos, Rodolfo M.; Scollard, David M.; Gelber, Robert H.

doi:10.1086/512809

Cited by 92 publications

(75 citation statements)

References 6 publications

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“…Tests could greatly aid general practitioners in their evaluation of suspected cases. This would appear particularly prudent in regions where a large proportion of patients present as MB leprosy cases, such as the Philippines (31). Importantly, the ability to objectively read and quantify NDO-LID test results using a Smart Reader eliminates the need for prior training/experience in interpreting test results.…”

Section: Discussionmentioning

confidence: 99%

Rapid Quantitative Serological Test for Detection of Infection with Mycobacterium leprae, the Causative Agent of Leprosy

Duthie

Balagon²,

Maghanoy³

et al. 2014

J Clin Microbiol

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Leprosy remains an important health problem in a number of regions. Early detection of infection, followed by effective treatment, is critical to reduce disease progression. New sensitive and specific tools for early detection of infection will be a critical component of an effective leprosy elimination campaign. Diagnosis is made by recognizing clinical signs and symptoms, but few clinicians are able to confidently identify these. Simple tests to facilitate referral to leprosy experts are not widely available, and the correct diagnosis of leprosy is often delayed. In this report, we evaluate the performance of a new leprosy serological test (NDO-LID). As expected, the test readily detected clinically confirmed samples from patients with multibacillary (MB) leprosy, and the rate of positive results declined with bacterial burden. NDO-LID detected larger proportions of MB and paucibacillary (PB) leprosy than the alternative, the Standard Diagnostics leprosy test (87.0% versus 81.7% and 32.3% versus 6.5%, respectively), while also demonstrating improved specificity (97.4% versus 90.4%). Coupled with a new cell phone-based test reader platform (Smart Reader), the NDO-LID test provided consistent, objective test interpretation that could facilitate wider use in nonspecialized settings. In addition, results obtained from sera at the time of diagnosis, versus at the end of treatment, indicated that the quantifiable nature of this system can also be used to monitor treatment efficacy. Taken together, these data indicate that the NDO-LID/Smart Reader system can assist in the diagnosis and monitoring of MB leprosy and can detect a significant number of earlier-stage infections. Despite advances toward the elimination of leprosy over the last 2 decades, new case detection rates have stabilized over the last decade and leprosy remains an important health problem in many regions (1). Like the number of registered cases, however, the number of clinicians who can reliably diagnose leprosy has waned, and delays in determining the correct diagnosis are common (2, 3). Efforts to develop and improve surveillance and referral systems appear necessary to achieve the early detection required to ensure that prompt and appropriate treatment can be provided to limit disabilities. The development of simple and practical tools to facilitate diagnosis would appear prudent.Currently, the diagnosis of leprosy is dependent on the appearance and recognition of clinical signs and symptoms. When skinsmear or pathology services are available, leprologists utilize the Ridley-Jopling scale to characterize five forms of the disease (4, 5). In practice, however, most field programs lack such services, and the clinical system suggested by WHO to classify individual patients and to select their treatment regimen is used (6). The WHO system uses skin lesions, bacterial positivity by skin smear, and the number of involved nerves to group leprosy patients into one of two simplified categories: multibacillary (MB) leprosy (patients are typically smear pos...

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Section: Discussionmentioning

confidence: 99%

Rapid Quantitative Serological Test for Detection of Infection with Mycobacterium leprae, the Causative Agent of Leprosy

Duthie

Balagon²,

Maghanoy³

et al. 2014

J Clin Microbiol

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“…Leprosy is a contagious, granulomatous and chronic infectious disease caused by Mycobacterium leprae, an obligate intracellular bacillus that affects mainly the skin and peripheral nerves [1][2][3] . It can be better understood when regarded as an association of two diseases: first, a chronic infection that induces a cell-mediated immune response; second, a peripheral neuropathy which is triggered by infection and followed by a series of immunological events, whose evolution, sequels and disabilities often last many years, even after infection has ceased [4][5][6][7] .…”

mentioning

confidence: 99%

Study of the profile of the neurotrophin BDNF in new leprosy cases before, during and after multidrug therapy

Costa

Mendonça

Penido³

et al. 2011

Arq. Neuro-Psiquiatr.

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Brain-derived neurotrophic factor (BDNF) is a neurotrophin involved in the survival of neurons and growth and differentiation of dendrites and axons. The purpose of the present study was to evaluate plasma levels of BDNF of leprosy patients at different stages of multidrug therapy (MDT) in comparison with non-infected individuals. Plasma levels of BDNF were measured by ELISA in 30 healthy controls and 37 leprosy patients at diagnosis, during and after MDT. Plasma levels of BDNF tended to be higher in control subjects in comparison with leprosy patients, but this difference does not reach statistical significance. Interestingly, BDNF levels changed following MDT, achieving statistical difference only at the 2 nd dose of MDT. These results indicate that BDNF may not be a surrogate marker of leprosy infection and/or related neuropathy. Further research is needed to investigate the meaning of BDNF level changes following leprosy treatment. Key words: leprosy, BDNF, peripheral neuropathy, biomarker, follow-up.Estudo do perfil da neurotrofina BDNF em casos novos de hanseníase antes, durante e após poliquimioterapia RESUMO O fator neurotrófico derivado do cérebro (BDNF) é uma neurotrofina envolvida na sobrevivência neuronal e no crescimento e diferenciação dos dendritos e axônios. O objetivo do presente estudo foi avaliar os níveis plasmáticos do BDNF de pacientes com hanseníase em diferentes fases da poliquimioterapia (PQT), em comparação com indivíduos não-infectados. Os níveis plasmáticos do BDNF foram mensurados pelo teste ELISA em 30 controles sadios e 37 pacientes com hanseníase no momento do diagnóstico, durante e após PQT. Os níveis plasmáticos do BDNF mostraram-se maiores nos indivíduos controles em comparação com os pacientes com hanseníase, mas não houve diferença estatisticamente significante. Curiosamente, os níveis de BDNF modificaram-se com o tratamento, mostrando diferença estatística apenas na segunda dose de PQT. Esses resultados indicam que o BDNF pode não ser um marcador de infecção na hanseníase e/ ou neuropatias relacionadas. Novas pesquisas são necessárias para investigar o significado das alterações nos níveis de BDNF ao longo do tratamento da hanseníase. Palavras-chave: hanseníase, BDNF, neuropatia periférica, biomarcador, seguimento.

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“…Tuberculoid leprosy (TT) was defined as a paucibacillary (PB) patient, it means BI=0, with 1 to 5 hypo pigmented or erythematous sharply demarcated macules, with hypoesthesia, and involvement of one peripheral nerve identified by enlargement and/or localized pain (24,25). Lepromatous leprosy (LL) was defined as a multibacillary (MB) patient, IB>0, with more than 5 skin lesions, nodules, plaques or papules, loss of sensitivity and compromised of several nerves (24,25).…”

Section: Case Definitionmentioning

confidence: 99%

“…Lepromatous leprosy (LL) was defined as a multibacillary (MB) patient, IB>0, with more than 5 skin lesions, nodules, plaques or papules, loss of sensitivity and compromised of several nerves (24,25).…”

Section: Case Definitionmentioning

confidence: 99%