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Memórias do Instituto Oswaldo Cruz
Fundação Oswaldo Cruz, Fiocruz
ISSN: 1678-8060 EISSN: 1678-8060
Vol. 112, No. 12, 2017, pp. 822-828
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Bioline Code: oc17119
Full paper language: English
Document type: Research Article
Document available free of charge
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Memórias do Instituto Oswaldo Cruz, Vol. 112, No. 12, 2017, pp. 822-828
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Evidence of hidden leprosy in a supposedly low endemic area of Brazil
Bernardes Filho, Fred; Paula, Natália Aparecida de; Leite, Marcel Nani; Abi-Rached, Thania Loyola Cordeiro; Vernal, Sebastian; Silva, Moises Batista da; Barreto, Josafá Gonçalves; Spencer, John Stewart & Frade, Marco Andrey Cipriani
Abstract
OBJECTIVES Show that hidden endemic leprosy exists in a municipality of inner São Paulo state (Brazil) with active surveillance
actions based on clinical and immunological evaluations.
METHODS The study sample was composed by people randomly selected by a dermatologist during medical care in the public emergency
department and by active surveillance carried out during two days at a mobile clinic. All subjects received a dermato-neurological
examination and blood sampling to determine anti-PGL-I antibody titers by enzyme-linked immunosorbent assay (ELISA).
RESULTS From July to December 2015, 24 new cases of leprosy were diagnosed; all were classified as multibacillary (MB) leprosy,
one with severe Lucio’s phenomenon. Seventeen (75%) were found with grade-1 or 2 disability at the moment of diagnosis. Anti-PGL-I titer was positive in 31/133 (23.3%) individuals, only 6/24 (25%) were positive in newly diagnosed leprosy cases.
CONCLUSIONS During the last ten years before this study, the average new case detection rate (NCDR) in this town was
2.62/100,000 population. After our work, the NCDR was raised to 42.8/100,000. These results indicate a very high number of
hidden leprosy cases in this supposedly low endemic area of Brazil.
Keywords
leprosy; Mycobacterium leprae; serology
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