Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients

Abstract Reduction in incidence has been associated with the introduction of novel approaches, like chemo/immune-prophylaxis. Incidence determined through follow-up cohort studies can evaluate the implementation of these innovative policies towards control and prevention. We have assessed the incide...

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Autores principales:	Mariana Andrea Hacker, Anna Maria Sales, Nádia Cristina Duppre, Euzenir Nunes Sarno, Milton Ozório Moraes
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4f52d0bafff44e62bc5db82505002b7f
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spelling	oai:doaj.org-article:4f52d0bafff44e62bc5db82505002b7f2021-12-02T13:50:41ZLeprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients10.1038/s41598-021-81643-42045-2322https://doaj.org/article/4f52d0bafff44e62bc5db82505002b7f2021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81643-4https://doaj.org/toc/2045-2322Abstract Reduction in incidence has been associated with the introduction of novel approaches, like chemo/immune-prophylaxis. Incidence determined through follow-up cohort studies can evaluate the implementation of these innovative policies towards control and prevention. We have assessed the incidence in our contacts cohort over past 33 years, considering the effect of demographic and clinical variables. Survival analysis was used to estimate the risk of leprosy. A total of 9024 contacts were evaluated, of which 192 developed leprosy, resulting in an overall incidence of 1.4/1000 person-years. The multivariate analysis showed that the major risk factors were (i) contact from MB index cases and (ii) consanguinity (iii) intra household contact. Lower risk was detected for contacts with BCG scar who were revaccinated. There was a significant decrease in accumulated risk between the 2011–2019 period compared with 1987, probably linked to the improvement in laboratory tools to monitor contacts, thereby providing early diagnosis of contacts at intake and reduction of transmission. Our findings suggest that a combination of contact surveillance and tracing, adequate neurodermatological examination, and availability of molecular tools is highly effective in supporting early diagnosis, while a second dose of the BCG vaccination can exert extra protection.Mariana Andrea HackerAnna Maria SalesNádia Cristina DuppreEuzenir Nunes SarnoMilton Ozório MoraesNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mariana Andrea Hacker Anna Maria Sales Nádia Cristina Duppre Euzenir Nunes Sarno Milton Ozório Moraes Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients
description	Abstract Reduction in incidence has been associated with the introduction of novel approaches, like chemo/immune-prophylaxis. Incidence determined through follow-up cohort studies can evaluate the implementation of these innovative policies towards control and prevention. We have assessed the incidence in our contacts cohort over past 33 years, considering the effect of demographic and clinical variables. Survival analysis was used to estimate the risk of leprosy. A total of 9024 contacts were evaluated, of which 192 developed leprosy, resulting in an overall incidence of 1.4/1000 person-years. The multivariate analysis showed that the major risk factors were (i) contact from MB index cases and (ii) consanguinity (iii) intra household contact. Lower risk was detected for contacts with BCG scar who were revaccinated. There was a significant decrease in accumulated risk between the 2011–2019 period compared with 1987, probably linked to the improvement in laboratory tools to monitor contacts, thereby providing early diagnosis of contacts at intake and reduction of transmission. Our findings suggest that a combination of contact surveillance and tracing, adequate neurodermatological examination, and availability of molecular tools is highly effective in supporting early diagnosis, while a second dose of the BCG vaccination can exert extra protection.
format	article
author	Mariana Andrea Hacker Anna Maria Sales Nádia Cristina Duppre Euzenir Nunes Sarno Milton Ozório Moraes
author_facet	Mariana Andrea Hacker Anna Maria Sales Nádia Cristina Duppre Euzenir Nunes Sarno Milton Ozório Moraes
author_sort	Mariana Andrea Hacker
title	Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients
title_short	Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients
title_full	Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients
title_fullStr	Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients
title_full_unstemmed	Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients
title_sort	leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4f52d0bafff44e62bc5db82505002b7f
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Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients

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