Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies.
The number of new cases of leprosy reported worldwide has remained essentially unchanged for the last decade despite continued global use of free multidrug therapy (MDT) provided to any diagnosed leprosy patient. In order to more effectively interrupt the chain of transmission, new strategies will b...
Guardado en:
| Autores principales: | , , , , , , , , , , , , |
|---|---|
| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2021
|
| Materias: | |
| Acceso en línea: | https://doaj.org/article/9d197ce8dad04cdda5bbe4f1ac4a366b |
| Etiquetas: |
Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
|
| id |
oai:doaj.org-article:9d197ce8dad04cdda5bbe4f1ac4a366b |
|---|---|
| record_format |
dspace |
| spelling |
oai:doaj.org-article:9d197ce8dad04cdda5bbe4f1ac4a366b2021-12-02T20:04:03ZLatent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies.1932-620310.1371/journal.pone.0251631https://doaj.org/article/9d197ce8dad04cdda5bbe4f1ac4a366b2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251631https://doaj.org/toc/1932-6203The number of new cases of leprosy reported worldwide has remained essentially unchanged for the last decade despite continued global use of free multidrug therapy (MDT) provided to any diagnosed leprosy patient. In order to more effectively interrupt the chain of transmission, new strategies will be required to detect those with latent disease who contribute to furthering transmission. To improve the ability to diagnose leprosy earlier in asymptomatic infected individuals, we examined the combined use of two well-known biomarkers of M. leprae infection, namely the presence of M. leprae DNA by PCR from earlobe slit skin smears (SSS) and positive antibody titers to the M. leprae-specific antigen, Phenolic Glycolipid I (anti-PGL-I) from leprosy patients and household contacts living in seven hyperendemic cities in the northern state of Pará, Brazilian Amazon. Combining both tests increased sensitivity, specificity and accuracy over either test alone. A total of 466 individuals were evaluated, including 87 newly diagnosed leprosy patients, 52 post-treated patients, 296 household contacts and 31 healthy endemic controls. The highest frequency of double positives (PGL-I+/RLEP+) were detected in the new case group (40/87, 46%) with lower numbers for treated (12/52, 23.1%), household contacts (46/296, 15.5%) and healthy endemic controls (0/31, 0%). The frequencies in these groups were reversed for double negatives (PGL-I-/RLEP-) for new cases (6/87, 6.9%), treated leprosy cases (15/52, 28.8%) and the highest in household contacts (108/296, 36.5%) and healthy endemic controls (24/31, 77.4%). The data strongly suggest that household contacts that are double positive have latent disease, are likely contributing to shedding and transmission of disease to their close contacts and are at the highest risk of progressing to clinical disease. Proposed strategies to reduce leprosy transmission in highly endemic areas may include chemoprophylactic treatment of this group of individuals to stop the spread of bacilli to eventually lower new case detection rates in these areas.Moises Batista da SilvaWei LiRaquel Carvalho BouthAngélica Rita GobboAna Caroline Cunha MessiasTania Mara Pires MoraesErika Vanessa Oliveira JorgeJosafá Gonçalves BarretoFred Bernardes FilhoGuilherme Augusto Barros CondeMarco Andrey Cipriani FradeClaudio Guedes SalgadoJohn Stewart SpencerPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251631 (2021) |
| institution |
DOAJ |
| collection |
DOAJ |
| language |
EN |
| topic |
Medicine R Science Q |
| spellingShingle |
Medicine R Science Q Moises Batista da Silva Wei Li Raquel Carvalho Bouth Angélica Rita Gobbo Ana Caroline Cunha Messias Tania Mara Pires Moraes Erika Vanessa Oliveira Jorge Josafá Gonçalves Barreto Fred Bernardes Filho Guilherme Augusto Barros Conde Marco Andrey Cipriani Frade Claudio Guedes Salgado John Stewart Spencer Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies. |
| description |
The number of new cases of leprosy reported worldwide has remained essentially unchanged for the last decade despite continued global use of free multidrug therapy (MDT) provided to any diagnosed leprosy patient. In order to more effectively interrupt the chain of transmission, new strategies will be required to detect those with latent disease who contribute to furthering transmission. To improve the ability to diagnose leprosy earlier in asymptomatic infected individuals, we examined the combined use of two well-known biomarkers of M. leprae infection, namely the presence of M. leprae DNA by PCR from earlobe slit skin smears (SSS) and positive antibody titers to the M. leprae-specific antigen, Phenolic Glycolipid I (anti-PGL-I) from leprosy patients and household contacts living in seven hyperendemic cities in the northern state of Pará, Brazilian Amazon. Combining both tests increased sensitivity, specificity and accuracy over either test alone. A total of 466 individuals were evaluated, including 87 newly diagnosed leprosy patients, 52 post-treated patients, 296 household contacts and 31 healthy endemic controls. The highest frequency of double positives (PGL-I+/RLEP+) were detected in the new case group (40/87, 46%) with lower numbers for treated (12/52, 23.1%), household contacts (46/296, 15.5%) and healthy endemic controls (0/31, 0%). The frequencies in these groups were reversed for double negatives (PGL-I-/RLEP-) for new cases (6/87, 6.9%), treated leprosy cases (15/52, 28.8%) and the highest in household contacts (108/296, 36.5%) and healthy endemic controls (24/31, 77.4%). The data strongly suggest that household contacts that are double positive have latent disease, are likely contributing to shedding and transmission of disease to their close contacts and are at the highest risk of progressing to clinical disease. Proposed strategies to reduce leprosy transmission in highly endemic areas may include chemoprophylactic treatment of this group of individuals to stop the spread of bacilli to eventually lower new case detection rates in these areas. |
| format |
article |
| author |
Moises Batista da Silva Wei Li Raquel Carvalho Bouth Angélica Rita Gobbo Ana Caroline Cunha Messias Tania Mara Pires Moraes Erika Vanessa Oliveira Jorge Josafá Gonçalves Barreto Fred Bernardes Filho Guilherme Augusto Barros Conde Marco Andrey Cipriani Frade Claudio Guedes Salgado John Stewart Spencer |
| author_facet |
Moises Batista da Silva Wei Li Raquel Carvalho Bouth Angélica Rita Gobbo Ana Caroline Cunha Messias Tania Mara Pires Moraes Erika Vanessa Oliveira Jorge Josafá Gonçalves Barreto Fred Bernardes Filho Guilherme Augusto Barros Conde Marco Andrey Cipriani Frade Claudio Guedes Salgado John Stewart Spencer |
| author_sort |
Moises Batista da Silva |
| title |
Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies. |
| title_short |
Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies. |
| title_full |
Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies. |
| title_fullStr |
Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies. |
| title_full_unstemmed |
Latent leprosy infection identified by dual RLEP and anti-PGL-I positivity: Implications for new control strategies. |
| title_sort |
latent leprosy infection identified by dual rlep and anti-pgl-i positivity: implications for new control strategies. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/9d197ce8dad04cdda5bbe4f1ac4a366b |
| work_keys_str_mv |
AT moisesbatistadasilva latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT weili latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT raquelcarvalhobouth latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT angelicaritagobbo latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT anacarolinecunhamessias latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT taniamarapiresmoraes latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT erikavanessaoliveirajorge latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT josafagoncalvesbarreto latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT fredbernardesfilho latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT guilhermeaugustobarrosconde latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT marcoandreyciprianifrade latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT claudioguedessalgado latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies AT johnstewartspencer latentleprosyinfectionidentifiedbydualrlepandantipglipositivityimplicationsfornewcontrolstrategies |
| _version_ |
1718375619779100672 |