Single lesion paucibacillary leprosy: Baseline profile of the Brazilian multicenter cohort study

In Brazil, there is little information about the clinical and epidemiologic al characteristics of paucibacillary, single skin lesion leprosy patients ( SSL-PB). Only recently has the official notification system distinguished l eprosy patients with a single lesion as a clinical entity, fur whom the sin gle-dose ROM (rifampin, ofloxacin and minocycline) regimen has been recomme nded. In this paper, we describe the baseline clinical features and the immunolog ical background of a multicenter cohort of SSL-PB leprosy cases enrolled be tween December 1997-1998, Patients were recruited at health centers located ill the following regions: Southeast = Rio de Janeiro; North = Amazon and Rondonia states and Center-West = Goias state, Eligible cases were newly de tected, untreated single-lesion leprosy patients without thickened nerve in volvement, and were assessed by clinical, bacilloscopic and histopathologic al exams. The Mitsuda skin test and anti-PGL-I serology (ELISA) were also p erformed. Of the 299 SSL-PB leprosy patients, 259 (86.6%) fulfilled the cri teria for single-dose ROM intervention. Our results showed that patients re cruited from different sites had similar features, considering the clinical and immunological profiles, There was a predominance of adults (mean age 3 2.4; S.D. = 16.0), and a BCG scar was detected in 76.7% of the children (le ss than or equal to 15 years old). Only 7 cases were diagnosed as the multi bacillary type, representing less than 3% of the patients being misclassifi ed. Our data indicate that in Brazil SSL-DB case ascertainment based on cli nical and bacilloscopic criteria can be accurately defined under a routine control program; 75.0% of SSL-PB cases were Mitsuda positive (greater than or equal to5 mm) and seropositivity for anti-PGL-I was detected in 17.3% of the patients. These data are compatible with effective cell-mediated immun ity and low bacillary load, suggesting favorable clinical outcomes for most SSL-PB participants of this cohort.