Cmt. Martelli et al., Single lesion paucibacillary leprosy: Baseline profile of the Brazilian multicenter cohort study, INT J LEPR, 68(3), 2000, pp. 247-257
Citations number
28
Categorie Soggetti
Microbiology
Journal title
INTERNATIONAL JOURNAL OF LEPROSY AND OTHER MYCOBACTERIAL DISEASES
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.