Abstract
BackgroundThe diagnosis of leprosy is based on clinical symptoms of the disease, which may not be sufficient to ensure early diagnosis. The development of effective tools for the early detection of infection, such as rapid tests that can be applied by non-specialists for early-stage leprosy identification, has been considered a research priority and may contribute to overcoming the complications associated with late diagnosis. The aim of this study was to analyze the factors associated with anti-phenolic glycolipid-I (PGL-I) seropositivity among the household contacts of leprosy cases.MethodsA cross-sectional study of individuals from the northeastern municipalities of the state of Minas Gerais, Brazil, was performed. Anti-PGL-I seropositivity was evaluated by assessing specific antibody production using the ML Flow test. A Poisson regression with a robust error variance was used to evaluate the relationship between anti-PGL-I seropositivity and the independent variables investigated.ResultsThe overall anti-PGL-I seropositivity was 13.5 %, and among the contacts of leprosy cases that were classified as paucibacillary or multibacillary, it was 8.4 and 17.3 %, respectively. The factors associated with the variation of anti-PGL-I seropositivity among the study population were the presence of signs suggestive of leprosy (PR = 3.68; 95 % CI: 1.56–8.71), the operational leprosy classification (PR = 2.17; 95 % CI: 1.22–3.86) and grade 1 (PR = 1.83; 95 % CI: 1.02–3.26) or grade 2 disability (PR = 2.42; 95 % CI: 1.02–5.47) of the index leprosy case.ConclusionsThe presence of signs suggestive of leprosy and the operational classification of leprosy cases were associated with anti-PGL-I seropositivity. The serological tests available for leprosy are not considered to be diagnostic tests but can be used as auxiliary assessments in combination with clinical parameters to identify exposed individuals at high risk of developing leprosy and those exhibiting the initial stages of this disease.
Highlights
The diagnosis of leprosy is based on clinical symptoms of the disease, which may not be sufficient to ensure early diagnosis
The study participants consisted of 393 household contacts, 53 of whom displayed a positive result on the ML Flow test, corresponding to a seropositivity of 13.5 %
The household contacts who exhibited signs suggestive of leprosy displayed a significantly higher anti-phenolic glycolipid-I (PGL-I) seropositivity than those who exhibited no characteristic signs of the disease (PR = 3.68, p = 0.003)
Summary
The diagnosis of leprosy is based on clinical symptoms of the disease, which may not be sufficient to ensure early diagnosis. The development of effective tools for the early detection of infection, such as rapid tests that can be applied by non-specialists for early-stage leprosy identification, has been considered a research priority and may contribute to overcoming the complications associated with late diagnosis. The slit skin smear is among the most widely used supplementary assessments to confirm this diagnosis and to determine the operational classification of leprosy Other assessments, such as histopathological examination, the Mitsuda reaction, serological tests and the identification. The development of effective tools for the early detection of infection [9], such as rapid tests that can be applied by non-specialists for the identification of leprosy at an early (subclinical) stage, have been considered a research priority [10] and may contribute to overcoming the complications associated with late diagnosis
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