Abstract
BackgroundLeprosy is is still considered a public health issue and in Colombia 7–10% of new cases are found in children, indicating both active transmission and social inequality. We hypothesized that circulating antibodies against Natural Octyl Disaccharide-Leprosy IDRI Diagnostic (NDO-LID) (a combination of Mycobacterium leprae antigens) could reveal the social and environmental aspects associated with higher frequencies of M. leprae infection among children and adolescents in Colombia.MethodsAn observational cross-sectional study was conducted involving sampling from 82 children and adolescents (younger than 18 years of age) who had household contact with index leprosy patients diagnosed in the last 5 years. Data were analyzed through bivariate analysis made by applying a Pearson x2 test for qualitative variables, while quantitative variables, depending on their distribution, were analyzed using either a Student’s t-test or Mann-Whitney U test. Multivariate analysis was performed using a multiple regression and binomial logistic approach.ResultsA bivariate analysis demonstrated that antibody titers against NDO-LID were significantly greater in children and adolescents with a low socioeconomic status that had: lived in vulnerable areas of the UAChR shared region; eaten armadillo meat; exposure of over 10 years to an index case and; not received BCG immunization. Moreover, a multivariate analysis showed that residing in the UAChR region has a strong association with a greater possibility of M. leprae infection.ConclusionsM. leprae transmission persists among young Colombians, and this is associated with social and environmental conditions. An intensification of efforts to identify new leprosy cases in vulnerable and forgotten populations where M. leprae transmission continues therefore appears necessary.
Highlights
Leprosy is is still considered a public health issue and in Colombia 7–10% of new cases are found in children, indicating both active transmission and social inequality
We previously reported that the synthetic mimetic of Phenolic glycolipid-I (PGL-I), natural octyl disaccharide (NDO), can be combined with recombinant protein Leprosy IDRI Diagnostic (LID)-1 to provide the Natural Octyl Disaccharide-Leprosy IDRI Diagnostic (NDO-LID) conjugate that can detect antibodies in the serum of leprosy patients and many household contacts (HHC) [7]
The objective of this study was to determine the relationship between anti-NDO-LID antibodies (IgM, IgG, protein A titers), taking into account that the levels of these immunoglobulins are strongly linked with M. leprae infection levels [7, 10], and social and environmental aspects that could be associated with a higher M. leprae infection rate in children and adolescents in the higher risk regions of Colombia
Summary
Leprosy is is still considered a public health issue and in Colombia 7–10% of new cases are found in children, indicating both active transmission and social inequality. We hypothesized that circulating antibodies against Natural Octyl Disaccharide-Leprosy IDRI Diagnostic (NDO-LID) (a combination of Mycobacterium leprae antigens) could reveal the social and environmental aspects associated with higher frequencies of M. leprae infection among children and adolescents in Colombia. Approximately 225,000 new leprosy cases are diagnosed each year around the world, with 8.9% of these cases occurring in children and adolescents [2, 3]. In Colombia, 300–500 new cases of leprosy are reported per year. Seven percent of the new leprosy cases occurred in children younger than 15 years of age, 59% of these cases were in children 10–14 years of age [4, 5]. Thorough evaluation by physical examination, detection of antibodies against the gold
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