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Leprosy among patient contacts: a multilevel study of risk factors

Sales, Anna M ; Ponce de Leon, Antonio ; Düppre, Nádia C ; Hacker, Mariana A ; Nery, José Augusto C ; Sarno, Euzenir N ; Penna, Maria L F Lockwood, Diana

PLoS neglected tropical diseases, 2011-03, Vol.5 (3), p.e1013-e1013 [Periódico revisado por pares]

United States: Public Library of Science

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  • Título:
    Leprosy among patient contacts: a multilevel study of risk factors
  • Autor: Sales, Anna M ; Ponce de Leon, Antonio ; Düppre, Nádia C ; Hacker, Mariana A ; Nery, José Augusto C ; Sarno, Euzenir N ; Penna, Maria L F
  • Lockwood, Diana
  • Assuntos: Adolescent ; Adult ; Child ; Child, Preschool ; Contact Tracing - methods ; Disease control ; Disease Transmission, Infectious ; Epidemiology ; Female ; Households ; Humans ; Infant ; Infectious diseases ; Leprosy ; Leprosy - epidemiology ; Leprosy - transmission ; Male ; Medicine ; Middle Aged ; Mycobacterium leprae - isolation & purification ; Patients ; Population ; Risk Assessment ; Risk factors ; Tropical diseases ; Variables ; Young Adult
  • É parte de: PLoS neglected tropical diseases, 2011-03, Vol.5 (3), p.e1013-e1013
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
    ObjectType-Article-2
    ObjectType-Feature-1
    Conceived and designed the experiments: AMS APdL MAH ENS MLFP. Performed the experiments: AMS NCD JACN. Analyzed the data: AMS APdL NCD MAH. Contributed reagents/materials/analysis tools: AMS JACN ENS MLFP. Wrote the manuscript: AMS APdL NCD ENS MLFP.
  • Descrição: This study aimed to evaluate the risk factors associated with developing leprosy among the contacts of newly-diagnosed leprosy patients. A total of 6,158 contacts and 1,201 leprosy patients of the cohort who were diagnosed and treated at the Leprosy Laboratory of Fiocruz from 1987 to 2007 were included. The contact variables analyzed were sex; age; educational and income levels; blood relationship, if any, to the index case; household or non-household relationship; length of time of close association with the index case; receipt of bacillus Calmette-Guérin (BGG) vaccine and presence of BCG scar. Index cases variables included sex, age, educational level, family size, bacillary load, and disability grade. Multilevel logistic regression with random intercept was applied. Among the co-prevalent cases, the leprosy-related variables that remained associated with leprosy included type of household contact, [odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.02, 1.73] and consanguinity with the index case, (OR = 1.89, 95% CI: 1.42-2.51). With respect to the index case variables, the factors associated with leprosy among contacts included up to 4 years of schooling and 4 to 10 years of schooling (OR = 2.72, 95% CI: 1.54-4.79 and 2.40, 95% CI: 1.30-4.42, respectively) and bacillary load, which increased the chance of leprosy among multibacillary contacts for those with a bacillary index of one to three and greater than three (OR = 1.79, 95% CI: 1.19-2.17 and OR: 4.07-95% CI: 2.73, 6.09), respectively. Among incident cases, household exposure was associated with leprosy (OR = 1.96, 95% CI: 1.29-2.98), compared with non-household exposure. Among the index case risk factors, an elevated bacillary load was the only variable associated with leprosy in the contacts. Biological and social factors appear to be associated with leprosy among co-prevalent cases, whereas the factors related to the infectious load and proximity with the index case were associated with leprosy that appeared in the incident cases during follow-up.
  • Editor: United States: Public Library of Science
  • Idioma: Inglês
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