Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon
IntroductionThe detection of leprosy in children is an important epidemiological marker of the disease, indicating the community’s early exposure to Mycobacterium leprae and active transmission of the infection.MethodsIn order to detect new cases among children by combining clinical evaluation and l...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-06-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1218388/full |
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| author | Izabelle Laissa Viana Costa Patrícia Fagundes da Costa Sâmela Miranda da Silva Angélica Rita Gobbo Pablo Diego do Carmo Pinto Pablo Diego do Carmo Pinto Pablo Diego do Carmo Pinto John Stewart Spencer Moises Batista da Silva Claudio Guedes Salgado Claudio Guedes Salgado |
| author_facet | Izabelle Laissa Viana Costa Patrícia Fagundes da Costa Sâmela Miranda da Silva Angélica Rita Gobbo Pablo Diego do Carmo Pinto Pablo Diego do Carmo Pinto Pablo Diego do Carmo Pinto John Stewart Spencer Moises Batista da Silva Claudio Guedes Salgado Claudio Guedes Salgado |
| author_sort | Izabelle Laissa Viana Costa |
| collection | DOAJ |
| description | IntroductionThe detection of leprosy in children is an important epidemiological marker of the disease, indicating the community’s early exposure to Mycobacterium leprae and active transmission of the infection.MethodsIn order to detect new cases among children by combining clinical evaluation and laboratory tests, we conducted an active case finding among individuals under 15 years old on Caratateua Island, located in the city of Belém, in the Pará state, an endemic region in the Amazon. Dermato-neurological examination, collection of 5 mL of peripheral blood for IgM anti-PGL-I antibody titration, and intradermal scraping for bacilloscopy and amplification of the specific RLEP region by qPCR were performed.ResultsOut of the 56 examined children, 28/56 (50%) new cases were identified. At the time of evaluation, 38/56 (67.8%) children presented one or more clinical alterations. Seropositivity was detected in 7/27 (25.9%) new cases and 5/24 (20.8%) undiagnosed children. DNA amplification of Mycobacterium leprae was observed in 23/28 (82.1%) of new cases and in 5/26 (19.2%) of non-cases. Out of the total cases, 11/28 (39.2%) were exclusively diagnosed by clinical evaluation performed during the active case finding. Seventeen new cases (60.8%) were detected considering the clinical alterations found in addition to positive results for qPCR. In this group, 3/17 (17.6%) qPCR-positive children presented significant clinical changes 5.5 months after the first evaluation.DiscussionOur research detected a number of cases 5.6 times higher compared to the total number of pediatric cases recorded throughout the year 2021 in the municipality of Belém, which shows a critical scenario of underdiagnosing of leprosy among children under 15 years old in the region. We propose the use of qPCR technique to identify new cases among children with oligosymptomatic or early disease in endemic areas, in addition to the training of Primary Health Care professionals and the implementation of the Family Health Strategy coverage in the visited area. |
| first_indexed | 2024-03-13T03:55:24Z |
| format | Article |
| id | doaj.art-ef8f22d65f0a49ecbb231d4b30f4cdbb |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-13T03:55:24Z |
| publishDate | 2023-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-ef8f22d65f0a49ecbb231d4b30f4cdbb2023-06-22T07:58:31ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-06-011010.3389/fmed.2023.12183881218388Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian AmazonIzabelle Laissa Viana Costa0Patrícia Fagundes da Costa1Sâmela Miranda da Silva2Angélica Rita Gobbo3Pablo Diego do Carmo Pinto4Pablo Diego do Carmo Pinto5Pablo Diego do Carmo Pinto6John Stewart Spencer7Moises Batista da Silva8Claudio Guedes Salgado9Claudio Guedes Salgado10Laboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, BrazilLaboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, BrazilLaboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, BrazilLaboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, BrazilLaboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, BrazilLaboratório de Genética Humana e Médica, Instituto de Ciência Biológicas, UFPA, Belém, BrazilFaculdade de Medicina, Instituto de Ciências Médicas, UFPA, Belém, Pará, BrazilDepartment of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, CO, United StatesLaboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, BrazilLaboratório de Dermato-Imunologia, Universidade Federal do Pará, Marituba, Pará, BrazilCoordenação de Atenção às Doenças Transmissíveis na Atenção Primária à Saúde, Departamento de Gestão do Cuidado Integral, Secretaria de Atenção Primária à Saúde, Ministério da Saúde, Brasília, Distrito Federal, BrazilIntroductionThe detection of leprosy in children is an important epidemiological marker of the disease, indicating the community’s early exposure to Mycobacterium leprae and active transmission of the infection.MethodsIn order to detect new cases among children by combining clinical evaluation and laboratory tests, we conducted an active case finding among individuals under 15 years old on Caratateua Island, located in the city of Belém, in the Pará state, an endemic region in the Amazon. Dermato-neurological examination, collection of 5 mL of peripheral blood for IgM anti-PGL-I antibody titration, and intradermal scraping for bacilloscopy and amplification of the specific RLEP region by qPCR were performed.ResultsOut of the 56 examined children, 28/56 (50%) new cases were identified. At the time of evaluation, 38/56 (67.8%) children presented one or more clinical alterations. Seropositivity was detected in 7/27 (25.9%) new cases and 5/24 (20.8%) undiagnosed children. DNA amplification of Mycobacterium leprae was observed in 23/28 (82.1%) of new cases and in 5/26 (19.2%) of non-cases. Out of the total cases, 11/28 (39.2%) were exclusively diagnosed by clinical evaluation performed during the active case finding. Seventeen new cases (60.8%) were detected considering the clinical alterations found in addition to positive results for qPCR. In this group, 3/17 (17.6%) qPCR-positive children presented significant clinical changes 5.5 months after the first evaluation.DiscussionOur research detected a number of cases 5.6 times higher compared to the total number of pediatric cases recorded throughout the year 2021 in the municipality of Belém, which shows a critical scenario of underdiagnosing of leprosy among children under 15 years old in the region. We propose the use of qPCR technique to identify new cases among children with oligosymptomatic or early disease in endemic areas, in addition to the training of Primary Health Care professionals and the implementation of the Family Health Strategy coverage in the visited area.https://www.frontiersin.org/articles/10.3389/fmed.2023.1218388/fullleprosychildrenRLEP qPCRanti-PGL-Iactive case finding |
| spellingShingle | Izabelle Laissa Viana Costa Patrícia Fagundes da Costa Sâmela Miranda da Silva Angélica Rita Gobbo Pablo Diego do Carmo Pinto Pablo Diego do Carmo Pinto Pablo Diego do Carmo Pinto John Stewart Spencer Moises Batista da Silva Claudio Guedes Salgado Claudio Guedes Salgado Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon Frontiers in Medicine leprosy children RLEP qPCR anti-PGL-I active case finding |
| title | Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon |
| title_full | Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon |
| title_fullStr | Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon |
| title_full_unstemmed | Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon |
| title_short | Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon |
| title_sort | leprosy among children in an area without primary health care coverage in caratateua island brazilian amazon |
| topic | leprosy children RLEP qPCR anti-PGL-I active case finding |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1218388/full |
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