HHC and patients were tested for BI using the Ziehl Nielsen stain. Leprosy elimination - a virtual phenomenon or a reality? Results confirm that the use of multiple testing modalities and follow-up for HHC is important because the clinical exam done at the time of detection of the index case is not sufficient to know whether HHC are infected. SIVIGILA 2008. The prevalence of leprosy in Colombia reported in 2008 was 0.87 per 100,000 habitants (SI-VIGILA 2008). The 12 index cases of the HHC had a BI of zero and the clinical exam did not reveal active lesions of leprosy and/or clinical relapse in the second evaluation. Int J Lepr Other Mycobact Dis 55: 286-292.
Situación de la lepra en Colombia. Secretaría Distrital de Salud - Versión: 210.74.0 - 15/09/2020. Only 32 (52.5%) of the study's first round participants were followed up. [ Links ], Goulart IM, Bernardes Souza DO, Marques CR, Pimenta VL, Gonçalves MA, Goulart LR 2008. Situación de la lepra en Colombia.
1986, Amezcua et al. Nine of the HHC were males and 23 were females.
VIGILANCIA Y ANALISIS DEL RIESGO EN SALUD PÚBLICA PROTOCOLO DE VIGILANCIA EN SALUD PUBLICA NOMBRE EVENTO PRO-R02.017 Versión 02 2016 – Enero 30 Página 2 de 31 1. These index cases included 11 patients with diagnosis of paucibacillary (PB) leprosy [bacillary index (BI) = 0] and one patient with multibacillary (MB) leprosy (BI = 2,4) at the time of the first evaluation. La prevalencia de lepra actualmente es inferior a 1 caso por 10.000 habitantes lo que la hace un problema de salud pública menor (1), la estrategia mundial para el control de la lepra 2016-2020, con el lema “Acelerar la acción hacia un mundo sin lepra” se estructura en tres pilares estratégicos: 1. All of the index cases were re-contacted in 2007. Slit skin smear (SSS) from ear lobes, elbows and lesions were taken, along with nasal mucus samples (NS). La estrategia central se ha encaminado a la implementación de la Somos el Sistema Nacional de Vigilancia en Salud Pública -SIVIGILA, que se ha creado para realizar la provisión en forma sistemática y oportuna, de información sobre la dinámica de los eventos que afecten o puedan afectar la salud de la población Colombiana, con el fin de: Orientar las políticas y la planificación en salud pública. 2008). [ Links ], Received 27 April 2009 Accepted 26 August 2009 Financial support: Dirección Seccional de Salud de Antioquia, Instituto Colombiano de Medicina Tropical - Universidad CES, + Corresponding author: ncardona@ces.edu.co, All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License, Av. This HHC was diagnosed as a PB patient and received the appropriate treatment, according to WHO recommendations. Survey to identify Mycobacterium leprae - infected household contacts of patients from prevalent regions of leprosy in Colombia. Lepr Rev 77: 1-50. Household contacts (HHC) are a high-risk population for developing leprosy (Goulart et al. Risk and protective factors for leprosy development determined by epidemiological surveillance of household contacts. Follow-up of the household contacts (HHC) of leprosy patients is still the best strategy for early detection of leprosy. After explanation of the study and procedures, volunteers provided informed consent. The number of new cases has remained around 350-500 since the multi-drug therapy (MDT) was introduced in 1985 (SIVIGILA 2008), indicating that the therapy has not been effective in preventing transmission (Meima et al. 2005, 2008).
Grade I and II disability was observed in 100% of patients. Key words: household contacts - leprosy patients - follow-up - post-elimination region. Clinical, bacteriological and immunological follow-up of household contacts of leprosy patients from a post-elimination area - Antioquia, Colombia, Nora Cardona-Castro+; Juan Camilo Beltrán-Alzate; Marcela Romero-Montoya, Instituto Colombiano de Medicina Tropical, Universidad CES, Cra 43A 52Sur-99, Sabaneta, Antioquia, Colombia. Periodic evaluation of HHC by clinical exam, immune response and bacteriological state can contribute to the detection of infected HHC for new and early leprosy cases.
They were tested at both times by clinical examination, bacillary index (BI), PCR from a slit skin smear (SSS) and anti PGL-1 IgM titres. Lepra 1. Global strategy for further reducing the leprosy burden and sustaining leprosy control activities 2006-2010. Treatment for PB leprosy was initiated in accordance with WHO recommendations. Brasil, 4365 - Pavilhão Mourisco, Manguinhos. The ages of the HHC ranged from 11-79 years old with an average age of 41.5 years. Nevertheless, clinical examination is not a good tool for detecting subclinical leprosy due to the fact that leprosy is a disease with a slow onset and the symptoms are difficult to detect in the early stage of infection (Lockwood 2002). PCR primers that can detect low levels of Mycobacterium leprae DNA. 2001). The possible failure of treatment due to non-adherence or the appearance of antibiotic resistance need to be evaluated (Hernández et al. Results reveal that leprosy transmission is occurring in post-elimination areas. San José, Costa Rica. Serological specificity of phenolic glycolipid I from Mycobacterium leprae and use in serodiagnosis of leprosy. [ Links ], Meeker HC, Levis WR, Sersen E, Schuller-Levis G, Brennan PJ, Buchanan TM 1986. ELISA detection of IgM antibodies against phenolic glycolipid-I in the management of leprosy: a comparison between laboratories. Rev Panam Salud Publica 23: 73-77. There were 345 new leprosy cases detected in Colombia in 2008 (SIVIGILA 2008); 3.52% of these were in children under 15 years of age and the percentage of grade II disability among new cases was 7.79% (WHO 2006). [ Links ], Hernández E, Cardona-Castro N, Rodríguez G, Villegas S, Beltrán C, Kimura M, Vissa V, Gómez Y 2008.
We are now recommending a yearly follow-up of HHC in an effort to reduce the risk of losing critical information. bles en el control de la lepra. [ Links ], SIVIGILA 2008. J Med Microbiol 50: 177-182. One HHC had one light, hypo-pigmented skin lesion (2 x 3 cm), located on her left thigh with an anaesthetic area surrounding the lesion, which was BI negative and nested PCR positive from her SSS.
At present, the Leprosy Control Programs do not routinely use to detect clinical leprosy follow-up in HHC since only one clinical examination is stipulated as a control measure at the time the index case is diagnosed. 2005). Sensitivity and specificity of the FLA-ABS test for leprosy in Mexican populations. [ Links ], Cardona-Castro N, Beltrán C, Manrique R 2008. Bull World Health Org 82: 373-380. Due to migration, not all of the participants could be followed, resulting in a loss of information. Generalidades En 1991, la Organización Mundial de la Salud ŒOMSŒ propuso la meta de elimina-ción de la lepra como problema de salud pœblica para el aæo 2000, lo que signi-fica reducir la prevalencia a menos de un caso por cada 10 mil habitantes.
Periodic evaluation of HHC can contribute to the detection of infected HHC as well as new and early leprosy cases. HHC serum samples were tested for anti PGL-1 IgM, which was applied using the native PGL-1 antigen provided by Dr. Patrick Brennan from Colorado State University, USA, following a previously described methodology (Cho et al. [ Links ], Isenberg H 1992. 2004) and that the number of new cases remains the same in a region that is considered to be in a post-elimination phase.
In agreement with resolution 008430 of 1993 that regulates health studies in Colombia, this investigation was considered to involve minimal risk. Int J Lepr Other Mycobact Dis 54: 530-539. Tratamiento específico: A finales de los años 40 comenzó la era del tratamiento con la dapsona y sus derivados. None of the HHC showed positive BI, including the new patient. Twelve leprosy patients were the index cases of the 61 HHC; eight were male and four were female. Thirty-two of 61 HHC (52%) were re-contacted. Operational guidelines. [ Links ] WHO - World Health Organization 2006. Protocolo de Vigilancia de Lepra 6 La investigación de contactos cercanos y la búsqueda de la fuente de infección pueden ser útiles.
[ Links ], WHO - World Health Organization 2006. Therefore, diagnosis is often delayed, contributing to the onset of the disease and allowing transmission and sequelae (Lockwood & Kumar 2004). Nine HHC who had negative titres at the time of the first study showed positive titres for anti PGL-1 IgM in 2007 (sero-conversion of 28%); one of them was an 11-year-old girl. INTRODUCCIÓN “En 1991, la 44 Asamblea Mundial de la Salud aprobó la propuesta de eliminar la lepra
Mem Inst Oswaldo Cruz 103: 332-336.
Recibido: 23/11/07 Revisado: 28/11/07 Aprobado: 9/12/07. Other studies have shown frequencies of infected contacts that range from 13-93% (Meeker et al. Leprosy in Colombia is not a public health problem and control of leprosy is in the "post-elimination phase" (WHO 2006). [ Links ], Lockwood DN, Kumar B 2004.Treatment of leprosy. @ Todos los derechos reservados *Habeas data *Términos y condiciones Classification as a post-elimination area contributes to the lack of financial resources for surveillance and leprosy public health control measures in a high-risk population. BMJ 324: 1516-1518. 1987, Cardona-Castro et al. Several regions of Colombia, however, show large differences in leprosy prevalence.
Azálea Espinoza Aguirre 1. It is important to note that one of the HHC who sero-converted was an 11-year-old girl, which demonstrates the importance of follow-up of M. leprae infection in children for early disease detection and disability prevention in a young population. Nine of 32 HHC showed negative titres for PGL-1 during the first study, but after six years they now have positive titres (a 28% sero-conversion rate), which should signify either new exposition or infection or a slow immune response after contact with M. leprae. Clin Vaccine Immunol 15: 101-105. M. leprae DNA from SSS and NS of HHC was extracted using the DNeasy kit®. Resumen The use of other tests in addition to periodic evaluations by clinical exam to detect infected HHC, as well as detailing their immune response and bacteriological state, can contribute to the identification of infected HHC and new leprosy cases (Cardona-Castro et al. [ Links ], Lockwood DN 2002. Available from: www.minsalud.gov.co.
Operational guidelines. [ Links ], Meima A, Smith W, van Ootmarssen G, Richardus JH, Habbema DF 2004. Infection by Mycobacterium leprae of household contacts of lepromatous leprosy patients from a post-elimination leprosy region of Colombia. Available from: www.minsalud.gov.co. Infect Immun 41: 1077-1083. BMJ 328: 1447-1448. Estudio de resistencia a la rifampicina y la dapsona en tres pacientes con recurrencia de lepra. The results of the evolution of these 29 HHC could change the results of this follow-up, a fact that represents a bias of this study. BI was recorded (Isenberg 1992). For the nested PCR, only the new patient was positive. HHC and index cases were examined for signs or symptoms of skin and peripheral nervous leprosy. Correspondencia: azalea1@racsa.co.cr. Amezcua ME, Escobar-Gutierrez A, Mayen E, Cazares JV 1987. Nine HHC (28%) showed sero-conversion and one had a skin lesion (BI negative, nested PCR positive). [ Links ], Cho SN, Yanagihara DL, Hunter SW, Gelber RH, Brennan PJ 1983. 1 Dirección: Dirección de Vigilancia de la Salud, Ministerio de Salud de Costa Rica. The smears were examined for the presence of acid-fast bacilli (AFB). [ Links ], Donoghue HD, Holton J, Spielgelman M 2001. Prevalence of leprosy in Costa Rica between 1998 and 2003. HHC from a post-elimination region of Colombia studied in 2001-2002 were re-contacted in 2007.
Mem Inst Oswaldo Cruz 100: 703-707. Global strategy for further reducing the leprosy burden and sustaining leprosy control activities 2006-2010.
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