Evidence of hidden leprosy in a supposedly low endemic area of Brazil

OBJECTIVES Show that hidden endemic leprosy exists in a municipality of inner São Paulo state (Brazil) with active surveillance actions based on clinical and immunological evaluations. METHODS The study sample was composed by people randomly selected by a dermatologist during medical care in the public emergency department and by active surveillance carried out during two days at a mobile clinic. All subjects received a dermato-neurological examination and blood sampling to determine anti-PGL-I antibody titers by enzyme-linked immunosorbent assay (ELISA). RESULTS From July to December 2015, 24 new cases of leprosy were diagnosed; all were classified as multibacillary (MB) leprosy, one with severe Lucio's phenomenon. Seventeen (75%) were found with grade-1 or 2 disability at the moment of diagnosis. Anti-PGL-I titer was positive in 31/133 (23.3%) individuals, only 6/24 (25%) were positive in newly diagnosed leprosy cases. CONCLUSIONS During the last ten years before this study, the average new case detection rate (NCDR) in this town was 2.62/100,000 population. After our work, the NCDR was raised to 42.8/100,000. These results indicate a very high number of hidden leprosy cases in this supposedly low endemic area of Brazil.

Bibliographic Details

Main Authors:	Bernardes Filho,Fred, Paula,Natália Aparecida de, Leite,Marcel Nani, Abi-Rached,Thania Loyola Cordeiro, Vernal,Sebastian, Silva,Moises Batista da, Barreto,Josafá Gonçalves, Spencer,John Stewart, Frade,Marco Andrey Cipriani
Format:	Digital revista
Language:	English
Published:	Instituto Oswaldo Cruz, Ministério da Saúde 2017
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0074-02762017001200822
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