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Early detection of leprosy by examination of household contacts, determination of serum anti-PGL-1 antibodies and consanguinity

BAZAN-FURINI, Renata; MOTTA, Ana Carolina F; SIMÃO, João Carlos L; TARQUÍNIO, Daniela Chaves; MARQUES JR, Wilson; BARBOSA, Marcello Henrique N; FOSS, Norma Tiraboschi
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica
ENG
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A cross-sectional clinical trial in which the serum anti-phenolic glycolipid (anti-PGL-1) antibodies were analysed in household contacts (HHC) of patients with leprosy as an adjunct early leprosy diagnostic marker was conducted. The families of 83 patients underwent clinical examination and serum anti-PGL1 measurement using enzyme-linked immunosorbent assay. Of 320 HHC, 98 were contacts of lepromatous leprosy (LL), 80 were contacts of borderline lepromatous (BL), 28 were contacts of borderline (BB) leprosy, 54 were contacts of borderline tuberculoid (BT), 40 were contacts of tuberculoid (TT) and 20 were contacts of indeterminate (I) leprosy. Consanguinity with the patients was determined for 232 (72.5%) HHC. Of those 232 contacts, 183 had linear consanguinity. Forty-nine HHC had collateral consanguinity. Fifty-eight contacts (18.1%) tested positive for anti-PGL1 antibodies. The number of seropositive contacts based on the clinical forms of the index case was 17 (29.3%) for LL, 15 (25.9%) for BL, one (1.7%) for BB, 14 (24.1%) for BT, three (5.2%) for TT and eight (13.7%) for I. At the one year follow-up, two (3.4%) of these seropositive contacts had developed BT leprosy. The results of the present study indicate that the serum anti-PGL-1 IgM antibody may be useful for evaluating antigen exposure and as a tool for an early leprosy diagnosis in HHC.; FAEPA; CNPq; The São Paulo State Foundation against Leprosy

Leprosy in transplant recipients: report of a case after liver transplantation and review of the literature

TRINDADE, M. A. B.; PALERMO, M. L.; PAGLIARI, C.; VALENTE, N.; NAAFS, B.; MASSAROLLO, P. C. B.; D`ALBUQUERQUE, L. A. C.; BENARD, G.
Fonte: WILEY-BLACKWELL PUBLISHING, INC Publicador: WILEY-BLACKWELL PUBLISHING, INC
Tipo: Artigo de Revista Científica
ENG
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P>Leprosy still is an important public health problem in several parts of the world including Brazil. Unlike the diseases caused by other mycobacteria, the incidence and clinical presentation of leprosy seems little affected in immunosuppressed patients. We report the first case, to our knowledge, of a liver transplant patient who developed multi-bacillary leprosy. The patient presented with papules and infiltrated plaques with loss of sensation suggestive of leprosy 3.5 years after living-related liver transplantation for autoimmune hepatitis. A skin biopsy showing non-caseating macrophagic granulomas, neuritis, and intact acid-fast bacilli on Fite-Faraco stain, confirmed the diagnosis of borderline lepromatous leprosy. The donor of the liver did not show any evidence of leprosy. During follow-up, the patient presented 2 episodes of upgrading leprosy type I reactions, 1 mild before leprosy treatment, and 1 moderate 3 months after receiving standard multi-drug treatment (rifampicin, clofazimine, and dapsone). These reactions were accompanied by increase in liver function tests, especially of canalicular enzymes. This reaction occurred despite the patient`s triple immunosuppression regimen. The moderate reaction was successfully treated with further immunosuppression (prednisone...

Seropositivity to anti-phenolic glycolipid-I in leprosy cases, contacts and no known contacts of leprosy in an endemic and a non-endemic area in northeast Brazil

FROTA, Cristiane C.; FREITAS, Max V. C.; FOSS, Norma T.; LIMA, Luana N. C.; RODRIGUES, Laura C.; BARRETO, Mauricio L.; KERR, Ligia R. S.
Fonte: ELSEVIER SCIENCE INC Publicador: ELSEVIER SCIENCE INC
Tipo: Artigo de Revista Científica
ENG
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The seroprevalence rates of IgM anti-phenolic glycolipid-I (PGL-I) antibodies in four study groups with differing exposure to Mycobacterium leprae in Ceara. Brazil were investigated between March 2005 and August 2006. The first three groups in a high prevalence area included 144 cases of leprosy, their 380 contacts and 317 participants with no known leprosy contact. The fourth group in a low prevalence area consisted of 87 participants with no known leprosy contact living in an area in which no cases of leprosy had been reported in the previous 6 months. Seropositivity and levels of IgM antibodies to PGL-I were investigated using ELISA. The seropositivity levels of anti-PGL-I among the different clinical forms of leprosy cases were 61% for lepromatous, 25% for tuberculoid and 27% indeterminate. The levels of anti-PGL-I antibodies in the endemic area differentiated leprosy cases from non-cases. However, the seropositivity was similar among contact cases (15.8%) and no known leprosy contact cases from high (15.1%) and low (13.8%) prevalence areas. The seropositivity of both contacts and no known contacts was much higher than previously reported among no known contacts in other endemic areas. The study indicates that anti-PGL-I antibodies are not useful as immunological markers of household leprosy contacts and no known leprosy contacts in endemic areas. (C) 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.; health authorities of Sobral and Mulungu...

Condicionantes sociais na delimitação de espaços endêmicos de hanseníase; Social conditions in the delimitation of areas endemic for leprosy

Souza, Luis Roberto de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 21/09/2012 PT
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INTRODUÇÃO: A hanseníase é uma doença infecciosa crônica granulomatosa, cujo agente etiológico é uma bactéria de vida intracelular obrigatória, o Mycobacterium leprae, que tem no homem seu principal reservatório. A doença possui distribuição universal, predominando atualmente, em latitudes tropicais e tem sido enquadrada entre as enfermidades negligenciadas, atingindo desproporcionalmente populações pobres e marginalizadas. O bacilo é altamente contagioso, de baixa patogenicidade e acomete primordialmente pele e nervos, com grande potencial incapacitante. A doença grassou no Velho Mundo durante a Idade Média e praticamente desapareceu da Europa ainda no início do século XX, antes que qualquer recurso terapêutico eficaz estivesse disponível. Introduzida com os primeiros colonizadores europeus, a hanseníase é doença endêmica no Brasil e um problema de saúde pública. A hanseníase é hiperendêmica em muitos municípios, notadamente nos estados das regiões Norte e Centro-Oeste, que abrangem biomas de cerrado, pântano e floresta amazônica, em vastas áreas de baixa densidade demográfica; estas áreas vêm sofrendo enorme pressão antrópica relacionada ao incremento de atividades agropecuárias e extrativistas...

Manifestações músculoesqueléticas e auto-anticorpos em crianças e adolescentes com hanseníase; Musculoskeletal manifestations and autoantibodies in children and adolescents with leprosy

Neder, Luciana
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 11/02/2014 PT
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Introdução: A hanseníase é uma doença infecciosa crônica causada pelo Mycobacterium leprae. É considerada um dos maiores problemas de saúde pública nos países em desenvolvimento. Os principais sinais clínicos são manchas de pele com perda de sensibilidade e envolvimento de nervos periféricos. Manifestações musculoesqueléticas são descritas em adultos, mas este envolvimento é raramente descrito na população pediátrica. Objetivo: Avaliar envolvimento musculoesquelético e auto-anticorpos em pacientes pediátricos com hanseníase. Métodos: Foram avaliados 50 pacientes com hanseníase e 47 crianças e adolescentes saudáveis de acordo com manifestações musculoesqueléticas (artralgia, artrite e mialgia), síndromes dolorosas musculoesqueléticas (fibromialgia juvenil, síndrome de hipermobilidade articular benigna, síndrome miofascial e tendinite) e painel de auto-anticorpos e crioglobulinas. Escores de avaliação de saúde e tratamento foram realizados nos pacientes com hanseníase. Resultados: A frequência de manifestações musculoesqueléticas foi maior em pacientes com hanseníase comparada aos controles (14% vs. 0%, p=0,0012). Cinco pacientes com hanseníase tinham poliartrite assimétrica das pequenas articulações das mãos (10% vs. 0%...

Leprosy treatment dropout: A sistematic review

Girão, Régio José Santiago; Soares, Nara Lívia Rezende; Pinheiro, Juliana Viana; Oliveira, Giuliano Da Paz; De Carvalho, Sionara Melo Figueiredo; De Abreu, Luiz Carlos; Valenti, Vitor E.; Fonseca, Fernando Luiz Affonso
Fonte: Universidade Estadual Paulista Publicador: Universidade Estadual Paulista
Tipo: Revisão
ENG
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Background: Leprosy is a chronic infectious disease endemic in some undeveloped areas, and still represents a public health problem in Brazil. Therefore, the control of this endemic disease depends necessarily on the institution of correct treatment and containment of treatment dropout. This study aims to conduct a systematic review of published studies on treatment dropout of leprosy. Methods. We conducted a systematic review of articles on treatment dropout of leprosy, published between january 2005 and april 2013, on MEDLINE and SciELO databases. The search was performed using the MeSH terms: leprosy; patients dropouts and the keywords: leprosy, treatment and noncompliance, leprosy in association, beside the equivalents in Portuguese. Results: There were originally 196 references. After analyzing the titles and abstracts of articles, 20 articles were obtained and included in the final sample. Discussion. Leprosy is a notifiable disease known as its disfiguring capability and the high rate of non-compliance to treatment. The low adhesion is responsible for the remaining potential sources of infection, irreversible complications, incomplete cure and, additionally, may lead to resistance to multiple drugs. Many factors are responsible for the interruption or dropout treatment: socioeconomic factors...

Leprosy neuropathy: clinical presentations

Nascimento,Osvaldo J M
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2013 EN
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Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. The different clinical presentations of the disease are determined by the quality of the host immune response. Early detection of leprosy and treatment by multidrug therapy are the most important steps in preventing deformity and disability. Thus the early recognition of the clinical leprosy presentation is essential. Mononeuritis, mononeuritis multiplex (MM), polyneuritis (MM summation) are the most frequent. The frequent anesthetic skin lesions are absent in the pure neuritic leprosy presentation form. Isolated peripheral nerve involvement is common, including the cranial ones. Arthritic presentation is occasionally seen, usually misdiagnosed as rheumatoid arthritis. Attention should be given to autonomic dysfunctions in leprosy. There are clinical presentations with severe neuropathic pain - painful small-fiber neuropathy. Leprous late-onset neuropathy (LLON) clinical presentation should be considered facing a patient who develop an inflammatory neuropathy many years after a previous skin leprosy treatment.

Clinical variables associated with leprosy reactions and persistence of physical impairment

Oliveira,Daniela Teles de; Sherlock,Jonnia; Melo,Enaldo Vieira de; Rollemberg,Karla Caroline Vieira; Paixao,Telma Rodrigues Santos da; Abuawad,Yasmin Gama; Simon,Marise do Vale; Duthie,Malcolm; Jesus,Amelia Ribeiro de
Fonte: Sociedade Brasileira de Medicina Tropical - SBMT Publicador: Sociedade Brasileira de Medicina Tropical - SBMT
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2013 EN
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Introduction Leprosy is a chronic disease that affects skin and peripheral nerves. Disease complications include reactional episodes and physical impairment. One World Health Organization (WHO) goal of leprosy programs is to decrease the number of grade 2 impairment diagnoses by 2015. This study aims to evaluate clinical factors associated with the occurrence of leprosy reactions and physical impairment in leprosy patients. Methods We conducted a retrospective study of data from medical records of patients followed in two important centers for the treatment of leprosy in Aracaju, Sergipe, Brazil, from 2005 to 2011. We used the chi-square test to analyze associations between the following categorical variables: gender, age, operational classification, clinical forms, leprosy reactions, corticosteroid treatment, and physical impairment at the diagnosis and after cure. Clinical variables associated with multibacillary leprosy and/or reactional episodes and the presence of any grade of physical impairment after cure were evaluated using the logistic regression model. Results We found that men were more affected by multibacillary forms, reactional episodes, and grade 2 physical impairment at diagnosis. Leprosy reactions were detected in a total of 40% of patients and all were treated with corticosteroids. However...

Genetics of leprosy reactions: an overview

Fava,Vinicius; Orlova,Marianna; Cobat,Aurélie; Alcaïs,Alexandre; Mira,Marcelo; Schurr,Erwin
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2012 EN
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Type-1 (T1R) and Type-2 (T2R) leprosy reactions (LR), which affect up to 50% of leprosy patients, are aggressive inflammatory episodes of sudden onset and highly variable incidence across populations. LR are often diagnosed concurrently with leprosy, but more frequently occur several months after treatment onset. It is not uncommon for leprosy patients to develop recurring reactional episodes; however, they rarely undergo both types of LR. Today, LR are the main cause of permanent disabilities associated with leprosy and represent a major challenge in the clinical management of leprosy patients. Although progress has been made in understanding the immunopathology of LR, the factors that cause a leprosy patient to suffer from LR are largely unknown. Given the impact that ethnic background has on the risk of developing LR, host genetic factors have long been suspected of contributing to LR. Indeed, polymorphisms in seven genes [Toll-like receptors (TLR)1, TLR2, nucleotide-binding oligomerisation domain containing 2, vitamin D receptor, natural resistance-associated macrophage protein 1, C4B and interleukin-6] have been found to be associated with one or more LR outcomes. The identification of host genetic markers with predictive value for LR would have a major impact on nerve damage control in leprosy. In this review...

Examining ERBB2 as a candidate gene for susceptibility to leprosy (Hansen’s disease) in Brazil

Araújo,Sérgio Ricardo Fernandes; Jamieson,Sarra Elisabeth; Dupnik,Kathryn Margaret; Monteiro,Glória Regina; Nobre,Maurício Lisboa; Dias,Márcia Sousa; Trindade Neto,Pedro Bezerra; Queiroz,Maria do Carmo Palmeira; Gomes,Carlos Eduardo Maia; Blackwell,J
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2014 EN
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Leprosy remains prevalent in Brazil. ErbB2 is a receptor for leprosy bacilli entering Schwann cells, which mediates Mycobacterium leprae-induced demyelination and the ERBB2 gene lies within a leprosy susceptibility locus on chromosome 17q11-q21. To determine whether polymorphisms at the ERBB2 locus contribute to this linkage peak, three haplotype tagging single nucleotide polymorphisms (tag-SNPs) (rs2517956, rs2952156, rs1058808) were genotyped in 72 families (208 cases; 372 individuals) from the state of Pará (PA). All three tag-SNPs were associated with leprosy per se [best SNP rs2517959 odds ratio (OR) = 2.22; 95% confidence interval (CI) 1.37-3.59; p = 0.001]. Lepromatous (LL) (OR = 3.25; 95% CI 1.37-7.70; p = 0.007) and tuberculoid (TT) (OR = 1.79; 95% CI 1.04-3.05; p = 0.034) leprosy both contributed to the association, which is consistent with the previous linkage to chromosome 17q11-q21 in the population from PA and supports the functional role of ErbB2 in disease pathogenesis. To attempt to replicate these findings, six SNPs (rs2517955, rs2517956, rs1810132, rs2952156, rs1801200, rs1058808) were genotyped in a population-based sample of 570 leprosy cases and 370 controls from the state of Rio Grande do Norte (RN) and the results were analysed using logistic regression analysis. However...

Vivências compartilhadas de filhos separados pela hanseníase no RN a luz da história oral de vida; Experiences shared by children of parents separated by leprosy at RN in the light of oral History of Life.

Cabral, Ana Michele de Farias
Fonte: Universidade Federal do Rio Grande do Norte; BR; UFRN; Programa de Pós-Graduação em Enfermagem; Assistência à Saúde Publicador: Universidade Federal do Rio Grande do Norte; BR; UFRN; Programa de Pós-Graduação em Enfermagem; Assistência à Saúde
Tipo: Dissertação Formato: application/pdf
POR
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Several epidemics marked the lives of individuals and communities in all historical periods, and a prime example is leprosy, infectious disease marked by stigma, prejudice and social exclusion. In the past, the compulsory isolation of patients with leprosy caused serious social and psychological problems, resulting in the separation and the partial or total disruption of the family relationship. Children deprived of this living, removed often inhumanely, were kept and bred in preventoriums / educational establishments. This study aimed to: rescue the oral history of life of the children of leprosy patients that were built in preventorium Osvaldo Cruz, Natal, Rio Grande do Norte; develop a contextual analysis about these children; know the life trajectory of children of leprosy patients institutionalized in preventoriums / educational establishments; produce a documentary on the history of life of children of parents separated by leprosy; forming MORHAN of Rio Grande do Norte state; and implement the I Meeting of MORHAN of Rio Grande do Norte state. This is an exploratory and descriptive study, with a qualitative approach, approved by the ERC No. 024/024/2012 Liga Norteriograndense Contra o Câncer. We used the contributions of the method and technique of oral history of life as methodological reference. We interviewed 10 individuals egress from preventorium Osvaldo Cruz in Natal/RN...

Marcadores moleculares, imunológicos e genéticos das reações hansênicas; Molecular markers, genetic and immunological reactions of leprosy

SOUSA, Ana Lúcia Osório Maroclo de
Fonte: Universidade Federal de Goiás; BR; UFG; Doutorado em Medicina Tropical; Ciências da Saúde Publicador: Universidade Federal de Goiás; BR; UFG; Doutorado em Medicina Tropical; Ciências da Saúde
Tipo: Tese de Doutorado Formato: application/pdf
POR
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Type 1 (T1R) and Type 2 (T2R) leprosy reactions are complications in the clinical management of leprosy patients because they can lead to neural damage and impairment, resulting in irreversible deformities and disabilities. This thesis, presented as research article/manuscript has investigated potential markers for the diagnosis and prognosis of leprosy reactions. In the first study, we evaluated a multicentric cohort of leprosy patients with single skin lesion which is considered the earliest clinical manifestation of the disease. In this study, at the moment of diagnosis a skin biopsy was collected for histopathology and for the investigation of Mycobacterium leprae DNA by polymerase chain reaction (ML-PCR). After diagnosis patients were treated with single dose of Rifampicin, Ofloxacin and Minocyclin (ROM) and were clinically monitored during 3 years .During follow up, around 15% of patients developed T1R. In multivariate analysis, age > 40 years and MLPCR positivity were associated with T1 manifestation. The second study aimed to identify potential circulating markers associated with leprosy reactions. Plasma levels of 27 cytokines/chemokines/growth factors were quantified by multiplex assay. A nested case control study compared the levels of these factors in leprosy patients with or without T1R and T2R. Leprosy patients were paired by sex...

Reatividade sorológica a proteínas recombinantes do Mycobacterium leprae em diferentes grupos populacionais de distintas regiões endêmicas do Brasil; Seroreactivity to new Mycobacterium leprae protein antigens in different leprosy endemic regions in Brazil

Pinto, Emerith Mayra Hungria
Fonte: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Medicina Tropical e Saúde Pública (IPTSP); Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG) Publicador: Universidade Federal de Goiás; Brasil; UFG; Programa de Pós-graduação em Medicina Tropical e Saúde Pública (IPTSP); Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG)
Tipo: Dissertação Formato: application/pdf
POR
Relevância na Pesquisa
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The development of laboratory tests applicable for the diagnosis/classification of the different clinical forms of leprosy is considered a research priority. The completion of Mycobacterium leprae genome together with new gene cloning/expression techniques and new bioinformatic tools have promoted the production and availability of new M. leprae recombinant proteins for immunologic assessment. Goal: This study assessed the serologic reactivity to M. leprae recombinant proteins among leprosy patients and controls from two hiperendemic regions in Brazil: “Rondonópolis/MT” and “Vila do Prata/Igarapé-Açú/PA” (former leprosy colony). Material and Methods: IgG antibodies to M. leprae recombinant proteins (92f, 46f, LID-1, ML0405 e ML1213; 2 g/ml) and IgM antibodies for the PGL-I synthetic trissacaride (NT-P-BSA; 0.01 g/ml) were detected by ELISA. The following study groups were included (n=847): newly diagnosed untreated leprosy patients (paucibacillary- PB and multibacillary- MB), household contacts of MB patients (HHC), healthy endemic controls (EC) and former MB that concluded leprosy multidrug therapy (MDT) (post MDT). Results: Among participants from Rondonópolis/MT (n=764), the seropositivity of MB patients (n=58) was 59% for 92f...

Caracterização clínica, epidemiológica e laboratorial das reações hansênicas durante e após poliquimioterapia: análise de potenciais fatores preditivos; Characterization Clinical, Epidemiological and Laboratory of leprosy reactions during and after Multidrug therapy: analysis of potential predictors

Antunes, Douglas Eulálio
Fonte: Universidade Federal de Uberlândia Publicador: Universidade Federal de Uberlândia
Tipo: Dissertação
POR
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37.25%
A hanseníase, doença infecciosa crônica causada pelo Mycobacterium leprae, ainda persiste como um problema de saúde pública no Brasil devido ao seu alto potencial de causar incapacidades físicas desencadeadas principalmente por reações hansênicas que podem ocorrer antes, durante e ou após a poliquimioterapia. O objetivo desse trabalho foi caracterizar as reações hansênicas no seu aspecto clínico, epidemiológico e laboratorial em pacientes diagnosticados no período de 2002 a 2009 em um Centro de Referência Nacional. Neste estudo observacional do tipo transversal utilizou-se fonte de dados secundárias, no qual foram avaliados 440 casos, com predomínio no grupo reacional da classificação operacional MB 80,5% (202/251), da forma clínica DT 33,9% (85/251), gênero masculino 68,5% (172/251), grupo étnico branco 53,4% (134/251) e faixa etária de 40 a 59 anos 52,2% (131/251). Do total de casos, 57% (251/440) apresentaram reações hansênicas, 47,9% (211/440) durante o tratamento e 35,9% (158/440) após a alta. O tipo de reação mais prevalente foi a do tipo1 com 64,5% (136/211) durante o tratamento, sendo que 73,5% (155/211) dos episódios reacionais ocorreram nos primeiros 3 meses, com média de 1,6 episódios por paciente; e 63...

A historical overview of leprosy epidemiology and control activities in Amazonas, Brazil

Cunha,Carolina; Pedrosa,Valderiza Lourenço; Dias,Luiz Carlos; Braga,Andréa; Chrusciak-Talhari,Anette; Santos,Mônica; Penna,Gerson Oliveira; Talhari,Sinésio; Talhari,Carolina
Fonte: Sociedade Brasileira de Medicina Tropical - SBMT Publicador: Sociedade Brasileira de Medicina Tropical - SBMT
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2015 EN
Relevância na Pesquisa
37.28%
Leprosy is an ancient infectious disease caused by Mycobacterium leprae. According to comparative genomics studies, this disease originated in Eastern Africa or the Near East and spread with successive human migrations. The Europeans and North Africans introduced leprosy into West Africa and the Americas within the past 500 years. In Brazil, this disease arrived with the colonizers who disembarked at the first colonies, Rio de Janeiro, Salvador and Recife, at the end of the sixteenth century, after which it was spread to the other states. In 1854, the first leprosy cases were identified in State of Amazonas in the north of Brazil. The increasing number of leprosy cases and the need for treatment and disease control led to the creation of places to isolate patients, known as leprosaria. One of them, Colonia Antônio Aleixo was built in Amazonas in 1956 according to the most advanced recommendations for isolation at that time and was deactivated in 1979. The history of the Alfredo da Matta Center (AMC), which was the first leprosy dispensary created in 1955, parallels the history of leprosy in the state. Over the years, the AMC has become one of the best training centers for leprosy, general dermatology and sexually transmitted diseases in Brazil. In addition to being responsible for leprosy control programs in the state...

Musculoskeletal manifestations and autoantibodies in children and adolescents with leprosy

Neder,Luciana; Rondon,Daniel A.; Cury,Silvana S.; Silva,Clovis A. da
Fonte: Sociedade Brasileira de Pediatria Publicador: Sociedade Brasileira de Pediatria
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2014 EN
Relevância na Pesquisa
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Objective:To evaluate musculoskeletal involvement and autoantibodies in pediatric leprosy patients.Methods:50 leprosy patients and 47 healthy children and adolescents were assessed according to musculoskeletal manifestations (arthralgia, arthritis, and myalgia), musculoskeletal pain syndromes (juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, and tendinitis), and a panel of autoantibodies and cryoglobulins. Health assessment scores and treatment were performed in leprosy patients.Results:At least one musculoskeletal manifestation was observed in 14% of leprosy patients and in none of the controls. Five leprosy patients had asymmetric polyarthritis of small hands joints. Nerve function impairment was observed in 22% of leprosy patients, type 1 leprosy reaction in 18%, and silent neuropathy in 16%. None of the patients and controls presented musculoskeletal pain syndromes, and the frequencies of all antibodies and cyoglobulins were similar in both groups (p > 0.05). Further analysis of leprosy patients demonstrated that the frequencies of nerve function impairment, type 1 leprosy reaction, and silent neuropathy were significantly observed in patients with versus without musculoskeletal manifestations (p = 0.0036...

The role of human T cell lymphotrophic virus type 1, hepatitis B virus and hepatitis C virus coinfections in leprosy

Machado,Paulo Roberto Lima; Johnson,Warren D; Glesby,Marshall J
Fonte: Instituto Oswaldo Cruz, Ministério da Saúde Publicador: Instituto Oswaldo Cruz, Ministério da Saúde
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/12/2012 EN
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Leprosy spectrum and outcome is associated with the host immune response against Mycobacterium leprae. The role of coinfections in leprosy patients may be related to a depression of cellular immunity or amplification of inflammatory responses. Leprosy remains endemic in several regions where human T cell lymphotrophic virus type 1 (HTLV-1), hepatitis B virus (HBV) or hepatitis C virus (HCV) are also endemic. We have evaluated the evidence for the possible role of these viruses in the clinical manifestations and outcomes of leprosy. HTLV-1, HBV and HCV are associated with leprosy in some regions and institutionalization is an important risk factor for these viral coinfections. Some studies show a higher prevalence of viral coinfection in lepromatous cases. Although HBV and HCV coinfection were associated with reversal reaction in one study, there is a lack of information about the consequences of viral coinfections in leprosy. It is not known whether clinical outcomes associated with leprosy, such as development of reactions or relapses could be attributed to a specific viral coinfection. Furthermore, whether the leprosy subtype may influence the progression of the viral coinfection is unknown. All of these important and intriguing questions await prospective studies to definitively establish the actual relationship between these entities.

T regulatory cells (TREG)(TCD4+CD25+FOXP3+) distribution in the different clinical forms of leprosy and reactional states

Parente,José Napoleão Tavares; Talhari,Carolina; Schettini,Antônio Pedro Mendes; Massone,Cesare
Fonte: Sociedade Brasileira de Dermatologia Publicador: Sociedade Brasileira de Dermatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2015 EN
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BACKGROUND: Leprosy is characterized histologically by a spectrum of different granulomatous skin lesions, reflecting patients' immune responses to Mycobacterium leprae. Although CD4+CD25+ FoxP3+ T regulatory cells are pivotal in the immuneregulation, presence, frequency, and distribution of Tregs in leprosy, its reactional states have been investigated in few studies. OBJECTIVES: This study aimed to verify the frequency and distribution of regulatory T cells in different clinical forms and reactional states of leprosy. METHODS: We performed an immunohistochemical study on 96 leprosy cases [Indeterminate (I): 9 patients; tuberculoid tuberculoid: 13 patients; borderline tuberculoid: 26 patients; borderline borderline: 3 patients; borderline lepromatous: 8 patients; lepromatous lepromatous: 27 patients; reversal reaction: 8 patients; and erythema nodosum leprosum: 2 patients]. RESULTS: FoxP3-positive cells were present in 100% of the cases with an average density of 2.82% of the infiltrate. Their distribution was not related to granulomatous structures or special locations. There was a statistically significant increment of FoxP3 expression in patients with leprosy reversal reactions when compared with patients presenting with type I leprosy (P= 0.0228); borderline tuberculoid leprosy (P = 0.0351) and lepromatous leprosy (P = 0.0344). CONCLUSIONS: These findings suggest that Tregs play a relevant role in the etiopathogenesis of leprosy...

Leprosy in China: epidemiological trends between 1949 and 1998

Chen,Xiang-Sheng; Li,Wen-Zhong; Jiang,Cheng; Ye,Gan-Yun
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
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OBJECTIVE: To report the epidemiological trends of leprosy in China from 1949 to 1998. METHODS: Data for the study were obtained from the computerized database of the National System of Leprosy Surveillance. FINDINGS: A total of 474 774 leprosy patients were detected during this 50-year period. Case detection rates per 100 000 population were highest in the 1950s and 1960s, with peaks appearing in 1957-58, 1963-66, 1969-70, and 1983-84, corresponding to mass surveys or screening surveys carried out in most areas or selected areas of the country. While the duration of the disease at the time of detection fell over the period, the disability rates, which were >50% in the early 1950s, have decreased gradually to 20.8% by 1997-98 but are still too high. More than 50% of cases were found through active methods in the periods 1955-58, 1965-66, and 1969-76, but in recent years cases are mostly detected through dermatological clinics or by voluntary reporting. The peak prevalences of the 1960s (i.e. >2 per 10 000 population) decreased annually from the 1970s onwards. By the end of 1998 the prevalence was 0.05 per 10 000 population. CONCLUSION: This study shows that leprosy was well controlled in China and that the WHO goal of elimination of leprosy as a public health problem has been achieved at the national and subnational levels. However...

Leprosy: too complex a disease for a simple elimination paradigm

Lockwood,Diana N.J.; Suneetha,Sujai
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/03/2005 EN
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Can leprosy be eliminated? This paper considers the question against the background of the WHO programme to eliminate leprosy. In 1991 the World Health Assembly set a target of eliminating leprosy as a public health problem by 2000. Elimination was defined as reaching a prevalence of < 1 case per 10 000 people. The elimination programme has been successful in delivering highly effective antibiotic therapy worldwide. However, despite this advance, new-case detection rates remain stable in countries with the highest rates of endemic leprosy, such as Brazil and India. This suggests that infection has not been adequately controlled by antibiotics alone. Leprosy is perhaps more appropriately classed as a chronic stable disease than as an acute infectious disease responsive to elimination strategies. In many countries activities to control and treat leprosy are being integrated into the general health-care system. This reduces the stigma associated with leprosy. However, leprosy causes long-term immunological complications, disability and deformity. The health-care activities of treating and preventing disabilities need to be provided in an integrated setting. Detecting new cases and monitoring disability caused by leprosy will be a challenge. One solution is to implement long-term surveillance in selected countries with the highest rates of endemic disease so that an accurate estimate of the burden of leprosy can be determined. It is also critical that broad-based research into this challenging disease continues until the problems are truly solved.