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Int J Lepr Other Mycobact Dis ; 68(3): 247-57, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11221086

RESUMEN

In Brazil, there is little information about the clinical and epidemiological characteristics of paucibacillary, single skin lesion leprosy patients (SSL-PB). Only recently has the official notification system distinguished leprosy patients with a single lesion as a clinical entity, for whom the single-dose ROM (rifampin, ofloxacin and minocycline) regimen has been recommended. In this paper, we describe the baseline clinical features and the immunological background of a multicenter cohort of SSL-PB leprosy cases enrolled between December 1997-1998. Patients were recruited at health centers located in the following regions: Southeast = Rio de Janeiro; North = Amazon and Rondônia states and Center-West = Goiás state. Eligible cases were newly detected, untreated single-lesion leprosy patients without thickened nerve involvement, and were assessed by clinical, bacilloscopic and histopathological exams. The Mitsuda skin test and anti-PGL-I serology (ELISA) were also performed. Of the 299 SSL-PB leprosy patients, 259 (86.6%) fulfilled the criteria for single-dose ROM intervention. Our results showed that patients recruited from different sites had similar features, considering the clinical and immunological profiles. There was a predominance of adults (mean age 32.4; S.D. = 16.0), and a BCG scar was detected in 76.7% of the children (< or = 15 years old). Only 7 cases were diagnosed as the multibacillary type, representing less than 3% of the patients being misclassified. Our data indicate that in Brazil SSL-PB case ascertainment based on clinical and bacilloscopic criteria can be accurately defined under a routine control program; 75.0% of SSL-PB cases were Mitsuda positive (> or = 5 mm) and seropositivity for anti-PGL-I was detected in 17.3% of the patients. These data are compatible with effective cell-mediated immunity and low bacillary load, suggesting favorable clinical outcomes for most SSL-PB participants of this cohort.


Asunto(s)
Lepra Lepromatosa/patología , Mycobacterium leprae/aislamiento & purificación , Selección de Paciente , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antiinfecciosos/administración & dosificación , Antiinfecciosos/uso terapéutico , Biopsia , Brasil/epidemiología , Niño , Estudios de Cohortes , Quimioterapia Combinada , Escolaridad , Femenino , Humanos , Leprostáticos/administración & dosificación , Leprostáticos/uso terapéutico , Lepra Lepromatosa/tratamiento farmacológico , Lepra Lepromatosa/epidemiología , Lepra Lepromatosa/microbiología , Masculino , Persona de Mediana Edad , Minociclina/administración & dosificación , Minociclina/uso terapéutico , Mycobacterium leprae/crecimiento & desarrollo , Ofloxacino/administración & dosificación , Ofloxacino/uso terapéutico , Rifampin/administración & dosificación , Rifampin/uso terapéutico
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