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Leprosy among schoolchildren in the Amazon region: A cross-sectional study of active search and possible source of infection by contact tracing.
Pedrosa, Valderiza Lourenço; Dias, Luiz Claudio; Galban, Enrique; Leturiondo, André; Palheta, Jamile; Santos, Monica; Moraes, Milton Ozório; Talhari, Carolina.
Afiliação
  • Pedrosa VL; Departamento de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus, Brazil.
  • Dias LC; Departamento de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus, Brazil.
  • Galban E; Departamento de Epidemiologia, Facultad de Medicina Calixto García, La Habana, Cuba.
  • Leturiondo A; Departamento de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus, Brazil.
  • Palheta J; Departamento de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus, Brazil.
  • Santos M; Departamento de Ensino e Pesquisa, Fundação Alfredo da Matta, Manaus, Brazil.
  • Moraes MO; Escola de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, Brazil.
  • Talhari C; Laboratório de Hanseníase, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
PLoS Negl Trop Dis ; 12(2): e0006261, 2018 02.
Article em En | MEDLINE | ID: mdl-29481570
BACKGROUND: The high rate of leprosy cases among children under 15 years of age in Brazil indicates ongoing transmission within the community. The identification of the new leprosy cases among contacts can help identify the source of infection and interrupt the transmission chain. This study aims to determine the detection rate of previously undiagnosed cases of leprosy among schoolchildren who are under 15 years of age living in Manaus, Amazonas, Brazil, and their possible source of infection by contact tracing. METHODOLOGY/PRINCIPAL FINDINGS: This was a school-based, cross-sectional study in which the identification of active leprosy cases was conducted in 277 out of 622 randomly selected public schools in Manaus, Amazonas, Brazil. Suspected cases of leprosy were referred to the Alfredo da Matta Foundation, a reference center for leprosy in Manaus. A total of 34,547 schoolchildren were examined, and 40 new leprosy cases were diagnosed. Among new cases, 57.5% were males, and 80.0% demonstrated paucibacillary leprosy. A total of 196 of 206 registered contacts were screened, and 52.5% of the newly diagnosed children's cases had at least one positive household contact. In these contacts, grandparents (52.4%) were the most common co-prevalent cases, while 14.3% were uncles, 9.5% were parents and 9.5% were granduncles. Seven contacts (5.0%), including four siblings of child patients were newly diagnosed. Our data indicate that the prevalence is 11.58 per 10,000, which is 17 times higher than the registered rate. CONCLUSIONS/SIGNIFICANCE: This study suggests that the detection rate of leprosy among schoolchildren may have remained unchanged over the past thirty years. It also indicates that that active case finding is necessary for reaching the World Health Organization's goals of zero detection among children, especially in endemic areas where the prevalence of leprosy is obscure. Moreover, we assert that all children must have their household contacts examined in order to identify the possible source of infection and interrupt the disease's transmission. Novel strategies to reinforce contact tracing associated with large-scale strategies of chemo- and immune-prophylaxis should be expanded to prevent the perpetuation of the disease cycle.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Busca de Comunicante / Hanseníase Paucibacilar / Hanseníase Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS Negl Trop Dis Assunto da revista: MEDICINA TROPICAL Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Busca de Comunicante / Hanseníase Paucibacilar / Hanseníase Tipo de estudo: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Child / Child, preschool / Female / Humans / Male País/Região como assunto: America do sul / Brasil Idioma: En Revista: PLoS Negl Trop Dis Assunto da revista: MEDICINA TROPICAL Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Estados Unidos