ArticlePLoS neglected tropical diseases2017
Unexpectedly high leprosy seroprevalence detected using a random surveillance strategy in midwestern Brazil: A comparison of ELISA and a rapid diagnostic test.
Article in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 6 of them syntheses that pooled it.
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Who cites it
50 citing papers in PubMed, 6 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- The Predictive Role of Biomarkers for Leprosy Prophylaxis in Contacts of Patients Who Are Indices of the Disease: A Systematic Review of the Literature.Mediators of inflammation · 2026Pooled it
- Innovative technologies to address neglected tropical diseases in African settings with persistent sociopolitical instability.Nature communications · 2024Pooled it
- Effectiveness and safety of multidrug therapy containing clofazimine for paucibacillary leprosy and clarithromycin for rifampicin-resistant leprosy: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Accuracy of rapid point-of-care serological tests for leprosy diagnosis: a systematic review and meta-analysis.Memorias do Instituto Oswaldo Cruz · 2022Pooled it
- Leprosy detection rate in patients under immunosuppression for the treatment of dermatological, rheumatological, and gastroenterological diseases: a systematic review of the literature and meta-analysis.BMC infectious diseases · 2021Pooled it
- Leprosy in children under 15 years of age in Brazil: A systematic review of the literature.PLoS neglected tropical diseases · 2018Pooled it
- Hidden burden of leprosy in incarcerated populations in northeast Brazil: active case detection and serological assessment.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Observational
- Seroprevalence ofThe Lancet regional health. Southeast Asia · 2026Article
- Serum geoepidemiology of leprosy biomarkers in a city-wide COVID-19 survey in Brazil.BMC infectious diseases · 2026Article
- Molecular Detection ofTropical medicine and infectious disease · 2025Review
- Large-scale field application of a fingerstick blood test for Mycobacterium leprae infection: Monitoring population-wide effects of case finding and post-exposure prophylaxis on transmission in the Comoros and Madagascar.PLOS global public health · 2025Article
- Leprosy in the 21st century: a comprehensive review of immunological mechanisms, diagnosis, and treatment.Revista do Instituto de Medicina Tropical de Sao Paulo · 2025Review
- Slit skin smear versus anti-phenolic glycolipid-I serology in diagnosis of leprosy: a cross sectional study.Archives of dermatological research · 2024Article
- Exploring Active Case Detection Approaches for Leprosy Diagnosis in Varied Endemic Settings: A Comprehensive Scoping Review.Life (Basel, Switzerland) · 2024Article
- A cost-effectiveness analysis of a novel algorithm to sequentially diagnose leprosy based on manufactured tests under the SUS perspective.Cadernos de saude publica · 2024Article
- ELISA-R: an R-based method for robust ELISA data analysis.Frontiers in immunology · 2024Article
- Challenges and advances in serological and molecular tests to aid leprosy diagnosis.Experimental biology and medicine (Maywood, N.J.) · 2023Review
- Effectiveness of population-wide screening and mass drug administration for leprosy control in Kiribati: the COMBINE protocol.BMJ open · 2023Article
- Serological testing for Hansen's disease diagnosis: Clinical significance and performance of IgA, IgM, and IgG antibodies against Mce1A protein.Frontiers in medicine · 2023Article
- ELISA Test Based on the Phenolic Glycolipid-I (PGL-I) ofPathogens (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
12 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeprosy diagnosis is mainly based on clinical evaluation, although this approach is difficult, especially for untrained physicians. We conducted a temporary campaign to detect previously unknown leprosy cases in midwestern Brazil and to compare the performance of different serological tests.
methodsA mobile clinic was stationed at the main bus terminal in Brasília, Brazil. Volunteers were quizzed and given a clinical exam to allow categorization as either patients, known contacts of patients or non-contacts, and blood was collected to determine anti-PGL-I and anti-LID-1 antibody titers by ELISA and by the NDO-LID rapid test. New cases of leprosy and the impact of performing this broad random surveillance strategy were evaluated. Accuracy values and concordance between the test results were evaluated among all groups.
resultsFour hundred thirty-four individuals were evaluated, and 44 (10.1%) were diagnosed with leprosy. Borderline forms were the most frequent presentation. Both tests presented higher positivity in those individuals with multibacillary disease. Serological tests demonstrated specificities arround 70% for anti-PGL-1 and anti-LID ELISA; and arround 40% for NDO-LID. Sensitivities ranged from 48 to 62%. A substantial agreement between NDO-LID and ELISA with concomitant positive results was found within leprosy patients (Kappa index = 0.79 CI95% 0.36-1.22).
conclusionsThe unexpectedly high leprosy prevalence in this population indicates ongoing community-based exposure to Mycobacterium leprae antigens and high rates of subclinical infection. All tests showed low specificity and sensitivity values and therefore cannot be considered for use as stand-alone diagnostics. Rather, considering their positivity among MB patients and non-patients, these tests can be considered effective tools for screening and identifying individuals at high risk who might benefit from regular monitoring.
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