ArticlePLoS neglected tropical diseases2020
Leprosy in a prison population: A new active search strategy and a prospective clinical analysis.
Article in PLoS neglected tropical diseases, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 21 citations in OpenAlex.
- 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
- Serum geoepidemiology of leprosy biomarkers in a city-wide COVID-19 survey in Brazil.BMC infectious diseases · 2026Article
- Development and validation of a machine learning approach for screening new leprosy cases based on the leprosy suspicion questionnaire.Scientific reports · 2025Article
- Article
- Toxoplasmosis Behind Bars: One Health Approach on Serosurvey Dynamics and Associated Risk Factors for Women Inmates, Correctional Officers, and In-Prison Feral Cats.Transboundary and emerging diseases · 2024Article
- Evaluating active leprosy case identification methods in six districts of Nepal.Infectious diseases of poverty · 2023Article
- Validation of a Simple Instrument of Fast Application to Track Disability in Leprosy Patients.Revista brasileira de ortopedia · 2023Article
- Article
- Serological Immunoassay for Hansen's Disease Diagnosis and Monitoring Treatment: Anti-Mce1A Antibody Response Among Hansen's Disease Patients and Their Household Contacts in Northeastern Brazil.Frontiers in medicine · 2022Article
- Innovative tracking, active search and follow-up strategies for new leprosy cases in the female prison population.PLoS neglected tropical diseases · 2021Article
- Active search strategies, clinicoimmunobiological determinants and training for implementation research confirm hidden endemic leprosy in inner São Paulo, Brazil.PLoS neglected tropical diseases · 2021Article
- Hidden leprosy in a low-endemic area in southern Brazil: changes in endemicity following an active search.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
- Leprosy case series in the emergency room: A warning sign for a challenging diagnosis.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesArticle
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Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study evaluates an active search strategy for leprosy diagnosis based on responses to a Leprosy Suspicion Questionnaire (LSQ), and analyzing the clinical, immunoepidemiological and follow-up aspects for individuals living in a prison population.
methodsA cross-sectional study based on a questionnaire posing 14 questions about leprosy symptoms and signs that was distributed to 1,400 prisoners. This was followed by dermatoneurological examination, anti-PGL-I serology and RLEP-PCR. Those without leprosy were placed in the Non-leprosy Group (NLG, n = 1,216) and those diagnosed with clinical symptoms of leprosy were placed in the Leprosy Group (LG, n = 34).
findingsIn total, 896 LSQ were returned (64%), and 187 (20.9%) of the responses were deemed as positive for signs/symptoms, answering 2.7 questions on average. Clinically, 1,250 (89.3%) of the prisoners were evaluated resulting in the diagnosis of 34 new cases (LG), based on well-accepted clinical signs and symptoms, a new case detection rate of 2.7% within this population, while the NLG were comprised of 1,216 individuals. The confinement time medians were 39 months in the LG while it was 36 months in the NLG (p>0.05). The 31 leprosy cases who responded to the questionnaire (LSQ+) had an average of 1.5 responses. The symptoms "anesthetized skin area" and "pain in nerves" were most commonly mentioned in the LG while "tingling, numbness in the hands/feet", "sensation of pricks and needles", "pain in nerves" and "spots on the skin" responses were found in more than 30% of questionnaires in the NLG. Clinically, 88.2% had dysesthetic macular skin lesions and 97.1% presented some peripheral nerve impairment, 71.9% with some degree of disability. All cases were multibacillary, confirming a late diagnosis. Anti-PGL-I results in the LG were higher than in the NLG (p<0.0001), while the RLEP-PCR was positive in 11.8% of the patients.
interpretationOur findings within the penitentiary demonstrated a hidden prevalence of leprosy, although the individuals diagnosed were likely infected while living in their former communities and not as a result of exposure in the prison. The LSQ proved to be an important screening tool to help identify leprosy cases in prisons.
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