ArticlePLoS neglected tropical diseases2021
Active search strategies, clinicoimmunobiological determinants and training for implementation research confirm hidden endemic leprosy in inner São Paulo, Brazil.
Article in PLoS neglected tropical diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 39 citations in OpenAlex.
- RIMOXCLAMIN's Therapeutic Impact in a Larger Brazilian Hansen's Disease Population.Open forum infectious diseases · 2026Trial
- 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
- Efficiency of the Sensory Mapping Score for Hansens's disease diagnosis and follow-up: a functional cure criterion?Frontiers in medicine · 2025Article
- Participatory development of Indonesia's national action plan for zero leprosy: strategies and interventions.Frontiers in public health · 2025Article
- Integrating Community Engagement in Zero Leprosy Efforts: A Pathway to Sustainable Early Detection, Control and Elimination.Tropical medicine and infectious disease · 2024Article
- Exploring Active Case Detection Approaches for Leprosy Diagnosis in Varied Endemic Settings: A Comprehensive Scoping Review.Life (Basel, Switzerland) · 2024Article
- Body map stories from Colombia: experiences of people affected by leprosy and the influence of peers during diagnosis and treatment.International journal for equity in health · 2024Article
- Neurological features of Hansen disease: a retrospective, multicenter cohort study.Scientific reports · 2024Article
- Serological testing for Hansen's disease diagnosis: Clinical significance and performance of IgA, IgM, and IgG antibodies against Mce1A protein.Frontiers in medicine · 2023Article
- Simulation-based training in Leprosy: development and validation of a scenario for community health workers.Revista brasileira de enfermagem · 2023Article
- 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
- Bacilloscopy and polymerase chain reaction of slit-skin smears and anti-phenolic glycolipid-I serology for Hansen's disease diagnosis.Frontiers in medicine · 2022Article
- Article
- 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
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study evaluates implementation strategies for leprosy diagnosis based on responses to a Leprosy Suspicion Questionnaire (LSQ), and analyzes immunoepidemiological aspects and follow-up of individuals living in a presumptively nonendemic area in Brazil. METHODOLOGY/PRINCIPAL
findingsQuasi-experimental study based on LSQ throughout Jardinópolis town by community health agents, theoretical-practical trainings for primary care teams, dermatoneurological examination, anti-PGL-I serology, RLEP-PCR, and spatial epidemiology. A Leprosy Group (LG, n = 64) and Non-Leprosy Group (NLG, n = 415) were established. Overall, 3,241 LSQs were distributed; 1,054 (32.5%) LSQ were positive for signs/symptoms (LSQ+). Among LSQ+ respondents, Q2-Tingling (pricking)? (11.8%); Q4-Spots on the skin? (11.7%); Q7-Pain in the nerves? (11.6%); Q1-Numbness in your hands and/or feet? (10.7%) and Q8-Swelling of hands and feet? (8.5%) were most frequently reported symptoms. We evaluated 479 (14.8%) individuals and diagnosed 64 new cases, a general new case detection rate (NCDR) of 13.4%; 60 were among 300 LSQ+ (NCDR-20%), while 4 were among 179 LSQ negative (NCDR-2.23%). In LG, Q7(65%), Q2(60%), Q1(45%), Q4(40%) and Q8(25%) were most frequent. All 2x2 crossings of these 5 questions showed a relative risk for leprosy ranging from 3 to 5.8 compared with NLG. All patients were multibacillary and presented hypochromatic macules with loss of sensation. LG anti-PGL-I titers were higher than NLG, while 8.9% were positive for RLEP-PCR. The leprosy cases and anti-PGL-I spatial mappings demonstrated the disease spread across the town. CONCLUSIONS/SIGNIFICANCE: Implementation actions, primarily LSQ administration focused on neurological symptoms, indicate hidden endemic leprosy in a nonendemic Brazilian state.
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