Tuberculosis in leprosy patients detected between 1902 and 1991 in French Polynesia.
From 1902 onward, notification and follow up of leprosy patients has been systematic in French Polynesia. Since 1960, a tuberculosis control program and a register has also been implemented. From 1902 to 1959, 673 cases of leprosy were detected [346 multibacillary (MB), 138 paucibacillary (PB), and 179 unclassified due to the loss of medical files by the time of classification which was done during the 1980s]. Of these 673 cases, 89 (13.2%) died from tuberculosis, giving a mean annual death rate of tuberculosis in leprosy patients of 232 per 100,000. Mortality from tuberculosis in leprosy patients detected between 1901 and 1930 was 20.7%, and decreased to 8.04% in patients detected from 1931 to 1959. In total, it was estimated that 26.4% of the leprosy cases had developed tuberculosis. From 1960 to 1991, 350 new cases of leprosy were detected (141 MB, 209 PB). Of them, 12 (3.4%) developed tuberculosis (7 before detection of leprosy, 5 after detection of leprosy). The dramatic decrease of the proportion of leprosy patients who developed tuberculosis between the periods 1902-1959 (26.4%) and 1960-1991 (3.4%) might be related to the important decline of the tuberculosis situation since 1960. From 1902 to 1959, mortality from tuberculosis occurred significantly more frequently in MB patients (13%) than in PB patients [4%, relative risk (RR) = 3.21, p = 0.003]. From 1960 to 1991, the incidence of tuberculosis seemed more frequent in MB patients (RR = 2.96, p = 0.07) whatever the sequence of detection of the two diseases. Our study suggests that lepromatous patients could share factors of susceptibility to mycobacterial diseases with patients developing tuberculosis.
Glaziou
P
P
Institut Territorial de Récherches Médicales Louis Malardé, Papéete, Tahiti, French Polynesia.
Cartel
J L
JL
Moulia-Pelat
J P
JP
Ngoc
L N
LN
Chanteau
S
S
Plichart
R
R
Grosset
J H
JH
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D049673:History, 20th Century; D006801:Humans; D015994:Incidence; D015440:Leprosy, Lepromatous / Q000266:history* / Q000401:mortality; D015441:Leprosy, Tuberculoid / Q000266:history* / Q000401:mortality; D008137:Longitudinal Studies; D008297:Male; D011114:Polynesia / Q000453:epidemiology; D012042:Registries; D012307:Risk Factors; D014376:Tuberculosis / Q000266:history* / Q000401:mortality