title: Active surveillance of leprosy contacts in country with low prevalence rate.
abstract: For advanced control of leprosy in Pakistan where the World Health Organization leprosy elimination goal was achieved in 1996, we conducted surveillance of Mycobacterium leprae-seropositive patients and their contacts and drug resistant strains of M. leprae. We measured anti-PGL-I antibody level in sera from leprosy patients and their contacts for early detection of M. leprae infection. Out of 34 leprosy patients undergoing treatment, 4 lepromatous leprosy patients were antibody positive, and 6.8 to 23.7 percent of occupational or household contacts were seropositive. Furthermore, three cases (1.2%) had a high antibody titer. For surveillance of drug resistant strains of M. leprae, dapsone and rifampin were targeted. Four out of 18 polymerase chain reaction (PCR) positive samples had mutation in folP gene, and among 10 PCR positive samples, one had a mutation in the rpoB gene. These results indicate that serological analysis of patient contacts might be useful to find out high risk individuals, and there are M. leprae strains resistant to chemotherapeutic agents in Pakistan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kai
authors.forename: Yumi
authors.initials: Y
authors.lastname: Maeda
authors.forename: Shinji
authors.initials: S
authors.lastname: Maeda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Fukutomi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Kashiwabara
authors.forename: Masahiko
authors.initials: M
authors.lastname: Makino
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Abbasi
authors.forename: Muhammad Zubair
authors.initials: MZ
authors.lastname: Khan
authors.forename: Pervez Ali
authors.initials: PA
authors.lastname: Shah
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial / Q000276:immunology; D002648:Child; D012321:DNA-Directed RNA Polymerases / Q000235:genetics; D003622:Dapsone / Q000494:pharmacology; D024881:Drug Resistance, Bacterial / Q000235:genetics; D005191:Family Characteristics; D006017:Glycolipids / Q000276:immunology; D006801:Humans; D007917:Leprostatic Agents / Q000494:pharmacology; D007918:Leprosy / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D015440:Leprosy, Lepromatous / Q000097:blood / Q000453:epidemiology; D009166:Mycobacterium leprae / Q000187:drug effects / Q000235:genetics; D016273:Occupational Exposure; D010154:Pakistan / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence; D012293:Rifampin / Q000494:pharmacology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D006017:Glycolipids; D007917:Leprostatic Agents; C045169:phenolic glycolipid I, Mycobacterium leprae; D003622:Dapsone; D012321:DNA-Directed RNA Polymerases; C105078:RNA polymerase beta subunit; D012293:Rifampin