title: Infection by Mycobacterium leprae of household contacts of lepromatous leprosy patients from a post-elimination leprosy region of Colombia.
abstract: The Leprosy Control Program of Antioquia, (post-elimination leprosy state of Colombia), had registered by 1999, 56 lepromatous leprosy patients and their household contacts (HHC). Our interest was to detect Mycobacterium leprae infection in these HHC. Clinical examination, acid-fast bacillary staining (AFB) in nasal secretions, and slit skin samples, IgM anti-PGL-I in serum and Lepromine A (Mitsuda) reactivity were tested. Two hundred forty eight HHC were studied, 49% were male. After clinical examination, two HHC were diagnosed as multi bacillary patients; 13% showed positive IgM anti-PGL-I titers; Mitsuda reaction (> or = 4 mm) was positive in 59%; AFB was negative in all samples, except in the two new patients. HHC were classified according to test results. Group 1: two new multi bacillary patients. Group 2: 15 HHC seropositive, Mitsuda-negative. Group 3: 13 HHC seropositive, Mitsuda-positive. Group 4: 130 HHC seronegative, Mitsuda-positive. Group 5: 88 HHC seronegative, Mitsuda-negative. These results are an indication that the transmission of the infection is still happening in a region considered in the post elimination phase. The two new patients represent an infection source for others contacts, and groups 2 and 3 are infected HHC that could develop the disease in future. Follow up of high risk population is necessary to achieve real elimination of leprosy.
authors.affiliation: Laboratorio de Microbiología, Instituto Colombiano de Medicina Tropical-Instituto de Ciencias de la Salud, AA 52162, Medellín, Colombia. ncardona@ces.edu.co
authors.forename: Nora M
authors.initials: NM
authors.lastname: Cardona-Castro
authors.forename: Sandra
authors.initials: S
authors.lastname: Restrepo-Jaramillo
authors.forename: Myriam
authors.initials: M
authors.lastname: Gil de la Ossa
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Brennan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006017:Glycolipids / Q000097:blood*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007428:Intradermal Tests; D007916:Lepromin / Q000276:immunology*; D015440:Leprosy, Lepromatous / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000276:immunology*; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D006017:Glycolipids; D007074:Immunoglobulin G; C045169:phenolic glycolipid I, Mycobacterium leprae; D007916:Lepromin