Multiplex PCR technique could be an alternative approach for early detection of leprosy among close contacts--a pilot study from India.
BACKGROUND
Implementation of Multi drug Therapy (MDT) regimen has resulted in the decline of the total number of leprosy cases in the world. Though the prevalence rate has been declining, the incidence rate remains more or less constant and high in South East Asian countries particularly in India, Nepal, Bangladesh, Pakistan and Srilanka. Leprosy, particularly that of multibacillary type spreads silently before it is clinically detected. An early detection and treatment would help to prevent transmission in the community. Multiplex PCR (M-PCR) technique appears to be promising towards early detection among contacts of leprosy cases.


METHODS
A total of 234 paucibacillary (PB) and 205 multibacillary (MB) leprosy cases were studied in a community of an endemic area of Bankura district of West Bengal (Eastern India). They were assessed by smear examination for acid-fast bacilli (AFB) and M-PCR technique. These patients were treated with Multidrug Therapy (MDT) as prescribed by WHO following detection. A total of 110 MB and 72 PB contacts were studied by performing M-PCR in their nasal swab samples.


RESULTS
83.4% of MB patients were observed to be positive by smear examination for AFB and 89.2% by M-PCR. While 22.2% of PB patients were found to be positive by smear examination for AFB, 80.3% of these patients were positive by M-PCR. Among leprosy contacts (using M-PCR), 10.9% were found to be positive among MB contacts and 1.3% among PB contacts. Interestingly, two contacts of M-PCR positive MB cases developed leprosy during the period of two years follow up.


CONCLUSIONS
The M-PCR technique appears to be an efficient tool for early detection of leprosy cases in community based contact tracing amongst close associates of PB and MB cases. Early contact tracing using a molecular biology tool can be of great help in curbing the incidence of leprosy further.
Banerjee
Surajita
S
Department of Biochemistry, IPGME&R, Kolkata, India.
Sarkar
Kamalesh
K
Gupta
Soma
S
Mahapatra
Prasanta Sinha
PS
Gupta
Siddhartha
S
Guha
Samudra
S
Bandhopadhayay
Debasis
D
Ghosal
Chaitry
C
Paine
Suman Kalyan
SK
Dutta
Rathindra Nath
RN
Biswas
Nibir
N
Bhattacharya
Basudev
B
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000379:methods; D042241:Early Diagnosis; D006801:Humans; D007194:India; D007918:Leprosy / Q000175:diagnosis* / Q000188:drug therapy; D008853:Microscopy / Q000379:methods; D010865:Pilot Projects; D016133:Polymerase Chain Reaction / Q000379:methods*
D000900:Anti-Bacterial Agents