title: Social contact patterns and leprosy disease: a case-control study in Bangladesh.
abstract: Socioeconomic and culturally defined social contact patterns are expected to be an important determinant in the continuing transmission of Mycobacterium leprae in leprosy-endemic areas. In a case-control study in two districts in Bangladesh, we assessed the association between social contact patterns and the risk of acquiring clinical leprosy. Social contacts of 90 recently diagnosed patients were compared to those of 199 controls. Leprosy was associated with a more intensive social contact pattern in the home [odds ratio (OR) 1·09, 95% confidence interval (CI) 1·00-1·19, P = 0·043] and in the nearby neighbourhood (OR 1·07, 95% CI 1·03-1·11, P = 0·001). Although it is known that M. leprae spreads most easily within households of infected persons, in endemic areas social contacts within the neighbourhood, village or urban ward, also appear to be important for transmission. We advise that disease control measures in leprosy-endemic areas should not be limited to households, but include high-risk groups in the nearby neighbourhood of patients.
authors.affiliation: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands.
authors.forename: S G
authors.initials: SG
authors.lastname: Feenstra
authors.affiliation: ICDDR, B, Health Systems and Infectious Diseases Division, Dhaka, Bangladesh.
authors.forename: Q
authors.initials: Q
authors.lastname: Nahar
authors.affiliation: The Leprosy Mission International Bangladesh, Rural Health Program, Dhaka, Bangladesh.
authors.forename: D
authors.initials: D
authors.lastname: Pahan
authors.affiliation: KIT Biomedical Research, Amsterdam, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Oskam
authors.affiliation: Erasmus MC, University Medical Center Rotterdam, Department of Public Health, Rotterdam, The Netherlands.
authors.forename: J H
authors.initials: JH
authors.lastname: Richardus
mesh_terms: D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007918:Leprosy / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission*; D008297:Male; D012111:Residence Characteristics; D012919:Social Behavior; D058992:Social Participation; D055815:Young Adult