title: Risk factors for leprosy reactions in three endemic countries.
abstract: The objective of this study was to ascertain risk factors for complications (reactions or neuritis) in leprosy patients at the time of diagnosis in three leprosy-endemic countries. Newly diagnosed patients were enrolled in Brazil, the Philippines, and Nepal, and risk factors for reactions and neuritis were assessed using a case-control approach: "cases" were patients with these complications, and controls were patients without complications. Of 1,972 patients enrolled in this study, 22% had complications before treatment. Type 1 reaction was diagnosed in 13.7% of patients, neuritis alone in 6.9.%, and type 2 reaction in 1.4%. The frequency of these complications was higher in Nepal, in lepromatous patients, in males, and in adults versus children. Reactions and neuritis were seen in patients at diagnosis, before treatment was started. Reactions were seen in adults and children, even in patients with only a single lesion. Neuritis was often present without other signs of reaction. Reactions and neuritis were more likely to occur in lepromatous patients, and were more likely to be seen in adults than in children.
authors.affiliation: National Hansen's Disease Programs, Baton Rouge, Louisiana; Federal University of Goias, Institute of Tropical Pathology and Public Health, Goias, Brazil; Federal University of Pernambuco, Tropical Medicine Department, Recife, Pernambuco, Brazil; Fundação de Dermatologia Tropical Alfredo da Matta, Manaus, Amazonas, Brazil; Leonard Wood Memorial Center for Leprosy Research, Cebu, Republic of The Philippines; Lalgadh Leprosy Hospital and Services Center, Dhanusha District, Nepal dscollard@hrsa.gov.
authors.forename: David M
authors.initials: DM
authors.lastname: Scollard
authors.affiliation: National Hansen's Disease Programs, Baton Rouge, Louisiana; Federal University of Goias, Institute of Tropical Pathology and Public Health, Goias, Brazil; Federal University of Pernambuco, Tropical Medicine Department, Recife, Pernambuco, Brazil; Fundação de Dermatologia Tropical Alfredo da Matta, Manaus, Amazonas, Brazil; Leonard Wood Memorial Center for Leprosy Research, Cebu, Republic of The Philippines; Lalgadh Leprosy Hospital and Services Center, Dhanusha District, Nepal.
authors.forename: Celina M T
authors.initials: CM
authors.lastname: Martelli
authors.affiliation: National Hansen's Disease Programs, Baton Rouge, Louisiana; Federal University of Goias, Institute of Tropical Pathology and Public Health, Goias, Brazil; Federal University of Pernambuco, Tropical Medicine Department, Recife, Pernambuco, Brazil; Fundação de Dermatologia Tropical Alfredo da Matta, Manaus, Amazonas, Brazil; Leonard Wood Memorial Center for Leprosy Research, Cebu, Republic of The Philippines; Lalgadh Leprosy Hospital and Services Center, Dhanusha District, Nepal.
authors.forename: Mariane M A
authors.initials: MM
authors.lastname: Stefani
authors.affiliation: National Hansen's Disease Programs, Baton Rouge, Louisiana; Federal University of Goias, Institute of Tropical Pathology and Public Health, Goias, Brazil; Federal University of Pernambuco, Tropical Medicine Department, Recife, Pernambuco, Brazil; Fundação de Dermatologia Tropical Alfredo da Matta, Manaus, Amazonas, Brazil; Leonard Wood Memorial Center for Leprosy Research, Cebu, Republic of The Philippines; Lalgadh Leprosy Hospital and Services Center, Dhanusha District, Nepal.
authors.forename: Maria de Fatima
authors.initials: Mde F
authors.lastname: Maroja
authors.affiliation: National Hansen's Disease Programs, Baton Rouge, Louisiana; Federal University of Goias, Institute of Tropical Pathology and Public Health, Goias, Brazil; Federal University of Pernambuco, Tropical Medicine Department, Recife, Pernambuco, Brazil; Fundação de Dermatologia Tropical Alfredo da Matta, Manaus, Amazonas, Brazil; Leonard Wood Memorial Center for Leprosy Research, Cebu, Republic of The Philippines; Lalgadh Leprosy Hospital and Services Center, Dhanusha District, Nepal.
authors.forename: Laarni
authors.initials: L
authors.lastname: Villahermosa
authors.affiliation: National Hansen's Disease Programs, Baton Rouge, Louisiana; Federal University of Goias, Institute of Tropical Pathology and Public Health, Goias, Brazil; Federal University of Pernambuco, Tropical Medicine Department, Recife, Pernambuco, Brazil; Fundação de Dermatologia Tropical Alfredo da Matta, Manaus, Amazonas, Brazil; Leonard Wood Memorial Center for Leprosy Research, Cebu, Republic of The Philippines; Lalgadh Leprosy Hospital and Services Center, Dhanusha District, Nepal.
authors.forename: Fe
authors.initials: F
authors.lastname: Pardillo
authors.affiliation: National Hansen's Disease Programs, Baton Rouge, Louisiana; Federal University of Goias, Institute of Tropical Pathology and Public Health, Goias, Brazil; Federal University of Pernambuco, Tropical Medicine Department, Recife, Pernambuco, Brazil; Fundação de Dermatologia Tropical Alfredo da Matta, Manaus, Amazonas, Brazil; Leonard Wood Memorial Center for Leprosy Research, Cebu, Republic of The Philippines; Lalgadh Leprosy Hospital and Services Center, Dhanusha District, Nepal.
authors.forename: Krishna B
authors.initials: KB
authors.lastname: Tamang
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007918:Leprosy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D010679:Philippines / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult