Description of leprosy classification at baseline among patients enrolled at the uniform multidrug therapy clinical trial for leprosy patients in Brazil.
The uniform multidrug therapy clinical trial, Brazil (U-MDT/CT-BR), database was used to describe and report the performance of available tools to classify 830 leprosy patients as paucibacillary (PB) and multibacillary (MB) at baseline. In a modified Ridley and Jopling (R&J) classification, considering clinical features, histopathological results of skin biopsies and the slit-skin smear bacterial load results were used as the gold standard method for classification. Anti-phenolic glycolipid-I (PGL-I) serology by ML Flow test, the slit skin smear bacterial load, and the number of skin lesions were evaluated. Considering the R&J classification system as gold standard, ML Flow tests correctly allocated 70% patients in the PB group and 87% in the MB group. The classification based on counting the number of skin lesions correctly allocated 46% PB patients and 99% MB leprosy cases. Slit skin smears properly classified 91% and 97% of PB and MB patients, respectively. Based on U-MDT/CT-BR results, classification of leprosy patients for treatment purposes is unnecessary because it does not impact clinical and laboratories outcomes. In this context, the identification of new biomarkers to detect patients at a higher risk to develop leprosy reactions or relapse remains an important research challenge.
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Rodrigo Scaliante
RS
Moura
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Gerson Oliveira
GO
Penna
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Ludimila Paula Vaz
LP
Cardoso
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Maria Araci
MA
de Andrade Pontes
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Rossilene
R
Cruz
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Heitor
H
de Sá Gonçalves
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Maria Lúcia
ML
Fernandes Penna
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil.
Mariane Martins
MM
de Araújo Stefani
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil samira@buhrer.net.
Samira
S
Bührer-Sékula
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use*; D007918:Leprosy / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D056006:Leprosy, Multibacillary / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D056005:Leprosy, Paucibacillary / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000382:microbiology / Q000473:pathology; D055815:Young Adult
D007917:Leprostatic Agents