title: Widespread nasal carriage of Mycobacterium lepraeamong a healthy population in a hyperendemic region of northeastern Brazil.
abstract: A case-control study was conducted to determine the presence ofMycobacterium lepraeDNA in nasal secretions of leprosy cases and nonleprosy individuals in Fortaleza, Brazil. It included 185 cases identified by physicians at the Dona Libânia National Reference Centre for Sanitary Dermatology (CDERM). A control group (Co) (n = 136) was identified among individuals from CDERM not diagnosed as leprosy cases. To augment the spatial analysis of M. leprae specific repetitive element (RLEP) positive prevalence, an external group (EG) (n = 121), a convenience sample of healthy students, were included. Polymerase chain reaction for the RLEP sequence was conducted for all participants. Prevalence of RLEP positivity for cases and Co were 69.2% and 66.9%, respectively, significantly higher than for EG (28.1%), and reported elsewhere. Male sex, belonging to a lower socioeconomic status (D/E), history of a previous contact with a case and being older, were associated with being a leprosy case. Our geographical analysis demonstrated that the bacillus is widespread among the healthy population, with clusters of RLEP positive multibacillary cases concentrated in distinct areas of the city. Our results suggest that in endemic areas, as in Fortaleza, surveillance for both nonhousehold leprosy contacts and members of the general population living in cluster areas should be implemented.
authors.affiliation: Seção de Bacteriologia e Micologia, Instituto Evandro Chagas, Belém, PA, Brasil.
authors.forename: Luana Nepomuceno Gondim Costa
authors.initials: LN
authors.lastname: Lima
authors.affiliation: Departamento de Patologia e Medicina Legal, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Cristiane Cunha
authors.initials: CC
authors.lastname: Frota
authors.affiliation: Departamento de Estatística e Matemática Aplicada, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Rosa Maria Salani
authors.initials: RM
authors.lastname: Mota
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Rosa Livia Freitas
authors.initials: RL
authors.lastname: Almeida
authors.affiliation: Centro de Referência Nacional em Dermatologia Sanitária Dona Libânia, Fortaleza, CE, Brasil.
authors.forename: Maria Araci de Andrade
authors.initials: MA
authors.lastname: Pontes
authors.affiliation: Centro de Referência Nacional em Dermatologia Sanitária Dona Libânia, Fortaleza, CE, Brasil.
authors.forename: Heitor de Sá
authors.initials: Hde S
authors.lastname: Gonçalves
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Laura Cunha
authors.initials: LC
authors.lastname: Rodrigues
authors.affiliation: Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Kendall
authors.affiliation: Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil.
authors.forename: Ligia
authors.initials: L
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics*; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007918:Leprosy / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000235:genetics / Q000302:isolation & purification*; D009297:Nasal Mucosa / Q000382:microbiology*; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012959:Socioeconomic Factors; D062206:Spatial Analysis; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial