Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento
Autor(a) principal: | |
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Data de Publicação: | 2003 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S1415-790X2003000300010 http://repositorio.unifesp.br/handle/11600/1828 |
Resumo: | Serum tests for the diagnosis of Leprosy using Phenolic GlicoLipid-1 (PGL-1), considered a specific antigen for M. leprae, have opened some possibilities for studying the epidemiological behavior of this disease. Some questions, such as incubation period, sub-clinical infection and the importance of household contacts for endemic control, have been better evaluated using this technique. The present study has the objective of verifying a possible association between the serological status and the occurrence of leprosy. The authors performed a 4-year follow-up of 6,520 individuals, all of them 5 years old or over, submitted to a PGL-1 ELISA test at the beginning of the study. The group was part of the universe of 7,416 inhabitants of the urban area of a highly endemic town of the State of São Paulo. The serological research identified 590 positive individuals (9.0%). Within this time period, 82 new cases were detected, 26 among the serum positive group (441/10,000), 48 among negatives (81/10,000) and 8 (89/10,000) among those who had not been tested. The analysis of results attempted to control for household contact status, considering that the standardized seropositive rate by age and sex was 9.61% in the contact group, and 7.64% in the non-contact group. The group of serum negatives and no household contact, the so called non- exposure group, was adopted as reference to compute the relative risk to develop leprosy within the study period. Detection rates were standardized considering age differences between the groups and the results were: seropositive household contact rate was 1,074/10,000, that is, 27 times higher than in the non-exposure group (63/10,000). The detection rate in the seropositive non-household contact group was 274/10,000 and in the seronegative household contact group 198/10,000, both higher than the rate in the non-exposure group but similar between each other. The serum positive condition accounted for an 8.6 times higher leprosy risk in the contact group and for a 4.4 times higher risk in the non-contact group. In the epidemiological situation of this research, a highly endemic leprosy area, 50% of the new cases were in the non-contact seronegative group, that is, those whose infection source was unknown. So, in practice, the test revealed itself to be of little usefulness. Anti-PGL-1 serology in low and medium leprosy prevalence areas still remains to be studied in order to reach more solid conclusions on its use in leprosy control. On the other hand, further serologic and other studies are recommended in order to improve the identification of sub-clinical infection, paucibacilar forms included, so as to expand the possibility of early diagnosis and effective influence on the endemic behavior of the disease. |
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Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimentoAnti PGL-1 serology and the risk of leprosy in a highly endemic area in the State of São Paulo, Brazil: four-year follow-upleprosyanti-PGL-1 testleprosy epidemiologycohort studyleprosy detection ratehousehold contactsleprosy serum testHanseníaseTeste anti-PGL-1Epidemiologia da hanseníaseEstudo de coortesTaxas de detecção de hanseníaseContatos intra-domiciliaresSorologia da hanseníaseSerum tests for the diagnosis of Leprosy using Phenolic GlicoLipid-1 (PGL-1), considered a specific antigen for M. leprae, have opened some possibilities for studying the epidemiological behavior of this disease. Some questions, such as incubation period, sub-clinical infection and the importance of household contacts for endemic control, have been better evaluated using this technique. The present study has the objective of verifying a possible association between the serological status and the occurrence of leprosy. The authors performed a 4-year follow-up of 6,520 individuals, all of them 5 years old or over, submitted to a PGL-1 ELISA test at the beginning of the study. The group was part of the universe of 7,416 inhabitants of the urban area of a highly endemic town of the State of São Paulo. The serological research identified 590 positive individuals (9.0%). Within this time period, 82 new cases were detected, 26 among the serum positive group (441/10,000), 48 among negatives (81/10,000) and 8 (89/10,000) among those who had not been tested. The analysis of results attempted to control for household contact status, considering that the standardized seropositive rate by age and sex was 9.61% in the contact group, and 7.64% in the non-contact group. The group of serum negatives and no household contact, the so called non- exposure group, was adopted as reference to compute the relative risk to develop leprosy within the study period. Detection rates were standardized considering age differences between the groups and the results were: seropositive household contact rate was 1,074/10,000, that is, 27 times higher than in the non-exposure group (63/10,000). The detection rate in the seropositive non-household contact group was 274/10,000 and in the seronegative household contact group 198/10,000, both higher than the rate in the non-exposure group but similar between each other. The serum positive condition accounted for an 8.6 times higher leprosy risk in the contact group and for a 4.4 times higher risk in the non-contact group. In the epidemiological situation of this research, a highly endemic leprosy area, 50% of the new cases were in the non-contact seronegative group, that is, those whose infection source was unknown. So, in practice, the test revealed itself to be of little usefulness. Anti-PGL-1 serology in low and medium leprosy prevalence areas still remains to be studied in order to reach more solid conclusions on its use in leprosy control. On the other hand, further serologic and other studies are recommended in order to improve the identification of sub-clinical infection, paucibacilar forms included, so as to expand the possibility of early diagnosis and effective influence on the endemic behavior of the disease.Os testes sorológicos para diagnóstico de hanseníase, usando o glicolipídeo-fenólico-1 (PGL-1), considerado antígeno específico do M. leprae, têm aberto algumas possibilidades de estudo do comportamento epidemiológico desta doença. Algumas questões, como tempo de latência da doença, infecção subclínica e importância do contato intra-domiciliar (contatos) no controle da endemia, puderam ser melhor analisadas usando este instrumental. Este estudo teve por objetivo verificar a existência de associação entre a situação sorológica e a ocorrência de hanseníase. Foram seguidas, durante 4 anos, 6.520 pessoas com idade igual ou superior a 5 anos, submetidas no início do seguimento ao teste sorológico Anti PGL-1, pertencentes ao universo de 7.416 habitantes da área urbana de um município paulista caracterizado por elevada endemicidade de hanseníase. Foi identificado um grupo de 590 indivíduos soropositivos (9,0 %). Foram diagnosticados, no período, 82 casos novos de hanseníase, 26 no grupo de soropositivos (441 casos novos/10.000 indivíduos) e 48 no de soronegativos (81/10.000). Entre os que não fizeram sorologia, surgiram 8 casos novos (89/10.000). Procurou-se controlar, na análise, a condição de contato, dado que a taxa de soropositividade padronizada por idade e sexo era de 9,61% no grupo de contatos e 7,65% no de não-contatos. Tomando-se os não-contatos soronegativos como o grupo de não expostos, foram calculados os riscos relativos de adoecimento no período, a partir das taxas de detecção padronizadas por idade, resultando no seguinte: os contatos ID soropositivos apresentaram a taxa de 1.704/10.000, 27 vezes maior que a dos não-expostos, igual a 63/10.000; os não-contatos soropositivos e os contatos soronegativos apresentaram taxas, respectivamente, de 274 e 198/10.000, ambas maiores que as dos não-expostos e iguais entre si. A soropositividade associou-se à elevação de 8,6 vezes do risco de hanseníase entre os contatos e de 4,4 entre os não-contatos. Na situação epidemiológica estudada, caracterizada por elevada endemicidade de hanseníase, 50% dos casos novos surgiram entre os não-contatos soronegativos, ou seja, sem fonte de infecção conhecida. Portanto, o teste anti-PGL-1 usado revela-se, na prática, de pouca aplicabilidade. Resta estudar ainda o comportamento da sorologia anti-PGL-1 em áreas de média e baixa endemicidade para que se possa tirar conclusões mais consubstanciadas sobre sua utilidade no controle da endemia. Recomenda-se o aprofundamento das pesquisas sorológicas e de outras que aprimorem o diagnóstico precoce da infecção subclínica, inclusive para detecção de formas paucibacilares, para se ampliar as possibilidades de influir no controle endêmico.Secretaria de Estado da Saúde de São Paulo Centro de Vigilância EpidemiológicaUNESP Faculdade de Medicina de Botucatu Departamento de Saúde PúblicaCentro de Saúde de SeveríniaSecretaria de Estado da Saúde de São Paulo Centro de Vigilância Epidemiológica Prof. A. VranjacUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Departamento de DermatologiaUNIFESP, EPM, Depto. de DermatologiaSciELOAssociação Brasileira de Saúde ColetivaSecretaria de Estado da Saúde de São Paulo Centro de Vigilância EpidemiológicaUniversidade Estadual Paulista (UNESP)Centro de Saúde de SeveríniaSecretaria de Estado da Saúde de São Paulo Centro de Vigilância Epidemiológica Prof. A. VranjacUniversidade Federal de São Paulo (UNIFESP)Brasil, Mitie Tada L.r.f.Oliveira, Luiz Roberto DeRímoli, Nely S.Cavallari F., SérgioGonçalves, Otília S.Lessa, Zenaide L.Rotta, Osmar [UNIFESP]2015-06-14T13:30:07Z2015-06-14T13:30:07Z2003-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion262-271application/pdfhttp://dx.doi.org/10.1590/S1415-790X2003000300010Revista Brasileira de Epidemiologia. Associação Brasileira de Saúde Coletiva, v. 6, n. 3, p. 262-271, 2003.10.1590/S1415-790X2003000300010S1415-790X2003000300010.pdf1415-790XS1415-790X2003000300010http://repositorio.unifesp.br/handle/11600/1828porRevista Brasileira de Epidemiologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-28T05:14:07Zoai:repositorio.unifesp.br/:11600/1828Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-28T05:14:07Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento Anti PGL-1 serology and the risk of leprosy in a highly endemic area in the State of São Paulo, Brazil: four-year follow-up |
title |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento |
spellingShingle |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento Brasil, Mitie Tada L.r.f. leprosy anti-PGL-1 test leprosy epidemiology cohort study leprosy detection rate household contacts leprosy serum test Hanseníase Teste anti-PGL-1 Epidemiologia da hanseníase Estudo de coortes Taxas de detecção de hanseníase Contatos intra-domiciliares Sorologia da hanseníase |
title_short |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento |
title_full |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento |
title_fullStr |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento |
title_full_unstemmed |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento |
title_sort |
Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento |
author |
Brasil, Mitie Tada L.r.f. |
author_facet |
Brasil, Mitie Tada L.r.f. Oliveira, Luiz Roberto De Rímoli, Nely S. Cavallari F., Sérgio Gonçalves, Otília S. Lessa, Zenaide L. Rotta, Osmar [UNIFESP] |
author_role |
author |
author2 |
Oliveira, Luiz Roberto De Rímoli, Nely S. Cavallari F., Sérgio Gonçalves, Otília S. Lessa, Zenaide L. Rotta, Osmar [UNIFESP] |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Secretaria de Estado da Saúde de São Paulo Centro de Vigilância Epidemiológica Universidade Estadual Paulista (UNESP) Centro de Saúde de Severínia Secretaria de Estado da Saúde de São Paulo Centro de Vigilância Epidemiológica Prof. A. Vranjac Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Brasil, Mitie Tada L.r.f. Oliveira, Luiz Roberto De Rímoli, Nely S. Cavallari F., Sérgio Gonçalves, Otília S. Lessa, Zenaide L. Rotta, Osmar [UNIFESP] |
dc.subject.por.fl_str_mv |
leprosy anti-PGL-1 test leprosy epidemiology cohort study leprosy detection rate household contacts leprosy serum test Hanseníase Teste anti-PGL-1 Epidemiologia da hanseníase Estudo de coortes Taxas de detecção de hanseníase Contatos intra-domiciliares Sorologia da hanseníase |
topic |
leprosy anti-PGL-1 test leprosy epidemiology cohort study leprosy detection rate household contacts leprosy serum test Hanseníase Teste anti-PGL-1 Epidemiologia da hanseníase Estudo de coortes Taxas de detecção de hanseníase Contatos intra-domiciliares Sorologia da hanseníase |
description |
Serum tests for the diagnosis of Leprosy using Phenolic GlicoLipid-1 (PGL-1), considered a specific antigen for M. leprae, have opened some possibilities for studying the epidemiological behavior of this disease. Some questions, such as incubation period, sub-clinical infection and the importance of household contacts for endemic control, have been better evaluated using this technique. The present study has the objective of verifying a possible association between the serological status and the occurrence of leprosy. The authors performed a 4-year follow-up of 6,520 individuals, all of them 5 years old or over, submitted to a PGL-1 ELISA test at the beginning of the study. The group was part of the universe of 7,416 inhabitants of the urban area of a highly endemic town of the State of São Paulo. The serological research identified 590 positive individuals (9.0%). Within this time period, 82 new cases were detected, 26 among the serum positive group (441/10,000), 48 among negatives (81/10,000) and 8 (89/10,000) among those who had not been tested. The analysis of results attempted to control for household contact status, considering that the standardized seropositive rate by age and sex was 9.61% in the contact group, and 7.64% in the non-contact group. The group of serum negatives and no household contact, the so called non- exposure group, was adopted as reference to compute the relative risk to develop leprosy within the study period. Detection rates were standardized considering age differences between the groups and the results were: seropositive household contact rate was 1,074/10,000, that is, 27 times higher than in the non-exposure group (63/10,000). The detection rate in the seropositive non-household contact group was 274/10,000 and in the seronegative household contact group 198/10,000, both higher than the rate in the non-exposure group but similar between each other. The serum positive condition accounted for an 8.6 times higher leprosy risk in the contact group and for a 4.4 times higher risk in the non-contact group. In the epidemiological situation of this research, a highly endemic leprosy area, 50% of the new cases were in the non-contact seronegative group, that is, those whose infection source was unknown. So, in practice, the test revealed itself to be of little usefulness. Anti-PGL-1 serology in low and medium leprosy prevalence areas still remains to be studied in order to reach more solid conclusions on its use in leprosy control. On the other hand, further serologic and other studies are recommended in order to improve the identification of sub-clinical infection, paucibacilar forms included, so as to expand the possibility of early diagnosis and effective influence on the endemic behavior of the disease. |
publishDate |
2003 |
dc.date.none.fl_str_mv |
2003-09-01 2015-06-14T13:30:07Z 2015-06-14T13:30:07Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S1415-790X2003000300010 Revista Brasileira de Epidemiologia. Associação Brasileira de Saúde Coletiva, v. 6, n. 3, p. 262-271, 2003. 10.1590/S1415-790X2003000300010 S1415-790X2003000300010.pdf 1415-790X S1415-790X2003000300010 http://repositorio.unifesp.br/handle/11600/1828 |
url |
http://dx.doi.org/10.1590/S1415-790X2003000300010 http://repositorio.unifesp.br/handle/11600/1828 |
identifier_str_mv |
Revista Brasileira de Epidemiologia. Associação Brasileira de Saúde Coletiva, v. 6, n. 3, p. 262-271, 2003. 10.1590/S1415-790X2003000300010 S1415-790X2003000300010.pdf 1415-790X S1415-790X2003000300010 |
dc.language.iso.fl_str_mv |
por |
language |
por |
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Revista Brasileira de Epidemiologia |
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info:eu-repo/semantics/openAccess |
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openAccess |
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262-271 application/pdf |
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Associação Brasileira de Saúde Coletiva |
publisher.none.fl_str_mv |
Associação Brasileira de Saúde Coletiva |
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reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
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Universidade Federal de São Paulo (UNIFESP) |
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UNIFESP |
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UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP |
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Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
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biblioteca.csp@unifesp.br |
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1814268460382814208 |