Sorologia Anti PGL-1 e risco de ocorrência de hanseníase em área de alta endemicidade do Estado de São Paulo: quatro anos de seguimento

Detalhes bibliográficos
Autor(a) principal: Brasil, Mitie Tada L.r.f.
Data de Publicação: 2003
Outros Autores: Oliveira, Luiz Roberto De, Rímoli, Nely S., Cavallari F., Sérgio, Gonçalves, Otília S., Lessa, Zenaide L., Rotta, Osmar [UNIFESP]
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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spelling 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
dc.relation.none.fl_str_mv Revista Brasileira de Epidemiologia
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.format.none.fl_str_mv 262-271
application/pdf
dc.publisher.none.fl_str_mv Associação Brasileira de Saúde Coletiva
publisher.none.fl_str_mv Associação Brasileira de Saúde Coletiva
dc.source.none.fl_str_mv reponame:Repositório Institucional da UNIFESP
instname:Universidade Federal de São Paulo (UNIFESP)
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instname_str Universidade Federal de São Paulo (UNIFESP)
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repository.name.fl_str_mv Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)
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