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Widespread nasal carriage of Mycobacterium lepraeamong a healthy population in a hyperendemic region of northeastern Brazil

2015; Instituto Oswaldo Cruz, Ministério da Saúde; Volume: 110; Issue: 7 Linguagem: Inglês

10.1590/0074-02760150178

1678-8060

Luana Nepomuceno Gondim Costa Lima, Cristiane Cunha Frota, Rosa Maria Salani Mota, Rosa Lívia Freitas de Almeida, Maria Araci de Andrade Pontes, Heitor de Sá Gonçalves, Laura C. Rodrigues, Carl Kendall, Lígia Regina Franco Sansigolo Kerr,

Infectious Diseases and Tuberculosis

A case-control study was conducted to determine the presence ofMycobacterium leprae DNA 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.