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Boigny RN, de Sousa Cavalcante KK, Florencio CMGD, Nogueira PSF, Gomes CM, Alencar CH. Temporal trends and space-time distribution of leprosy relapse in Brazil from 2001 to 2021. Trans R Soc Trop Med Hyg 2024; 118:537-549. [PMID: 38708714 DOI: 10.1093/trstmh/trae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 02/20/2024] [Accepted: 03/21/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND To analyse the temporal trends and spatiotemporal distribution of leprosy relapse in Brazil from 2001 to 2021. METHODS An ecological study with a temporal trend approach and space-time analysis of leprosy relapse in Brazil was carried out with data from the Notifiable Diseases Information System. RESULTS A total of 31 334 patients who experienced leprosy relapse were identified. The number of recurrent cases tended to increase throughout the study period, and this increase was significant among females and in almost all age groups, except for those <15, 50-59 and ≥70 y. Several clusters of high- and low-risk patients were identified across all regions with a heterogeneous distribution. CONCLUSIONS The burden of relapse showed an increasing trend in some groups and was distributed in all regions.
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Affiliation(s)
- Reagan Nzundu Boigny
- Federal University of Ceará, Faculty of Medicine, Postgraduate Program in Public Health, Prof. Costa Mendes street, 1608th - 5° Floor - Rodolfo Teófilo, Fortaleza, CE 60430-140, Brazil
| | - Kellyn Kessiene de Sousa Cavalcante
- Federal University of Ceará, Faculty of Medicine, Postgraduate Program in Public Health, Prof. Costa Mendes street, 1608th - 5° Floor - Rodolfo Teófilo, Fortaleza, CE 60430-140, Brazil
| | - Caroline Mary Gurgel Dias Florencio
- Federal University of Ceará, Faculty of Medicine, Postgraduate Program in Public Health, Prof. Costa Mendes street, 1608th - 5° Floor - Rodolfo Teófilo, Fortaleza, CE 60430-140, Brazil
| | - Paula Sacha Frota Nogueira
- Federal University of Ceará, Faculty of Pharmacy, Dentistry and Nursing, Department of Nursing, Alexandre Baraúna street, 1115th - Rodolfo Teófilo, Fortaleza, CE 60430-160, Brazil
| | - Ciro Martins Gomes
- University of Brasília, Faculty of Medicine, Postgraduate Program in Medical Sciences, Campus Universitário Darcy Ribeiro, Brasília-DF, 70910-900, Brazil
| | - Carlos Henrique Alencar
- Federal University of Ceará, Faculty of Medicine, Postgraduate Program in Public Health, Prof. Costa Mendes street, 1608th - 5° Floor - Rodolfo Teófilo, Fortaleza, CE 60430-140, Brazil
- Federal University of Ceará, Faculty of Medicine, Postgraduate Program in Pathology, Alexandre Baraúna street, 949 - Rodolfo Teófilo, Fortaleza, CE 60430-160, Brazil
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Juan C, Lledó L, Torralba M, Gómez JR, Giménez C. Leprosy in Spain: A Descriptive Study of Admissions at Fontilles Sanatorium between 1909 and 2020. Trop Med Infect Dis 2024; 9:130. [PMID: 38922042 PMCID: PMC11209616 DOI: 10.3390/tropicalmed9060130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 06/06/2024] [Accepted: 06/07/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND The study aimed to characterize patients with leprosy admitted to Fontilles throughout the 20th and 21st centuries, focusing on differences across three periods (I, II, and III). It also explored variables linked to patient survival. METHODS This was a retrospective descriptive study analyzing the medical records of Fontilles patients from 1909 to 2020. It assessed 26 clinical, sociodemographic, and temporal variables (n = 2652). RESULTS Most patients were male, single, multibacillary (MB), and farmers, from Andalusia and the Valencian Community. The origin of patients shifted over time towards being mostly foreign-born in period III. More than a half were previously admitted and had family members with leprosy. While leprosy reactions decreased over time, neurological symptoms were increasingly diagnosed. The age at onset, admission, and death increased progressively over time. The survival of patients with leprosy at Fontilles depended on the age at admission and the period. CONCLUSIONS Improved knowledge, services, and awareness regarding leprosy led to increased age at onset and more favorable outcomes. The prolonged time between symptom onset and diagnosis indicates that leprosy is still a neglected disease. Although MB forms are more severe, leprosy classification did not significantly impact the survival rates of patients at Fontilles.
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Affiliation(s)
- Cristina Juan
- Department of Biomedicine and Biotechnology, Faculty of Pharmacy, Alcalá University, 28805 Alcalá de Henares, Madrid, Spain; (L.L.); (C.G.)
| | - Lourdes Lledó
- Department of Biomedicine and Biotechnology, Faculty of Pharmacy, Alcalá University, 28805 Alcalá de Henares, Madrid, Spain; (L.L.); (C.G.)
| | - Miguel Torralba
- Internal Medicine Unit, Department of Medicine and Medical specialities, IDISCAM, Faculty of Medicine, Alcalá University, 28805 Alcalá de Henares, Madrid, Spain;
| | - José Ramón Gómez
- Sanatorium San Francisco de Borja, Fontilles, 03791 Alicante, Spain;
| | - Consuelo Giménez
- Department of Biomedicine and Biotechnology, Faculty of Pharmacy, Alcalá University, 28805 Alcalá de Henares, Madrid, Spain; (L.L.); (C.G.)
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Alrehaili J. Leprosy Classification, Clinical Features, Epidemiology, and Host Immunological Responses: Failure of Eradication in 2023. Cureus 2023; 15:e44767. [PMID: 37809252 PMCID: PMC10557090 DOI: 10.7759/cureus.44767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Leprosy is of big concern in the medical fraternity. Leprosy is also known as Hansen's disease. It is a curable communicable disease that remains prevalent in most countries all over the globe. It is a chronic granulomatous infection commonly caused by Mycobacterium leprae and Mycobacterium lepromatosis, which mainly show an effect on the skin and peripheral nerves. To control the disease and minimize the impact of the disease, much effort has been put into it for decades. Nearly 0.2 million fresh cases were documented in 2017 worldwide in spite of being declared "eradicated" by the WHO in the year 2000. However, impressive achievements have been made in several countries, including India; still, we are lagging behind the ultimate goal of the final disappearance of leprosy. Extensive migration is a crucial element that may transmit leprosy to unaffected areas. Additionally, there are several areas in the USA where person-to-person leprosy transmission has been reported without a prior history of exposure. Recently, WHO instigated a new Global Leprosy Strategy 2021-2030, termed "Towards Zero Leprosy." In this article, we review the clinical features, leprosy epidemiology, transmission, classification, host immunological response, and diagnostic challenges.
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Li X, Jin G, Yang J, Li Y, Wei P, Zhang L. Epidemiological characteristics of leprosy during the period 2005-2020: A retrospective study based on the Chinese surveillance system. Front Public Health 2023; 10:991828. [PMID: 36711406 PMCID: PMC9874668 DOI: 10.3389/fpubh.2022.991828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/21/2022] [Indexed: 01/12/2023] Open
Abstract
Background Jiangsu Province is located in the Yangtze River Delta region, with a total area of 107,200 square kilometers. Since 1949, over 55,000 cases have been registered, with Taixing accounting for the highest number of patients. The proportion of new cases with MB and G2D was higher compared to other regions. As a result, Jiangsu has been considered a priority area for public health interventions in China. Methods This paper mainly described the population, time, and spatial distribution of the newly detected leprosy cases in Jiangsu Province between 2005 and 2020. In this study, all the data were entered into Microsoft Excel and SPSS for the descriptive analysis. ArcGIS was applied to create statistical maps, and Geoda was used to conduct spatial autocorrelation analysis with local Moran's I statistics (LISA). The epidemiological data were obtained from LEPMIS. In addition, population data were obtained from the Statistical Yearbook of Jiangsu Province. Results During the study period, 363 new cases were reported. Of these, 232 were men and 131 were women (1.77:1). The mean age at diagnosis was 60.56 years, and no adolescent cases were identified. Three hundred and twenty-seven (90.08%) were diagnosed with MB and 36 (9.92%) with PB. 31.68% (115/363) of the patients presented with G2D. Farmers accounted for 74.9%, and most cases were identified in skin clinics (248, 68.32%). We observed a decreasing trend in detection rate, with a higher concentration of new cases diagnosed between July and October. Spatial analysis showed that the new cases were primarily distributed in the northwest of Jiangsu province, and Suqian has the highest incidence of leprosy. Special attention should be paid to Wuzhong, a county with a potential risk of inter-provincial transmission. Furthermore, 55 new cases came from other Chinese provinces but lived in Jiangsu. Conclusion The NCDR of leprosy decreased, but the new cases showed disabilities, a sign of the late diagnosis. The results indicated that some regions were still suffering from the burden of leprosy. Thus, we recommend that the government should adopt effective strategies to promote leprosy control. The main priorities for eliminating new cases were to provide sustainable financial support, improve the quality of clinical services, strengthen preventive intervention and rehabilitation services for disabilities, provide health education among high-risk populations, and explore new approaches.
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Affiliation(s)
- Xiang Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Guangjie Jin
- Department of Chronic Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jing Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Yunhui Li
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Pingmin Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,*Correspondence: Pingmin Wei ✉
| | - Lianhua Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China,Department of Chronic Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China,Lianhua Zhang ✉
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Martoreli JF, Ramos ACV, Berra TZ, do Nascimento MC, Tavares RBV, Moura HSD, de Mello DF, Alves JD, Arcêncio RA. Clusters of risk for the occurrence of leprosy and disabilities in children under 15 years of age in Cuiabá: a geospatial study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023; 26:e230006. [PMID: 36629618 PMCID: PMC9838240 DOI: 10.1590/1980-549720230006.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 10/13/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE This study aimed to analyze the spatial distribution of leprosy and disabilities in children under 15 years of age in Cuiabá. METHODS Ecological study carried out in the city of Cuiabá, Mato Grosso, Brazil. The study population consisted of leprosy cases in children under 15 years old notified in the Notifiable Diseases Information System, between 2008 and 2018. Based on residential addresses, cases were georeferenced. In the analysis of the spatial distribution of the cases, the estimation of the Kernel density was used and, later, the statistics of spatial, spatio-temporal and Spatial Variation in Temporal Trends were applied. RESULTS 514 cases of leprosy were reported in children under 15 years of age in Cuiabá, with a percentage of 10.1% of cases with degree of physical disability 1 and 2.3% with degree of physical disability 2 at the time of diagnosis. With the techniques of spatial and spatio-temporal scanning, clusters of risk for leprosy were identified in the North, West, East and South regions of Cuiabá, and with the technique of Spatial Variation in Temporal Trends, a cluster was identified in the West region of Cuiabá. CONCLUSION In Cuiabá, cases of leprosy in children under 15 years of age with disabilities were distributed throughout the urban area of the city, with the highest density of cases in the North and West regions, followed by the East region. The clusters with the highest Relative Risk were identified in the East and West regions, characterized by having low and medium income levels.
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Affiliation(s)
- José Francisco Martoreli
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Escola de Enfermagem – Ribeirão Preto (SP), Brasil
| | - Antônio Carlos Vieira Ramos
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Escola de Enfermagem – Ribeirão Preto (SP), Brasil
| | - Thaís Zamboni Berra
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Escola de Enfermagem – Ribeirão Preto (SP), Brasil
| | | | - Reginaldo Bazon Vaz Tavares
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Escola de Enfermagem – Ribeirão Preto (SP), Brasil
| | - Heriederson Sávio Dias Moura
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Escola de Enfermagem – Ribeirão Preto (SP), Brasil
| | - Débora Falleiros de Mello
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Escola de Enfermagem – Ribeirão Preto (SP), Brasil
| | | | - Ricardo Alexandre Arcêncio
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Escola de Enfermagem – Ribeirão Preto (SP), Brasil
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Martoreli Júnior JF, Ramos ACV, Berra TZ, Nascimento MCD, Tavares RBV, Moura HSD, Mello DFD, Alves JD, Arcêncio RA. Clusters of risk for the occurrence of leprosy and disabilities in children under 15 years of age in Cuiabá: a geospatial study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2023. [DOI: 10.1590/1980-549720230006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
ABSTRACT Objective This study aimed to analyze the spatial distribution of leprosy and disabilities in children under 15 years of age in Cuiabá. Methods Ecological study carried out in the city of Cuiabá, Mato Grosso, Brazil. The study population consisted of leprosy cases in children under 15 years old notified in the Notifiable Diseases Information System, between 2008 and 2018. Based on residential addresses, cases were georeferenced. In the analysis of the spatial distribution of the cases, the estimation of the Kernel density was used and, later, the statistics of spatial, spatio-temporal and Spatial Variation in Temporal Trends were applied. Results 514 cases of leprosy were reported in children under 15 years of age in Cuiabá, with a percentage of 10.1% of cases with degree of physical disability 1 and 2.3% with degree of physical disability 2 at the time of diagnosis. With the techniques of spatial and spatio-temporal scanning, clusters of risk for leprosy were identified in the North, West, East and South regions of Cuiabá, and with the technique of Spatial Variation in Temporal Trends, a cluster was identified in the West region of Cuiabá. Conclusion In Cuiabá, cases of leprosy in children under 15 years of age with disabilities were distributed throughout the urban area of the city, with the highest density of cases in the North and West regions, followed by the East region. The clusters with the highest Relative Risk were identified in the East and West regions, characterized by having low and medium income levels
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Guevara A, Vicente VA, de Souza Lima BJF, Nery AF, Hagen F, Hahn RC. Chromoblastomycosis-Leprosy Co-Infection in Central West Brazil. Presentation of Three Cases and Literature Review. Mycopathologia 2022; 187:363-374. [PMID: 35764905 PMCID: PMC9325793 DOI: 10.1007/s11046-022-00646-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 06/15/2022] [Indexed: 11/26/2022]
Abstract
Chromoblastomycosis and leprosy are chronic diseases with high prevalence in tropical and subtropical regions. Brazil is one of the countries with the highest incidence and prevalence for both diseases, however, reports of co-infections are scarce. The aim of this study was to describe three cases of chromoblastomycosis-leprosy co-infection in patients from Mato Grosso state, Brazil. A review of chromoblastomycosis-leprosy co-infection was performed of English, Portuguese and Spanish publications in LILACS, SciELO, PubMed and Web of Science databases using the descriptors (chromoblastomycosis OR cromoblastomicose OR cromoblastomicosis) AND (leprosy OR hanseníase OR lepra), without time period delimitation. Nineteen cases were included, 16 cases were published in 11 articles, plus the three cases reported in the current study. Most reported coninfection cases came from Brazil. Majority of the patients were male with a mean age of 52.2 years. Farmer was the main occupational activity reported. In 12 patients, the clinical signs and symptoms of leprosy started first. No contacts with patients affected by leprosy, armadillos or history of injuries at the anatomical site of chromoblastomycosis lesions were reported. Five leprosy patients who received steroid treatment for leprosy reactions or neuropathies, were diagnosed with chromoblastomycosis during immunosuppressive therapy. Four cases (21.1%) were reported among the elderly patients. Co-infections in patients with chromoblastomycosis or leprosy are uncommon, but the possibility should always be considered, especially if the patient is undergoing immunosuppressive treatment or is elder.
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Affiliation(s)
- Armando Guevara
- Laboratory of Mycology/Research, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Vânia Aparecida Vicente
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Bruna Jacomel F de Souza Lima
- Microbiology, Parasitology and Pathology Post-Graduation Program, Department of Pathology, Federal University of Paraná, Curitiba, Paraná, Brazil
| | - Andréia Ferreira Nery
- Júlio Muller University Hospital - Ebserh, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil
| | - Ferry Hagen
- Department of Medical Mycology, Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584CT, Utrecht, The Netherlands.
- Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, The Netherlands.
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Rosane Christine Hahn
- Laboratory of Mycology/Research, Faculty of Medicine, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
- Júlio Muller University Hospital - Ebserh, Federal University of Mato Grosso, Cuiabá, Mato Grosso, Brazil.
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