Leprosy in a prison population: A new active search strategy and a prospective clinical analysis

Fred Bernardes Filho, Jaci Maria Santana, Regina Coeli Palma de Almeida, Glauber Voltan, Natália Aparecida de Paula, Marcel Nani Leite, Claudia Maria Lincoln Silva, Camila Tormena, Lean Basoli, Joelma Menezes, Moises Batista da Silva, John Stewart Spencer, Wilson Marques, Norma Tiraboschi Foss and Marco Andrey Cipriani Frade

PLOS Neglected Tropical Diseases, 2020, vol. 14, issue 12, 1-17

Abstract: Background: This study evaluates an active search strategy for leprosy diagnosis based on responses to a Leprosy Suspicion Questionnaire (LSQ), and analyzing the clinical, immunoepidemiological and follow-up aspects for individuals living in a prison population. Methods: A cross-sectional study based on a questionnaire posing 14 questions about leprosy symptoms and signs that was distributed to 1,400 prisoners. This was followed by dermatoneurological examination, anti-PGL-I serology and RLEP-PCR. Those without leprosy were placed in the Non-leprosy Group (NLG, n = 1,216) and those diagnosed with clinical symptoms of leprosy were placed in the Leprosy Group (LG, n = 34). Findings: In total, 896 LSQ were returned (64%), and 187 (20.9%) of the responses were deemed as positive for signs/symptoms, answering 2.7 questions on average. Clinically, 1,250 (89.3%) of the prisoners were evaluated resulting in the diagnosis of 34 new cases (LG), based on well-accepted clinical signs and symptoms, a new case detection rate of 2.7% within this population, while the NLG were comprised of 1,216 individuals. The confinement time medians were 39 months in the LG while it was 36 months in the NLG (p>0.05). The 31 leprosy cases who responded to the questionnaire (LSQ+) had an average of 1.5 responses. The symptoms “anesthetized skin area” and “pain in nerves” were most commonly mentioned in the LG while “tingling, numbness in the hands/feet”, “sensation of pricks and needles”, “pain in nerves” and “spots on the skin” responses were found in more than 30% of questionnaires in the NLG. Clinically, 88.2% had dysesthetic macular skin lesions and 97.1% presented some peripheral nerve impairment, 71.9% with some degree of disability. All cases were multibacillary, confirming a late diagnosis. Anti-PGL-I results in the LG were higher than in the NLG (p

Date: 2020
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pntd00:0008917

DOI: 10.1371/journal.pntd.0008917

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