Volume 92, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



The uniform multidrug therapy clinical trial, Brazil (U-MDT/CT-BR), database was used to describe and report the performance of available tools to classify 830 leprosy patients as paucibacillary (PB) and multibacillary (MB) at baseline. In a modified Ridley and Jopling (R&J) classification, considering clinical features, histopathological results of skin biopsies and the slit-skin smear bacterial load results were used as the gold standard method for classification. Anti-phenolic glycolipid-I (PGL-I) serology by ML Flow test, the slit skin smear bacterial load, and the number of skin lesions were evaluated. Considering the R&J classification system as gold standard, ML Flow tests correctly allocated 70% patients in the PB group and 87% in the MB group. The classification based on counting the number of skin lesions correctly allocated 46% PB patients and 99% MB leprosy cases. Slit skin smears properly classified 91% and 97% of PB and MB patients, respectively. Based on U-MDT/CT-BR results, classification of leprosy patients for treatment purposes is unnecessary because it does not impact clinical and laboratories outcomes. In this context, the identification of new biomarkers to detect patients at a higher risk to develop leprosy reactions or relapse remains an important research challenge.


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  1. Ridley DS, Jopling WH, , 1966. Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis 34: 255273. [Google Scholar]
  2. WHO, 2012. WHO Expert Committee on Leprosy: Eighth Report. Geneva, Switzerland: WHO. [Google Scholar]
  3. ILA, 2002. Report of the International Leprosy Association Technical Forum. Paris, France, February 22–28, 2002: the diagnosis and classification of leprosy. Int J Lepr Other Mycobact Dis 70 (Suppl 1): S23S31. [Google Scholar]
  4. Penna GO, Pontes MAA, Cruz R, Goncalves HS, Penna MLF, Bührer-Sékula S, , 2012. A clinical trial for uniform multidrug therapy for leprosy patients in Brazil: rationale and design. Mem Inst Oswaldo Cruz 107 (Suppl 1): 2227.[Crossref] [Google Scholar]
  5. Penna MLF, Buhrer-Sékula S, Pontes MAA, Cruz R, Gonçalves HDS, Penna GO, , 2012. Primary results of clinical trial for uniform multidrug therapy for leprosy patients in Brazil (U-MDT/CT-BR): reactions frequency in multibacillary patients. Lepr Rev 83: 308319. [Google Scholar]
  6. Moura RS, Calado KL, Oliveira ML, Bührer-Sékula S, , 2008. Leprosy serology using PGL-I: a systematic review. Rev Soc Bras Med Trop 41 (Suppl 2): 1118.[Crossref] [Google Scholar]
  7. Oskam L, Slim E, Bührer-Sékula S, , 2003. Serology: recent developments, strengths, limitations and prospects: a state of the art overview. Lepr Rev 74: 196205. [Google Scholar]
  8. Parkash O, Kumar A, Pandey R, Nigam A, Girdhar BK, , 2008. Performance of a lateral flow test for the detection of leprosy patients in India. J Med Microbiol 57: 130132.[Crossref] [Google Scholar]
  9. Bobosha K, Tjon Kon Fat EM, van den Eeden SJF, Bekele Y, van der Ploeg-van Schip JJ, de Dood CJ, Dijkman K, Franken KLMC, Wilson L, Aseffa A, Spencer JS, Ottenhoff THM, Corstjens PLAM, Geluk A, , 2014. Field-evaluation of a new lateral flow assay for detection of cellular and humoral immunity against Mycobacterium leprae . PLoS Negl Trop Dis 8: e2845.[Crossref] [Google Scholar]
  10. Lockwood DNJ, Nicholls P, Smith WCS, Das L, Barkataki P, van Brakel W, Suneetha S, , 2012. Comparing the clinical and histological diagnosis of leprosy and leprosy reactions in the INFIR cohort of Indian patients with multibacillary leprosy. PLoS Negl Trop Dis 6: e1702.[Crossref] [Google Scholar]
  11. Kumar B, Dogra S, Kaur I, , 2004. Epidemiological characteristics of leprosy reactions: 15 years experience from north India. Int J Lepr Other Mycobact Dis 72: 125133.[Crossref] [Google Scholar]
  12. Baohong J, , 2001. Does there exist a subgroup of MB patients at greater risk of relapse after MDT? Lepr Rev 72: 37. [Google Scholar]
  13. Bührer-Sékula S, Smits HL, Gussenhoven GC, van Leeuwen J, Amador S, Fujiwara T, Klatser PR, Oskam L, , 2003. Simple and fast lateral flow test for classification of leprosy patients and identification of contacts with high risk of developing leprosy. J Clin Microbiol 41: 19911995.[Crossref] [Google Scholar]
  14. Landis JR, Koch GG, , 1977. The measurement of observer agreement for categorical data. Biometrics 33: 159174.[Crossref] [Google Scholar]
  15. Penna MLF, Buhrer-Sékula S, Pontes MAA, Cruz R, Gonçalves HS, Penna GO, , 2014. Results from the clinical trial of uniform multidrug therapy for leprosy patients in Brazil (U-MDT/CT-BR): decrease in bacteriological index. Lepr Rev 85: 262266. [Google Scholar]

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  • Received : 21 Jan 2014
  • Accepted : 18 Feb 2015
  • Published online : 03 Jun 2015

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