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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: 255–273.
-
2.
WHO, 2012. WHO Expert Committee on Leprosy: Eighth Report. Geneva, Switzerland: WHO.
-
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): S23–S31.
-
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): 22–27.
-
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: 308–319.
-
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): 11–18.
-
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: 196–205.
-
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: 130–132.
-
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.
-
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.
-
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: 125–133.
-
12.
Baohong J, 2001. Does there exist a subgroup of MB patients at greater risk of relapse after MDT? Lepr Rev 72: 3–7.
-
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: 1991–1995.
-
14.
Landis JR, Koch GG, 1977. The measurement of observer agreement for categorical data. Biometrics 33: 159–174.
-
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: 262–266.
| Past two years | Past Year | Past 30 Days | |
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Description of Leprosy Classification at Baseline Among Patients Enrolled at the Uniform Multidrug Therapy Clinical Trial for Leprosy Patients in Brazil
Rodrigo Scaliante Moura
Rodrigo Scaliante Moura
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Gerson Oliveira Penna
Gerson Oliveira Penna
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Ludimila Paula Vaz Cardoso
Ludimila Paula Vaz Cardoso
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Maria Araci de Andrade Pontes
Maria Araci de Andrade Pontes
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Rossilene Cruz
Rossilene Cruz
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Heitor de Sá Gonçalves
Heitor de Sá Gonçalves
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Maria Lúcia Fernandes Penna
Maria Lúcia Fernandes Penna
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Mariane Martins de Araújo Stefani
Mariane Martins de Araújo Stefani
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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Samira Bührer-Sékula
Samira Bührer-Sékula
Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil; Centre for Tropical Medicine, University of Brasília, Brasília DF, Brazil; Dona Libânia Dermatology Centre, Fortaleza, Ceará, Brazil; Alfredo da Matta Tropical Dermatology and Venereology Foundation, Manaus, Amazonas, Brazil; Epidemiology and Biostatistics Department, Fluminense Federal University, Rio de Janeiro, Brazil
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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.
Author Notes
Financial support: Rodrigo Scaliante Moura was a recipient of a scholarship from the National Council for Scientific and Technological Development/CNPq, Brazil (grant #152678/2011-5) and Ludimila Paula Vaz Cardoso was supported by a fellowship from the Coordination for the Improvement of Higher Education Personnel/CAPES, Brazil (grant #02479/09-5). Mariane Martins De Araújo Stefani is a recipient of a fellowship from CNPq (grant # 304869/2008-2). U-MDT/CT-BR was funded by the Department of Science and Technology (DECIT) of Brazilian Ministry of Health and CNPq (grant # 40.3293/2005-7).
Authors' addresses: Rodrigo Scaliante Moura, Ludimila Paula Vaz Cardoso, Mariane Martins de Araújo Stefani, and Samira Bührer-Sékula, Departamento de Imunologia, Instituto de Patologia Tropical e Saúde Pública, Sala 335, Rua 235 s/n, Setor Leste Universitário Goiânia, Goias, Brazil, E-mails: rodrigoscaliant@gmail.com, ludimilacardoso@gmail.com, mmastefani@gmail.com, samira@buhrer.net, and samira.buhrer@gmail.com. Gerson Oliveira Penna, Núcleo de Medicina Tropical, Campus Universitário Darci Ribeiro, Universidade de Brasília, Brasília–DF, E-mail: gpenna@gpenna.net. Maria Araci de Andrade Pontes and Heitor de Sá Gonçalves, Centro de Referência Nacional Dona Libânia–CDERM, Rua Pedro I, Centro, Fortaleza, Brazil–CE, E-mails: maracipontes@gmail.com and heitorsg@terra.com.br. Rossilene Cruz, Centro de Referência Nacional Alfredo da Matta–FUAM, Avenida Codajás, Cachoeirinha, Manaus–AM. Maria Lúcia Fernandes Penna, Centro de Ciências Médicas, Instituto de Saúde da Comunidade, Universidade Federal Fluminense, Rua Marques do Paraná, Centro, Niteroi, Brazil–RJ, E-mail: mlfpenna@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Ridley DS, Jopling WH, 1966. Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis 34: 255–273.
-
2.
WHO, 2012. WHO Expert Committee on Leprosy: Eighth Report. Geneva, Switzerland: WHO.
-
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): S23–S31.
-
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): 22–27.
-
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: 308–319.
-
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): 11–18.
-
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: 196–205.
-
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: 130–132.
-
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.
-
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.
-
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: 125–133.
-
12.
Baohong J, 2001. Does there exist a subgroup of MB patients at greater risk of relapse after MDT? Lepr Rev 72: 3–7.
-
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: 1991–1995.
-
14.
Landis JR, Koch GG, 1977. The measurement of observer agreement for categorical data. Biometrics 33: 159–174.
-
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: 262–266.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 62 | 62 | 20 |
| Full Text Views | 485 | 109 | 0 |
| PDF Downloads | 170 | 47 | 0 |