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This systematic review (number register: CRD42018112736) was performed to compare the sensitivity and specificity of leprosy diagnostic methods. The search was conducted in 3 electronic databases in January 2021. Studies evaluating leprosy diagnostic tests were included according the eligibility criteria. Meta-analysis was performed to calculate the sensibility and specificity of the groups. We included 36 studies. The test sensitivity for paucibacillary patients was 0.31 (95%CI: 0.29-0.33) and the specificity was 0.92 (95%CI: 0.92-0.93). In multibacillary patients, the sensitivity was 0.78 (95%CI: 0.77-0.80) and specificity was 0.92 (95%CI: 0.92-0.93). Comparing the sensitivity and specificity of the different techniques included, it should be noted that polymerase chain reaction (PCR) test presented the highest sensitivity for paucibacillary patients, while the western blot technique showed the highest sensitivity for multibacillary patients. However, further studies are needed to optimise the diagnosis of leprosy, requiring research with a larger number of samples and more uniform protocols.

Leprosy is a chronic infectious disease caused by Mycobacterium leprae . The identification of mycobacteria in tissue sections can be made through a microscopic examination with fite-faraco staining or PCR method. Paraffin blocks from four patients with leprosy were retrieved from The Pathologic Department of Dr.Soetomo Hospital, Surabaya. Two cases were from paucibacillary leprosy patients with no mycobacteria stained by fite-faraco. PCR assay showed a negative result. The other two cases were multibacillary leprosy with many bacteria stained by fite-faraco. PCR assay showed a positive result.

Objetivo En la lepra, el analisis de segregacion en varias poblaciones humanas sugiere una relacion de alelos particulares de los antigenos leucocitarios humanos (HLA) clase II con el desarrollo de las diferentes formas de la enfermedad. Con el objetivo de determinar si algun alelo de las moleculas de HLA clase II en la poblacion de la provincia del Chaco, Argentina, podrian estar comprometidos en el desarrollo de algunas de las formas de lepra multibacilar (MB) y/o paucibacilar (PB), se determino la frecuencia de los alelos de los loci DR y DQ en pacientes con lepra. Pacientes y metodos Se analizaron 89 muestras de pacientes con lepra (MB 70; PB 19) y 112 controles sanos. Se determinaron los alelos del locus DR y DQ, utilizando amplificacion generica por reaccion en cadena de la polimerasa (PCR) e hibridacion reversa con oligonucleotidos especificos (LIPA KEY-INNOGENETICS). Se encontro una disminucion en la frecuencia del alelo DQB1*0201/0202/0203 en pacientes con lepra multibacilar y disminucion del alelo DRB1*04 en pacientes con lepra paucibacilar respecto a controles, ambos con significacion estadistica. Resultados Segun los resultados observados, DQB1*0201/0202/0203 podria ser un alelo de proteccion en la forma multibacilar de la lepra y el alelo DRB1*04 estaria relacionado con proteccion en lepra paucibacilar. Discusion Pensamos que las diferencias halladas con otras poblaciones caucasicas reportadas por otros autores se deben a que la poblacion chaquena de origen caucasico tiene una fuerte mezcla con nativos de America del Sur, guaranies y tobas.

For this paper we conducted a secondary data analysis to test the hypothesis that a linear trend exists in the protective effect of bacillus Calmette-Guerin (BCG) vaccine against types of leprosy. We used data from two previous case-control studies to perform an unmatched test for linear trend. We observed that both the studies revealed a significant linear trend (P0.00001). One study that estimated an insignificant protective effect of BCG against paucibacillary leprosy showed a significant departure from linearity. We conclude that, the protective effect of BCG vaccination is differential across severity of leprosy as it brings about a shift in the immune response to a higher level of cell mediated immunity. We recommend that future studies dealing with the protective effect of BCG against leprosy should also conduct an analysis for trend.