Search

Introduction: Leprosy recurrence is the reappearance of the disease after treatment with current schemes and discharged for cure and may have variable incubation periods., Methods: This is a descriptive observational study of leprosy recurrence in Espírito Santo diagnosed between January 2018 and January 2020., Results: One hundred and ninety-two cases were available, of which 30 were diagnosed with leprosy recurrence., Conclusions: In 25 cases, the incubation period was 5-15 years after the first treatment, favoring bacillary persistence. In the remaining 5 cases, the disease had recurred after 15 years, pointing to reinfection as none of them exhibited drug resistance.

Skin biopsy samples from 145 relapse leprosy cases and from five different regions in Brazil were submitted for sequence analysis of part of the genes associated with Mycobacterium leprae drug resistance. Single nucleotide polymorphisms (SNPs) in these genes were observed in M. leprae from 4 out of 92 cases with positive amplification (4.3%) and included a case with a mutation in rpoB only, another sample with SNPs in both folP1 and rpoB, and two cases showing mutations in folP1, rpoB, and gyrA, suggesting the existence of multidrug resistance (MDR). The nature of the mutations was as reported in earlier studies, being CCC to CGC in codon 55 in folP (Pro to Arg), while in the case of rpoB, all mutations occurred at codon 531, with two being a transition of TCG to ATG (Ser to Met), one TCG to TTC (Ser to Phe), and one TCG to TTG (Ser to Leu). The two cases with mutations in gyrA changed from GCA to GTA (Ala to Val) in codon 91. The median time from cure to relapse diagnosis was 9.45 years but was significantly shorter in patients with mutations (3.26 years; P = 0.0038). More than 70% of the relapses were multibacillary, including three of the mutation-carrying cases; one MDR relapse patient was paucibacillary.

Leprosy may present acute/subacute inflammatory processes (leprosy reactions). The study characterized the reactional states of patients at health clinics in Vitória, Espírito Santo State, Brazil, and associated them with sociodemographic factors and clinical/nutritional variables. between January and December 2009, longitudinal follow-up of patients with leprosy continued until leprosy reactions occurred or patients completed 6 months of multidrug therapy. Of the 151 patients participating, 78 (51.7%) were females, 48 (31.8%) had 5 to 8 years schooling, 93 (61.6%) worked and earned from 1 to 3 minimum wages, and 55 (36.4 %) had leprosy reactions, but with no statistical association to socioeconomic characteristics or nutritional status. However, absence of reaction was more common in the low-weight group, suggesting a trend in this group to protection from the reaction (p = 0.0906). The study found no association between nutritional status and leprosy reaction.

Introduction: In 1997, after obtaining a combined multi-state double-blind randomly controlled clinical trial study from nine Indian centers involved in the treatment of Hansen's Disease, the Ministry of Health adapted the single dose ROM Therapy approach in those cases involving the treatment of a single skin lesion, paucibacillary leprosy without evidence of peripheral nerve trunk involvement and indication of negative baciloscope, in the Referral Centers in Brazil. The study aimed to evaluate the effectiveness of the single dose ROM Therapy approach in those patients who were treated from the period of 1997 to 1999 in the Ambulatory Dermatologic Unit in the Hospital in Vitória, ES., Methods: Fifty-four patients with tuberculoid and indeterminate leprosy were selected and treated with the single dose ROM Therapy approach. These patients were contacted from March 2006 up and until October 2006 for further clinical reevaluation., Results: From the studies conducted, the following results were found to exist: 29 patients (85,2%; 95%CI: 70-100,4) were cured, 5 patients (14,7%; 95%CI: 7,4-22,0) relapsed, and 20 patients didn't return; however, there are no additional records of any notification of other treatment(s) in the State Department of Health's informational data banks., Conclusions: The study demonstrated a rate of cure of 90.8% and a rate of relapse of 9.2% after a period of seven to nine years using the single dose ROM Therapy approach. Additionally, this alternative treatment further demonstrated a better effectiveness for a single skin lesion smaller than four centimeters and with an appearance in less than five years.

Leprosy relapse is the reappearance of the disease after regular treatment with current regimens and discharge due to cure. In this retrospective and descriptive cohort study, the aim was to evaluate the characteristics of cases of leprosy relapse in the State of Espírito Santo between 2000 and 2005. The investigation strategies consisted of monitoring the SINAN entries, with file analysis and case discussions at the State Reference Center. One hundred and four cases of relapse were studied, representing 1.12% of the new cases detected over this period. The greatest frequency was between 21 and 60 years of age; 59.6% were men; 44.2% presented relapse more than five years after discharge; 66.4% were multibacillary; and 42.2% presented positive bacilloscopy (complete bacilli) and therefore were relapse cases. Negatives bacilloscopy was observed in 57.8%. Prospective studies should be conducted to establish the real relapse rate.

Intestinal helminths are known to subvert the host's immune response towards a Th2 response, which in turn may lead to both eosinophilia and high immunoglobulin E titers often associated with these parasites. Mycobacterium leprae infection may lead to different clinical and pathological forms. Multibacillary forms are associated with Th2 cytokines, whereas paucibacillary forms are associated with Th1 cytokines. We report a significantly higher frequency of intestinal helminthic infections in patients with the lepromatous form, a multibacillary form of leprosy (odds ratio, 2.99; 95% confidence interval, 1.82-4.95; P = 0.006) when compared with patients with paucibacillary leprosy or to a control group without leprosy. A direct correlation was also found between mycobacterial index and the frequency of intestinal helminths. Our results suggest that the presence of intestinal helminths may facilitate the establishment of M. leprae infection or the progression to more severe forms of leprosy.