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Minimally invasive sampling to identify leprosy patients with a high bacterial burden in the Union of the Comoros
- Source :
- PLoS Neglected Tropical Diseases, 15(11). PUBLIC LIBRARY SCIENCE, PLoS Neglected Tropical Diseases, PLoS neglected tropical diseases, PLoS Neglected Tropical Diseases, Vol 15, Iss 11 (2021), PLoS Neglected Tropical Diseases, Vol 15, Iss 11, p e0009924 (2021)
- Publication Year :
- 2021
- Publisher :
- Public Library of Science (PLoS), 2021.
-
Abstract
- The World Health Organization (WHO) endorsed diagnosis of leprosy (also known as Hansen’s disease) entirely based on clinical cardinal signs, without microbiological confirmation, which may lead to late or misdiagnosis. The use of slit skin smears is variable, but lacks sensitivity. In 2017–2018 during the ComLep study, on the island of Anjouan (Union of the Comoros; High priority country according to WHO, 310 patients were diagnosed with leprosy (paucibacillary = 159; multibacillary = 151), of whom 263 were sampled for a skin biopsy and fingerstick blood, and 260 for a minimally-invasive nasal swab. In 74.5% of all skin biopsies and in 15.4% of all nasal swabs, M. leprae DNA was detected. In 63.1% of fingerstick blood samples, M. leprae specific antibodies were detected with the quantitative αPGL-I test. Results show a strong correlation of αPGL-I IgM levels in fingerstick blood and RLEP-qPCR positivity of nasal swabs, with the M. leprae bacterial load measured by RLEP-qPCR of skin biopsies. Patients with a high bacterial load (≥50,000 bacilli in a skin biopsy) can be identified with combination of counting lesions and the αPGL-I test. To our knowledge, this is the first study that compared αPGL-I IgM levels in fingerstick blood with the bacterial load determined by RLEP-qPCR in skin biopsies of leprosy patients. The demonstrated potential of minimally invasive sampling such as fingerstick blood samples to identify high bacterial load persons likely to be accountable for the ongoing transmission, merits further evaluation in follow-up studies.<br />Author summary Leprosy is the oldest infectious disease known to humankind. We still do not succeed in curbing its transmission, with more than 200,000 new patients detected worldwide each year. Identifying persons with a high burden of bacteria is key to curb transmission. To identify these persons, bacteria are counted in invasive and painful samples like slit skin smears and skin biopsies. We evaluated whether we can use less invasive samples, like fingerstick blood or nasal swabs, to determine the bacterial load. We found that the level of antibodies against M. leprae (αPGL-I IgM) in fingerstick blood correlates well with the bacterial load determined in skin biopsies from the same leprosy patient. Therefore, a high level of antibodies against M. leprae in fingerstick blood might identify persons who pose a potential risk for transmission of leprosy and could be prioritized for contact screening, which is essential for control of the disease.
- Subjects :
- Male
Bacterial Diseases
Physiology
Epidemiology
Biopsy
RC955-962
Comoros
Disability Evaluation
Medical Conditions
Mathematical and Statistical Techniques
Arctic medicine. Tropical medicine
Medicine and Health Sciences
Sampling (medicine)
Child
Mycobacterium leprae
medicine.diagnostic_test
biology
Transmission (medicine)
Statistics
Mycobacterium Leprae
Body Fluids
Actinobacteria
Blood
Infectious Diseases
Nasal Swab
Physical Sciences
Regression Analysis
Female
Leprosy
Public aspects of medicine
RA1-1270
Anatomy
Research Article
Neglected Tropical Diseases
DNA, Bacterial
medicine.medical_specialty
Adolescent
Infectious Disease Control
Fingerstick
Surgical and Invasive Medical Procedures
Linear Regression Analysis
Research and Analysis Methods
Signs and Symptoms
medicine
Humans
Statistical Methods
Bacteria
business.industry
Organisms
Public Health, Environmental and Occupational Health
Biology and Life Sciences
Tropical Diseases
biology.organism_classification
medicine.disease
Dermatology
Medical Risk Factors
Skin biopsy
Lesions
Human medicine
Clinical Medicine
business
Mathematics
Subjects
Details
- ISSN :
- 19352735 and 19352727
- Volume :
- 15
- Database :
- OpenAIRE
- Journal :
- PLOS Neglected Tropical Diseases
- Accession number :
- edsair.doi.dedup.....f300f8b2ab6102545bf7f8b30ff33861