OBJECTIVES: To compare a new scoring system for multibacillary (MB) leprosy relapses, which combines time factor, risk factors and clinical presentation at relapse, to WHO criteria. METHODS: Data were collected on all relapses diagnosed between 1998 and 2004 at the Marie-Adelaide-Centre in Karachi, Pakistan, including case histories, clinical manifestations, follow-up, bacterial indices, treatment and contacts. For the diagnosis of MB relapses a simple scoring system was developed and validated on a data-set of mouse foot pads (MFP)-confirmed relapses (Leprosy Reviews, 76, 2005, 241). Its sensitivity was further evaluated in the Karachi relapse cohort. The P-value was calculated with McNemar's test with continuity correction. RESULTS: The new scoring system that combines time factor, risk factors and clinical presentation at relapse had a higher sensitivity in MFP-confirmed relapses than the WHO-criteria (95%vs. 65%, P < 0.01). The sensitivity of the scoring system was also significantly higher than the WHO criteria in the 57 cases of MB-relapses diagnosed in Karachi (72%vs. 54%, P < 0.05). CONCLUSIONS: This new simple scoring system for diagnosing MB-relapses in leprosy should be further validated in a prospective study to confirm its superior sensitivity and to evaluate the specificity of these criteria by using MFP-confirmation for patients presenting with signs of activity after treatment.
OBJECTIVES: To compare a new scoring system for multibacillary (MB) leprosy relapses, which combines time factor, risk factors and clinical presentation at relapse, to WHO criteria. METHODS: Data were collected on all relapses diagnosed between 1998 and 2004 at the Marie-Adelaide-Centre in Karachi, Pakistan, including case histories, clinical manifestations, follow-up, bacterial indices, treatment and contacts. For the diagnosis of MB relapses a simple scoring system was developed and validated on a data-set of mouse foot pads (MFP)-confirmed relapses (Leprosy Reviews, 76, 2005, 241). Its sensitivity was further evaluated in the Karachi relapse cohort. The P-value was calculated with McNemar's test with continuity correction. RESULTS: The new scoring system that combines time factor, risk factors and clinical presentation at relapse had a higher sensitivity in MFP-confirmed relapses than the WHO-criteria (95%vs. 65%, P < 0.01). The sensitivity of the scoring system was also significantly higher than the WHO criteria in the 57 cases of MB-relapses diagnosed in Karachi (72%vs. 54%, P < 0.05). CONCLUSIONS: This new simple scoring system for diagnosing MB-relapses in leprosy should be further validated in a prospective study to confirm its superior sensitivity and to evaluate the specificity of these criteria by using MFP-confirmation for patients presenting with signs of activity after treatment.
Authors: Adalgiza da Silva Rocha; Alexandre Araujo Cunha Dos Santos; Patrícia Pignataro; José Augusto Nery; Antônio Basílio de Miranda; Diego Fonseca Soares; Amanda Nogueira Brum Fontes; Alice Miranda; Helen Ferreira; Neio Boéchat; Maria Eugênia Novisck Gallo; Euzenir Nunes Sarno; Maria Leide W De Oliveira; Philip Noel Suffys Journal: J Med Microbiol Date: 2011-05-19 Impact factor: 2.472
Authors: Adalgiza da Silva Rocha; Maria das Graças Cunha; Lucia Martins Diniz; Claudio Salgado; Maria Araci P Aires; José Augusto Nery; Eugênia Novisck Gallo; Alice Miranda; Monica M F Magnanini; Masanori Matsuoka; Euzenir Nunes Sarno; Philip Noel Suffys; Maria Leide W de Oliveira Journal: J Clin Microbiol Date: 2012-04-11 Impact factor: 5.948