Eyleen Nabyla Alvarenga Niitsuma1,2, Isabela de Caux Bueno2, Elis Oliveira Arantes2, Ana Paula Mendes Carvalho3, Gesner Francisco Xavier Junior4, Gabriel da Rocha Fernandes5, Francisco Carlos Félix Lana6. 1. Instituto Federal de Educação, Ciência e Tecnologia do Norte de Minas Gerais - Almenara (MG), Brasil. 2. Programa de Pós-graduação em Enfermagem, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil. 3. Diretoria de Vigilância de Condições Crônicas, Secretaria de Estado de Saúde de Minas Gerais - Belo Horizonte (MG), Brasil. 4. Biblioteca José Baeta Vianna, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil. 5. Instituto René Rachou, Fundação Oswaldo Cruz - Belo Horizonte (MG), Brasil. 6. Departamento de Enfermagem Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
Abstract
OBJECTIVE: To investigate the risk factors associated with leprosy in contacts of patients. METHOD: We carried out a systematic review and meta-analysis by searching the databases MEDLINE, Embase, Cochrane Library, CINAHL, LILACS, Scopus, and Web of Science until September 2019. Four reviewers carried out the selection, analysis, and evaluation of quality of studies. The random effects model was used to calculate the pooled relative risk (RR) and 95% confidence intervals (95% CI) when heterogeneity was greater than 50%. RESULTS: The search resulted in 2,148 references and included 24 reports. Most of the studies had been conducted in Brazil and India, had a cohort design and included household, neighbors, and social contacts. The risk factors associated with illness due to leprosy in contacts were: illiteracy (RR = 1,48; 95%CI 1,22 - 1,79), living in the same house (RR = 2,41; 95%CI 1,87 - 3,10) of a case of leprosy with high bacillary load (RR = 2.40; 95%CI 1.69 - 3.41), seropositivity to the Mycobacterium leprae PGL-1 (phenolic glycolipid-1) antigen (RR = 3.54; 95%CI 2.21 - 5.67), presence of the bacillus in the bloodstream (RR = 10.61; 95%CI 4.74 - 23.77) and negative Mitsuda reaction (RR = 2,68; 95%CI 1,76 - 4,07). Immunization with BCG (bacillus Calmette-Guérin) vaccine had a protective effect against leprosy. CONCLUSION: Leprosy in contacts of patients involves social determination, individual susceptibility, and difficulties in access to disease control actions, but modifiable risk factors are the main determinants of illness in this population.
OBJECTIVE: To investigate the risk factors associated with leprosy in contacts of patients. METHOD: We carried out a systematic review and meta-analysis by searching the databases MEDLINE, Embase, Cochrane Library, CINAHL, LILACS, Scopus, and Web of Science until September 2019. Four reviewers carried out the selection, analysis, and evaluation of quality of studies. The random effects model was used to calculate the pooled relative risk (RR) and 95% confidence intervals (95% CI) when heterogeneity was greater than 50%. RESULTS: The search resulted in 2,148 references and included 24 reports. Most of the studies had been conducted in Brazil and India, had a cohort design and included household, neighbors, and social contacts. The risk factors associated with illness due to leprosy in contacts were: illiteracy (RR = 1,48; 95%CI 1,22 - 1,79), living in the same house (RR = 2,41; 95%CI 1,87 - 3,10) of a case of leprosy with high bacillary load (RR = 2.40; 95%CI 1.69 - 3.41), seropositivity to the Mycobacterium leprae PGL-1 (phenolic glycolipid-1) antigen (RR = 3.54; 95%CI 2.21 - 5.67), presence of the bacillus in the bloodstream (RR = 10.61; 95%CI 4.74 - 23.77) and negative Mitsuda reaction (RR = 2,68; 95%CI 1,76 - 4,07). Immunization with BCG (bacillus Calmette-Guérin) vaccine had a protective effect against leprosy. CONCLUSION: Leprosy in contacts of patients involves social determination, individual susceptibility, and difficulties in access to disease control actions, but modifiable risk factors are the main determinants of illness in this population.
Authors: Celivane Cavalcanti Barbosa; Gilberto Silva Nunes Bezerra; Amanda Tavares Xavier; Maria de Fátima Pessoa Militão de Albuquerque; Cristine Vieira do Bonfim; Zulma Maria de Medeiros; Wayner Vieira de Souza Journal: Int J Environ Res Public Health Date: 2022-09-26 Impact factor: 4.614