scholarly journals Detection of new Mycobacterium leprae subtype in Bangladesh by genomic characterization to explore transmission patterns

2020 ◽  
Author(s):  
Maria Tió-Coma ◽  
Charlotte Avanzi ◽  
Els M. Verhard ◽  
Louise Pierneef ◽  
Anouk van Hooij ◽  
...  
Keyword(s):  
Molecular Detection ◽  
Mycobacterium Leprae ◽  
Post Exposure Prophylaxis ◽  
Strain Diversity ◽  
Reduced Genome ◽  
Nasal Swabs ◽  
Leprosy Patients ◽  
Genomic Characterization ◽  
Exposure Prophylaxis ◽  
Host Evolution

AbstractMycobacterium leprae, the causative agent of leprosy, is an unculturable bacterium with a considerably reduced genome (3.27 Mb) compared to homologues mycobacteria from the same ancestry. M. leprae transmission is suggested to occur through aerosols but the exact mechanisms of infection remains unclear. In 2001, the genome of M. leprae was first described and subsequently four genotypes (1-4) and 16 subtypes (A-P) were identified providing means to study global transmission patterns for leprosy.We investigated M. leprae carriage as well as infection in leprosy patients (n=60) and healthy household contacts (HHC; n=250) from Bangladesh using molecular detection of the bacterial element RLEP in nasal swabs (NS) and slit skin smears (SSS). In parallel, we explored bacterial strain diversity by whole-genome sequencing (WGS) and Sanger sequencing.In the studied cohort in Bangladesh, M. leprae DNA was detected in 33.3% of NS and 22.2% of SSS of patients with bacillary index of 0 whilst in HHC 18.0% of NS and 12.3% of SSS were positive.The majority of the M. leprae strains detected in this study belonged to genotype 1D (55%), followed by 1A (31%). Importantly, WGS allowed the identification of a new M. leprae genotype, designated 1B-Bangladesh (14%), which clustered separately between the 1A and 1B strains. Moreover, we established that the genotype previously designated 1C, is not an independent subtype but clusters within the 1D genotype.Intraindividual differences were present between the M. leprae strains obtained including mutations in hypermutated genes, suggesting mixed colonization/infection or in-host evolution.In summary, we observed that M. leprae is present in asymptomatic contacts of leprosy patients fueling the concept that these individuals contribute to the current intensity of transmission. Our data therefore emphasize the importance of sensitive and specific tools allowing post-exposure prophylaxis targeted at M. leprae-infected or -colonized individuals.

scholarly journals TTC Repeats Variation of Mycobacterium leprae Isolates for Analysis of Leprosy Transmission in Leprosy Endemic Area in East Java, INDONESIA

2010 ◽  
Vol 1 (1) ◽  
pp. 38 ◽  
Author(s):  
Dinar Adriaty ◽  
Ratna Wahyuni ◽  
Iswahyudi Iswahyudi ◽  
Indropo Agusni ◽  
Shinzo Izumi
Keyword(s):  
Water Resources ◽  
Molecular Typing ◽  
Endemic Area ◽  
Nasal Swab ◽  
Direct Sequencing ◽  
Mycobacterium Leprae ◽  
High Prevalence ◽  
Nasal Swabs ◽  
Leprosy Patients ◽  
Pattern Distribution

East Java province still has some pocket of leprosy endemic areas. In order to solve the problem, molecular typing will make it feasible to study the transmission pattern of Mycobacterium leprae in leprosy endemic area. The present study is to analyze the presence of M.leprae DNA in the environment and to study variation number of TTC repeats and their distribution. Poteran Island is located in Madura, East Java and was chosen because this island has a high prevalence of leprosy and remains stable for the last five years. All samples were analyzed by PCR and the numbers of TTC repeats were confirmed by direct sequencing. Of all collected samples, 26.4% isolates of water resources (24); 61.9% nasal swabs (26); and 35.3% skin tissues (24) are positives. No statistically difference in the pattern distribution of TTC repeats between skin tissues of patients and nasal swab of households contact (p=0.594); also distribution of TTC repeats between skin tissues of leprosy patients and those of water resources (p=0.441); and distribution of TTC repeats between nasal swab of households contact with water resources (p=0.906). It means that the transmission of M.leprae in leprosy endemic area has closely related in 3 aspects: agent, host & environment.

scholarly journals Molecular Detection of Dapsone and Rifampicin Resistance on Mycobacterium leprae from Leprosy Patients in East Java

2009 ◽  
Vol 3 (3) ◽  
pp. 115-120 ◽  
Author(s):  
DINAR ADRIATY ◽  
RATNA WAHYUNI ◽  
CITA ROSITA S PRAKOESWA ◽  
NI PUTU SUSARI ◽  
INDROPO AGUSNI ◽  
...  
Keyword(s):  
Molecular Detection ◽  
Mycobacterium Leprae ◽  
Rifampicin Resistance ◽  
Leprosy Patients

Molecular detection of multidrug-resistant Mycobacterium leprae from Indian leprosy patients

2018 ◽  
Vol 12 ◽  
pp. 214-219 ◽  
Author(s):  
Mallika Lavania ◽  
Itu Singh ◽  
Ravindra P. Turankar ◽  
Madhvi Ahuja ◽  
Vinay Pathak ◽  
...  
Keyword(s):  
Molecular Detection ◽  
Mycobacterium Leprae ◽  
Multidrug Resistant ◽  
Leprosy Patients

scholarly journals Protocol, rationale and design of PEOPLE (Post ExpOsure Prophylaxis for LEprosy in the Comoros and Madagascar): a cluster randomized trial on effectiveness of different modalities of implementation of post-exposure prophylaxis of leprosy contacts

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nimer Ortuno-Gutierrez ◽  
Assoumani Younoussa ◽  
Andriamira Randrianantoandro ◽  
Sofie Braet ◽  
Bertrand Cauchoix ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Cluster Randomized Trial ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Link Type ◽  
High Incidence ◽  
Leprosy Patients ◽  
Household Members ◽  
Cluster Randomized ◽  
Exposure Prophylaxis

Abstract Background Leprosy is an ancient infectious disease with a global annual incidence that has plateaued above 200,000 new cases since over a decade. New strategies are required to overcome this stalemate. Post-exposure prophylaxis (PEP) with a single dose of Rifampicin (SDR) has conditionally been recommended by the World Health Organization (WHO), based on a randomized-controlled-trial in Bangladesh. More evidence is required. The Post ExpOsure Prophylaxis for Leprosy (PEOPLE) trial will assess effectiveness of different modalities of PEP on the Comoros and Madagascar. Methods PEOPLE is a cluster-randomized trial with villages selected on previous leprosy-incidence and randomly allocated to four arms. Four annual door-to-door surveys will be performed in all arms. All consenting permanent residents will be screened for leprosy. Leprosy patients will be treated according to international guidelines and eligible contacts will be provided with SDR-PEP. Arm-1 is the comparator in which no PEP will be provided. In arms 2, 3 and 4, SDR-PEP will be provided at double the regular dose (20 mg/kg) to eligible contacts aged two years and above. In arm 2 all household-members of incident leprosy patients are eligible. In arm 3 not only household-members but also neighbourhood contacts living within 100-m of an incident case are eligible. In arm 4 such neighbourhood contacts are only eligible if they test positive to anti-PGL-I, a serological marker. Incidence rate ratios calculated between the comparator arm 1 and each of the intervention arms will constitute the primary outcome. Discussion Different trials on PEP have yielded varying results. The pivotal COLEP trial in Bangladesh showed a 57% reduction in incidence over a two-year period post-intervention without any rebound in the following years. A study in a high-incidence setting in Indonesia showed no effect of PEP provided to close contacts but a major effect of PEP provided as a blanket measure to an entire island population. High background incidence could be the reason of the lack of effect of PEP provided to individual contacts. The PEOPLE trial will assess effectiveness of PEP in a high incidence setting and will compare three different approaches, to identify who benefits most from PEP. Trial registration Clinicaltrials.Gov. NCT03662022. Initial Protocol Version 1.2, 27-Aug-2018.

scholarly journals Number of people requiring post-exposure prophylaxis to end leprosy: A modeling study

2021 ◽  
Vol 15 (2) ◽  
pp. e0009146
Author(s):  
Anneke T. Taal ◽  
David J. Blok ◽  
Wim H. van Brakel ◽  
Sake J. de Vlas ◽  
Jan Hendrik Richardus
Keyword(s):  
Contact Tracing ◽  
Post Exposure Prophylaxis ◽  
First Year ◽  
Post Exposure ◽  
Leprosy Patients ◽  
Using Data ◽  
The Individual ◽  
Exposure Prophylaxis ◽  
The Impact

Background Worldwide, around 210,000 new cases of leprosy are detected annually. To end leprosy, i.e. zero new leprosy cases, preventive interventions such as contact tracing and post-exposure prophylaxis (PEP) are required. This study aims to estimate the number of people requiring PEP to reduce leprosy new case detection (NCD) at national and global level by 50% and 90%. Methodology/Principal findings The individual-based model SIMCOLEP was fitted to seven leprosy settings defined by NCD and MB proportion. Using data of all 110 countries with known leprosy patients in 2016, we assigned each country to one of these settings. We predicted the impact of administering PEP to about 25 contacts of leprosy patients on the annual NCD for 25 years and estimated the number of contacts requiring PEP per country for each year. The NCD trends show an increase in NCD in the first year (i.e. backlog cases) followed by a significant decrease thereafter. A reduction of 50% and 90% of new cases would be achieved in most countries in 5 and 22 years if 20.6 and 40.2 million people are treated with PEP over that period, respectively. For India, Brazil, and Indonesia together, a total of 32.9 million people requiring PEP to achieve a 90% reduction in 22 years. Conclusion/Significance The leprosy problem is far greater than the 210,000 new cases reported annually. Our model estimates of the number of people requiring PEP to achieve significant reduction of new leprosy cases can be used by policymakers and program managers to develop long-term strategies to end leprosy.

Low awareness and use of post-exposure prophylaxis among adolescents and young adults in South Africa: implications for the prevention of new HIV infections

2020 ◽  
Vol 19 (3) ◽  
pp. 242-248
Author(s):  
Anthony Idowu Ajayi ◽  
Mohammed Sanusi Yusuf ◽  
Elmon Mudefi ◽  
Oladele Vincent Adeniyi ◽  
Ntombana Rala ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Hiv Infections ◽  
Adolescents And Young Adults ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Study of sharp injuries and blood splash exposures among healthcare workers in a tertiary hospital in Bangalore

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Shalini Sivananjiah Pradeep ◽  
Suman Gadicherla Raghu ◽  
Prathab A G ◽  
Banashankari G Rudresh ◽  
Radhika Kunnavil
Keyword(s):  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Post Exposure Prophylaxis ◽  
Care Hospital ◽  
Post Exposure ◽  
Increased Risk ◽  
Management Procedures ◽  
Exposure Prophylaxis ◽  
Sharps Injury ◽  
Sharps Injuries

The working environment of healthcare workers (HCW) exposes them to sharp injuries. This communication attempts to examine the injury registers, incidence of sharps injuries and blood splash exposures, and the post-exposure prophylaxis status of employees in a tertiary care hospital. Analysis included records form 54 locations of two units of a tertiary hospital attached to a Medical College. Maintenance of the injury register overall was highly satisfactory in both units. Two hundred and nine injuries were recorded from both units of the hospital. The majority of injuries (60.5%) occurred in the age group of 20-30 years with 70% among females. Waste handlers were at increased risk during waste management procedures. Thirty two percent of sharps injury injuries occurred in wards. Of the ward nursing staff, 25.3% received sharps injuries. Post-exposure prophylaxis for Hepatitis B (primary dose) was given to 25 HCWs; 11 received booster doses. The basic regimen for HIV post-exposure prophylaxis was given to 4 HCWs. Awareness about records maintenance, regular documentation, awareness and training, and implementation of appropriate preventive measures can reduce the incidence of injuries. Key words: Sharps, injury register, Health care workers (HCW),Post exposure prophylaxis (PEP)

Recent Advancement in the Diagnosis and Treatment of Leprosy

2018 ◽  
Vol 18 (18) ◽  
pp. 1550-1558
Author(s):  
Muhammad Aamir ◽  
Asma Sadaf ◽  
Sehroon Khan ◽  
Shagufta Perveen ◽  
Afsar Khan
Keyword(s):  
Vitamin D ◽  
Drug Treatment ◽  
Mycobacterium Leprae ◽  
Neglected Diseases ◽  
Specific Drug ◽  
Genetic Studies ◽  
Vitamin D Receptors ◽  
Micro Rnas ◽  
Leprosy Patients ◽  
Skin Biopsies

Background: Many of the tropical diseases are neglected by the researchers and medicinal companies due to lack of profit and other interests. The Drugs for Neglected Diseases initiative (DNDi) is established to overcome the problems associated with these neglected diseases. According to a report published by the WHO, leprosy (Hansen's disease) is also a neglected infectious disease. Methods: A negligible amount of advancements has been made in last few decades which includes the tools of diagnosis, causes, treatment, and genetic studies of the bacterium (Mycobacterium leprae) that causes leprosy. The diagnosis of leprosy at earlier stages is important for its effective treatment. Recent studies on vitamin D and its receptors make leprosy diagnosis easier at earlier stages. Skin biopsies and qPCR are the other tools to identify the disease at its initial stages. Results: Until now a specific drug for the treatment of leprosy is not available, therefore, Multi-Drug Therapy (MDT) is used, which is hazardous to health. Besides Mycobacterium leprae, recently a new bacterium Mycobacterium lepromatosis was also identified as a cause of leprosy. During the last few years the genetic studies of Mycobacterium leprae, the role of vitamin D and vitamin D receptors (VDR), and the skin biopsies made the treatment and diagnosis of leprosy easier at early stages. The studies of micro RNAs (miRNAs) made it easy to differentiate leprosy from other diseases especially from tuberculosis. Conclusion: Leprosy can be distinguished from sarcoidosis by quantitative study of reticulin fibers present in skin. The treatment used until now for leprosy is multi-drug treatment. The complete genome identification of Mycobacterium leprae makes the research easy to develop target specified drugs for leprosy. Rifampicin, identified as a potent drug, along with other drugs in uniform multi-drug treatment, has a significant effect when given to leprosy patients at initial stages. These are effective treatments but a specific drug for leprosy is still needed to be identified. The current review highlights the use of modern methods for the identification of leprosy at its earlier stages and the effective use of drugs alone as well as in combination.

Sign in / Sign up

Export Citation Format

Share Document