Monitoring of the efficacy of multidrug therapy (MDT) by polymerase chain reaction (PCR) and, <em>Mycobacterium leprae</em> particle agglutination (MLPA) test in leprosy patients

Leprosy caused by Mycobacterium leprae, is still considered a major health problem in many developing countries. The routine bacteriological test on the demonstration of acid-fast bacilli in skin smears is not sufficiently sensitive or specific in the paucibacillary leprosy patients. To detect DNA of Mycobacterium leprae by Polymerase Chain Reaction (PCR) from skin biopsy specimen as a means of diagnosis of paucibacillary leprosy. It was a cross-sectional study of clinically diagnosed 33 cases of Paucibacillary leprosy patients. Laboratory works were performed in the Department of Microbiology and Immunology and Department of pathology; Bangabandhu Sheikh Mujib Medical University (BSMMU) and Leprosy Control Institute and Hospital, Mohakhali, Dhaka from November 2013 to June 2015. It was observed that the mean age of patients was found 30.9±13.7 years, 19(57.6%) patients had two to five skin lesions, all (100%) patients had tuberculoid type of leprosy, all (100%) patients had loss of sensation and 18(54.5%) patients had nerve thickening. Regarding slit skin smear test, it was observed that all (100%) patients were slit skin smear negative for leprosy bacilli, 8(24.2%) patients had positive skin biopsy for histopathology and 15(45.5%) patients had positive skin biopsy for PCR. The validity of PCR for identification of paucibacillary leprosy correlated with sensitivity 100%, specificity 72%, accuracy 78.8%, positive predictive value 53.3% and negative predictive value 100%. Polymerase chain reaction (PCR) has definite value in the diagnosis of paucibacillary leprosy and can be regarded as a sensitive and specific diagnostic modality. CBMJ 2015 July: Vol. 04 No. 02 P: 41-48

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Evaluation of polymerase chain reaction amplification of Mycobacterium leprae-specific repetitive sequence in biopsy specimens from leprosy patients.

Journal of Clinical Microbiology ◽

10.1128/jcm.31.4.895-899.1993 ◽

1993 ◽

Vol 31 (4) ◽

pp. 895-899 ◽

Cited By ~ 27

Author(s):

K H Yoon ◽

S N Cho ◽

M K Lee ◽

R M Abalos ◽

R V Cellona ◽

...

Keyword(s):

Polymerase Chain Reaction ◽

Repetitive Sequence ◽

Polymerase Chain Reaction Amplification ◽

Mycobacterium Leprae ◽

Chain Reaction ◽

Biopsy Specimens ◽

Leprosy Patients ◽

Reaction Amplification ◽

Polymerase Chain

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Mycobacterium leprae in Daily Water Resources of Inhabitants Who Live in Leprosy Endemic Area of East Java

Indonesian Journal of Tropical and Infectious Disease ◽

10.20473/ijtid.v1i2.2164 ◽

2010 ◽

Vol 1 (2) ◽

pp. 65 ◽

Cited By ~ 5

Author(s):

Ratna Wahyuni ◽

Dinar Adriaty ◽

Iswahyudi Iswahyudi ◽

Cita Rosita S. Prakoeswa ◽

Indropo Agusni ◽

...

Keyword(s):

Water Samples ◽

Endemic Area ◽

Mycobacterium Leprae ◽

Multidrug Therapy ◽

Chain Reaction ◽

Daily Life Activities ◽

Leprosy Patients ◽

Daily Water ◽

Pcr Method ◽

Polymerase Chain

Leprosy still a health problem in Indonesia, where many leprosy pocket areas still persists, especially in the eastern part of the country. Although the program of WHO – Multidrug Therapy (MDT) regiment has been conducted elsewhere since 1980s, only the prevalence can be reduced but not the incidence of new leprosy cases. Theoretically after the source of leprosy (the infectious leprosy cases) has been treated, no more transmission of the disease and should be no more new leprosy cases will be found. To explain this phenomenon, the non-human resource of M.leprae became a new topic of debates, especially the existence of bacteria in the environment. A field study of the existence of M.leprae in the environment of leprosy endemic area had been conducted in a leprosy endemic area of the northern part of East Java. The aim of the study is to find any correlation of the existence of these bacteria in the environment with the presence of leprosy patients who live in that area, in order to study its role in the transmission of the disease. Ninety water samples from wells in the house of inhabitants who live in one endemic sub district were collected. The owner of the well was interviewed whether any leprosy patients who routinely use the water for their daily life activities. Water samples were examined by Polymerase Chain Reaction (PCR) method to detect M.leprae DNA, using the LpF-LpR and Lp3-Lp4 nested primers (99bp). The PCR results showed positive band for M.leprae in 22 out of 90 (24%) water samples. Water samples from wells that used by leprosy patients showed positive PCR in 11/48 (23%), while 11 out of 42 (26%) water samples from wells that never been used by leprosy cases showed positive result. Statistically there was no difference (p>0.05) in the positivity of M.leprae between the two groups. It was concluded that the existence of M.leprae in the daily water resource was not correlated with the present of leprosy cases in the area. Possible symbiosis between protozoan and mycobacterium in the environment were discussed.

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