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- IOC - Artigos de Periódicos [12642]
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LEPROSY AMONG PATIENT CONTACTS: A MULTILEVEL STUDY OF RISK FACTORS
Autor
Afiliación
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ. Brasil.
Universidade do Estado do Rio de Janeiro. Instituto de Medicina Social. Departamento de Epidemiologia. Rio de Janeiro, RJ, Brasil
Resumen en ingles
Background: This study aimed to evaluate the risk factors associated with developing leprosy among the contacts of newlydiagnosed
leprosy patients.
Methodology/Principal Findings: A total of 6,158 contacts and 1,201 leprosy patients of the cohort who were diagnosed
and treated at the Leprosy Laboratory of Fiocruz from 1987 to 2007 were included. The contact variables analyzed were sex;
age; educational and income levels; blood relationship, if any, to the index case; household or non-household relationship;
length of time of close association with the index case; receipt of bacillus Calmette-Gue´rin (BGG) vaccine and presence of
BCG scar. Index cases variables included sex, age, educational level, family size, bacillary load, and disability grade. Multilevel
logistic regression with random intercept was applied. Among the co-prevalent cases, the leprosy-related variables that
remained associated with leprosy included type of household contact, [odds ratio (OR) = 1.33, 95% confidence interval (CI):
1.02, 1.73] and consanguinity with the index case, (OR = 1.89, 95% CI: 1.42–2.51). With respect to the index case variables,
the factors associated with leprosy among contacts included up to 4 years of schooling and 4 to 10 years of schooling
(OR = 2.72, 95% CI: 1.54–4.79 and 2.40, 95% CI: 1.30–4.42, respectively) and bacillary load, which increased the chance of
leprosy among multibacillary contacts for those with a bacillary index of one to three and greater than three (OR = 1.79, 95%
CI: 1.19–2.17 and OR: 4.07–95% CI: 2.73, 6.09), respectively. Among incident cases, household exposure was associated with
leprosy (OR = 1.96, 95% CI: 1.29–2.98), compared with non-household exposure. Among the index case risk factors, an
elevated bacillary load was the only variable associated with leprosy in the contacts.
Conclusions/Significance: Biological and social factors appear to be associated with leprosy among co-prevalent cases,
whereas the factors related to the infectious load and proximity with the index case were associated with leprosy that
appeared in the incident cases during follow-up.
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