Detection of subclinical Mycobacterium leprae infection in children, contacts of leprosy cases, Fortaleza Ceará, Brazil

Federal University of Ceará. School of Medicine. Department of Pathology and Legal Medicine. Fortaleza, CE, Brazil.Federal University of Ceará. School of Medicine. Department of Pathology and Legal Medicine. Fortaleza, CE, Brazil.Federal University of Ceará. School of Medicine. Department of Pathology and Legal Medicine. Fortaleza, CE, Brazil.Ceará State University. Center for Health Sciences. Fortaleza,CE, Brazil.Federal University of Ceará. School of Medicine. Department of Pathology and Legal Medicine. Fortaleza, CE, Brazil.Dona Libania National Reference Center in Sanitary Dermatology. Fortaleza, CE, BrazilMinistério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, Brasil.Federal University of Ceará. School of Medicine. Department of Pathology and Legal Medicine. Fortaleza, CE, Brazil.Objectives: To investigate the subclinical infection of leprosy in contacts younger than 15 years old of new leprosy cases diagnosed at the Dona Libania Dermatology Center in Fortaleza, Ceara. Methods: This was a cross-sectional study involving 69 leprosy cases and 101 household contacts under 15 years old. Nasal secretion samples were collected in order to investigate the Bacilloscopic Index (BI) for M. leprae and to detect the DNA of the bacilli; we also investigated the seropositivity of the IgM antibody to the PGL1 antigen through the ML-Flow technique. Results: Evaluating the positivity of all three techniques used in the study, we obtained a frequency of 33.7% for ML-Flow, 16.1% for PCR of DNA and 1.98% for BI in nasal secretion. The positivity for RLEP PCR and in the anti-PGL-1 indicates stimulation of the immune response and consequent subclinical infection. In our study, all positive BI cases were also RLEP PCR positive, which confirms the presence of the bacillus in the nasal mucosa of the studied contacts. The seropositivity to anti-PGL-1 was higher among the female sex, the ones between 11 and 15 years old and among the contacts of paucibacillary (PB) cases. Conclusions: Such techniques when used together help the monitoring of contacts with greater risk of developing the disease, especially in childhood