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Introduction: Leprosy, a chronic infectious disease, is closely linked to the host immune response. According to the WHO, leprosy patients (L) and household contacts (HHC) are classified into subgroups: paucibacillary (PB) and multibacillary (MB), witch reflect the degree of infection in patients and the level of exposure of their contacts. The main goal of this study was to: i) establish a comprehensive overview of soluble mediator signatures of PBMCs upon in vitro antigen-specific stimuli and ii) identify whether the chemokine (CH) and cytokine (CY) signatures were associated with distinct clinical manifestations in (L) and immune response profiles in (HHC). Methods: Long-term PBMC cultures were carried out and supernatants collected for 12 CH and CY analisys by Cytometric Beads Array. Results and discussion: The CH and CY analysis, using continuous variable modeling, demonstrated that PBMCs from both L and HHC exhibited high levels of TNF upon M. leprae-stimuli. While lower production of IFN-γ were observed for L, low levels of CXCL8 was found for HHC. Soluble mediator signatures, analyzed using categorical variables, revealed that while high levels of TNF were observed for L, high levels of IFN-γ appeared as a hallmark of HHC. Overall, these analyses demonstrated that CXCL8, IFN-γ, and TNF were key markers differentiating L from HHC and endemic control (EC), especially considering the categorical analysis of the soluble mediator signatures. Data further demonstrated that higher levels of IFN-γ and lower levels CXCL8 was features associated with HHC(MB), whereas high levels of TNF were observed in both L subgroups. Moreover, data from integrative networks, based on correlation amongst soluble mediators, revealed that in M. leprae-stimuli, the number of correlations was lower in HHC(MB) compared to HHC(PB), but higher in L(MB) compared to L(PB). It was noted that the number of correlations decreased in the following order: EC > L > HHC. Our findings contribute to additional immunological features associated with L and HHC, witch can be useful complementary diagnostic/prognostic tools for classification of L and HHC, providing insights to enrich the research agenda about the hypothesis that HHC should be closely monitored as they may present a subclinical infection. [ABSTRACT FROM AUTHOR]

Simple Summary: Despite the ecological and public health importance of armadillos, the species is still poorly studied, especially regarding their reproductive aspects. In this work, we present the qualitative characteristics of preantral ovarian follicular population in juvenile six-banded armadillos infected or not by Mycobacterium leprae. The objective of this study was to characterize and estimate the population of ovarian preantral follicles in juvenile six-banded armadillos. Pairs of ovaries from five armadillos were collected during a routine epidemiological survey of leprosis (three healthy and two infected females). Ovaries weighed approximately 0.06 kg, representing a gonadosomatic index of 6.9 ± 0.8%. The mean ovarian follicular population was 15,567.2 preantral follicles per ovarian pair. For most females, follicular population was mainly composed of primordial follicles. No major histological ovarian parameter was affected by M. leprae infection. All females presented high rates of follicular degeneration, regardless of M. leprae infection. In conclusion, we present original particularities regarding the qualitative and quantitative characteristics of the ovarian population of juvenile six-banded armadillos. [ABSTRACT FROM AUTHOR]

Background: Leprosy (Hansen's disease) is an infectious disease most common in resource-limited countries caused by the acid-fast bacilli Mycobacterium leprae and Mycobacterium lepromatosis that frequently affects the skin and peripheral nerves. Prompt diagnosis and treatment with multidrug therapy is crucial to reduce disease transmission and sequelae, which include nerve function impairment, ocular injury, and stigmatizing physical deformities. Traditional treatment of multibacillary leprosy consists of 12–24 months of multidrug therapy with dapsone, rifampin, and clofazimine. However, this regimen is associated with high pill burden and side effects that limit adherence. Case presentation: We report a case of multibacillary leprosy in a previously healthy 30-year-old Hispanic man who recently immigrated to the USA from South America and presented with progressive nodular skin lesions on his face and extremities. He was treated with a monthly regimen of rifampin, moxifloxacin, and minocycline. At follow-up there was significant improvement of his cutaneous lesions without signs of reversal reaction or erythema nodosum leprosum. Conclusions: This case report adds to the growing repertoire of literature supporting the use of rifampin, moxifloxacin, and minocycline. Further studies are needed to assess the efficacy of this antimycobacterial regimen and monitor rates of relapse and delayed immunologic reactions, which may occur 5–10 years after completion of treatment. [ABSTRACT FROM AUTHOR]

Leprosy is a chronic disease of the skin and peripheral nerves caused by Mycobacterium leprae. A major public health and clinical problem are leprosy reactions, which are inflammatory episodes that often contribute to nerve damage and disability. Type I reversal reactions (T1R) can occur after microbiological cure of leprosy and affect up to 50% of leprosy patients. Early intervention to prevent T1R and, hence, nerve damage, is a major focus of current leprosy control efforts. In a prospective study, we enrolled and collected samples from 32 leprosy patients before the onset of T1R. Whole blood aliquots were challenged with M. leprae sonicate or media and total RNA was extracted. After a three-year follow-up, the transcriptomic response was compared between cells from 22 patients who remained T1R-free and 10 patients who developed T1R during that period. Our analysis focused on differential transcript (i.e. isoform) expression and usage. Results showed that, at baseline, cells from T1R-destined and T1R-free subjects had no main difference in their transcripts expression and usage. However, the cells of T1R patients displayed a transcriptomic immune response to M. leprae antigens that was significantly different from the one of cells from leprosy patients who remained T1R-free. Transcripts with significantly higher upregulation in the T1R-destined group, compared to the cells from T1R-free patients, were enriched for pathways and GO terms involved in response to intracellular pathogens, apoptosis regulation and inflammatory processes. Similarly, transcript usage analysis pinpointed different transcript proportions in response to the in-vitro challenge of cells from T1R-destined patients. Hence, transcript usage in concert with transcript expression suggested a dysregulated inflammatory response including increased apoptosis regulation in the peripheral blood cells of T1R-destined patients before the onset of T1R symptoms. Combined, these results provided detailed insight into the pathogenesis of T1R. Author summary: The prevention and clinical management of type 1 reactions (T1R) remain an important unmet need to reduce nerve damage in leprosy patients. It is not known why 30–50% of leprosy patients will develop T1R. This knowledge gap underlies the need for a better mechanistic understanding of T1R that could lead to biomarker candidates to identify leprosy patients who are at high risk of developing T1R. Here, we used a prospective design in which leprosy patients were enrolled before the onset of T1R.Whole blood samples were obtained at enrollment, aliquots were left unstimulated or were stimulated M. leprae antigens and total RNA was extracted. Patients were followed for three years at which time 10 out of 32 participants had developed T1R. Subsequent transcript expression and usage analyses revealed that groups differed little in their isoform landscape at baseline. Following stimulation, transcriptomic response differences became pronounced. Transcripts with higher response in T1R group preferentially involved genes of intracellular defense and inflammatory pathways. Among these transcripts, non-coding ones had higher frequency in T1R. Our study provided new insights into the T1R pathogenesis by suggesting a role for non-coding transcripts into the immune dysregulations of T1R and providing additional candidate genes and their isoforms to be further investigated. [ABSTRACT FROM AUTHOR]

Background: Leprosy is one of the neglected tropical diseases associated with significant morbidity in endemic regions. It causes disability affecting the daily activities and social participation of affected individuals. Understanding the prevalence and trend of leprosy-related disability throughout the world and the accuracy of disability data counted by WHO is crucial in guiding efforts to be made towards the targets set by WHO to be achieved by 2030. This study aims to show the significance of reporting leprosy-related disability at the end of MDT and critique how disability is counted in the context of WHO data. Methods: This is a mixed method study with a 5-year retrospective analysis of outcomes of newly diagnosed leprosy patients at ALERT Hospital in Ethiopia from 2016 to 2020. A comparative review and analysis of leprosy related G2D (Grade 2 Disability), globally, regionally, and in Ethiopia using WHO data was also done. In addition, semi-structured interview of health workers (HCWs) and professionals working in the field of leprosy at various organizations was conducted. Results: The trend of G2D among newly diagnosed leprosy patients shows no decline globally for the past 20 years. It is increasing in Africa and stable in the Southeast Asian and American regions where majority of leprosy patients are found showing the gap in early case identification and prompt treatment of leprosy cases. The total number of newly diagnosed leprosy cases at ALERT hospital between January 2016 and December 2020 were 1032 and among those patients who had completed treatment the prevalence of G2D was 33% at diagnosis and 23% at completion. The interview has also shown gaps in the completeness and quality of disability data reported to WHO and how disability is counted. Conclusion: Leprosy related G2D among newly diagnosed patient is not declining worldwide and even increasing in endemic regions like Ethiopia. More training should be given to health professionals in assessing disability. WHO should make some changes in the way it counts disability as the current definitions are prone to interpretation bias and lacks uniformity among various programmes and health workers. Prospective studies are needed in assessing disability progression post MDT so as design interventions and strategies in preventing worsening of disability after patients are discharged from treatment centre. Author summary: Leprosy is a bacterial infection caused by the Mycobacterium leprae. It mainly affects the skin, nerves and eyes leading to loss of sensation and dryness of the skin, blindness and deformity of fingers of the hands and feet. These visible physical health problems on affected individuals limits their daily activities and impedes their social interaction due to associated stigma and discrimination. The authors of this study examined a five-year data of newly diagnosed leprosy patients at ALERT Hospital in Ethiopia between 2016 and 2020.Disability caused by leprosy in Ethiopia, regionally and globally was assessed. In addition, interview was conducted with health professionals and leprosy experts. The number of patients with Grade 2 Disability, the highest level of leprosy disability, is not decreasing worldwide. At ALERT Hospital, 33% of diagnosed patients had Grade 2 Disability. The interviews also revealed gaps in disability counting and reporting. This study highlights that distality among newly diagnosed leprosy patients is not decreasing globally and even increasing in countries like Ethiopia where the disease is common. Therefore, more emphasis should be given in equipping health professionals in properly evaluating disability and standard definitions in assessing and counting disability should be used across leprosy programmes. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization (WHO) recommends rifampicin, dapsone and clofazimine multi-drug therapy (MDT) for the treatment of leprosy. Severe adverse effects include dapsone hypersensitivity syndrome, skin pigmentation, haemolytic anaemia, and hepatitis. At the Hospital for Tropical Diseases (HTD), London, United Kingdom monthly rifampicin, ofloxacin and minocycline (mROM) is used as first line treatment for leprosy. Objectives: To determine the clinical outcomes and experiences of individuals treated with mROM. Methods: A retrospective study of individuals with leprosy who were prescribed mROM at HTD was conducted. Demographic and clinical data were collected on outcomes including relapses, leprosy reactions, bacterial index (BI) and adverse effects. Individuals were interviewed using a semi-structured questionnaire to understand their experiences of mROM. Results: 29 individuals were identified and 20 interviewed. 26 (89.7%) individuals completed monthly mROM. 9 (31%) had switched from WHO MDT to mROM (five of whom (55.6%) were interviewed). BI reduced significantly following mROM treatment (p = 0.04). 17 individuals (58.6%) experienced a leprosy reaction. One of the 29 (3.4%) relapsed. The relapse rate was 9.5/1000 person years. 49 reports of adverse effects were either mild or moderate. The most frequent adverse effect (14/49) reported was orange discolouration of urine. No adverse effect required hospitalisation or discontinuation of mROM. Most individuals reported that skin lesions improved by the time they had completed mROM. Conclusions: In this small study in a non-endemic setting mROM was safe, effective and acceptable. mROM therapy is associated with improvement in skin lesions, decline in bacterial index and acceptable adverse effects. Larger, prospective, randomised studies are needed to determine whether relapse rates with mROM are equivalent or better than WHO MDT and to provide robust data on the seemingly better adverse effect profile of mROM. Author summary: Leprosy is a chronic disabling infectious disease caused by Mycobacterium leprae and Mycobacterium lepromatosis. Anti-bacterial treatment with rifampicin, dapsone and clofazimine recommended by the World Health Organization (WHO) is effective but associated with significant adverse effects. We report the effectiveness of monthly rifampicin, ofloxacin and minocycline in 29 individuals which was not associated with severe adverse effects. The monthly antimicrobial regime can be directly observed during routine clinical assessment reducing issues of adherence. Alternative antibacterial regimes for leprosy, including newer anti-mycobacterial agents and monthly dosing, should be compared to the WHO recommended standard of care in well-designed randomised controlled trials to assess efficacy and safety. [ABSTRACT FROM AUTHOR]

Background: Detection of infection with Mycobacterium leprae allows timely prophylactic treatment, thereby reducing transmission as well as the risk of permanent, leprosy-associated nerve damage. However, since there is no worldwide-implemented standard test for M. leprae infection, detection of infection in asymptomatic individuals remains a major challenge for control programs in endemic areas. In previous studies, we developed and field-tested a lateral flow assay (LFA) quantitatively detecting human IgM against M. leprae-specific phenolic glycolipid I (anti-PGL-I), a marker for both active and past infection. This rapid test utilizes luminescent, background-free, up-converting reporter particles (UCP) and immunochromatography (i.e. the UCP-LF test platform) for accurate quantitation of anti-PGL-I IgM without operator bias. The aim of this study was to evaluate the final version of this quantitative UCP-based rapid test (i.e. PGL-I QURapid), using serum and fingerstick blood (FSB). Methods: The test comprises a lateral flow strip, in a standard plastic or biodegradable cassette. It can be provided with a humanized, recombinant control to monitor test performance and calculate accurate anti-PGL-I IgM levels. The performance of this QUR-test was assessed using serum and FSB from patients with leprosy (n = 214), tuberculosis (n = 20), buruli ulcer (n = 19), leishmaniasis (n = 14), non-tuberculous mycobacterial (n = 35) infections, as well as healthy Dutch individuals (n = 710) and humanized, recombinant anti-PGL-I IgM antibodies. Plot receiver operating characteristic curves were created and sensitivity (Sn), specificity (Sp) and the area under the curve were calculated to evaluate test performance. Results: Test results classified multibacillary leprosy patients with 95.0% Sn and 100% Sp using serum and 91.5% Sn and 99.8% Sp using FSB. Qualitative test results could be read after 2 min flow time, with accurate quantitation from 10 min onwards. The new anti-PGL-I IgM control supports production of batches with predetermined seropositivity thresholds and monitoring of the PGL-I QUR-test in various settings. Conclusion: The operational version of the PGL-I QURapid with point-of-care applicability, meets the WHO target product profile criteria. Thus, this QUR-test is ready for public health implementations. [ABSTRACT FROM AUTHOR]

Introduction Contemporary medical science has been using fat grafting in aesthetic and reconstructive procedures, consistently achieving successful outcomes. Hansen's disease, caused by Mycobacterium leprae , leads to hand deformities due to peripheral neuropathy, resulting in soft-tissue atrophy, volume loss, and compromised hand function. Tendon transfer surgery is a common remedy for functionality, but it often does not address aesthetic concerns and the patient's psychological impact of living with an atrophic hand. Autologous fat grafting can effectively address these concerns. Materials and Methods This prospective study evaluates the efficacy of fat grafting for hand rejuvenation in patients with Hansen's disease posttendon transfer surgery, focusing on aesthetic and psychological outcomes. We recorded data from 12 patients who underwent the procedure between 2015 and 2024. Using the Coleman technique, fat was harvested from the paraumbilical region of the abdomen and injected into various hand regions. Results Autologous fat grafting showed high patient satisfaction with significant improvements in hand contour, skin texture, and psychological health. The benefits of the procedure included improved self-esteem, enhanced quality of life, reduced social stigma, and psychological well-being. Conclusion Autologous fat grafting is a safe and effective technique for hand rejuvenation in patients with Hansen's disease, after functional treatment addressing both physical deformities and their psychological impacts. It could be considered one of the components in the comprehensive management of Hansen's disease–related hand deformities, significantly enhancing patients' overall quality of life. [ABSTRACT FROM AUTHOR]

Background Carpal tunnel syndrome (CTS) has already been described as a possible form of neural leprosy presentation. However, the median nerve can be involved in this neuropathy in proximal segments and, sometimes, with an asymmetric impairment of the digital branches.

We found Mycobacterium leprae, the most common etiologic agent of Hansen disease or leprosy, in tissues from 9 (18.75%) of 48 nine-banded armadillos (Dasypus novemcinctus) collected across continental Ecuador. Finding evidence of a wildlife reservoir is the first step to recognizing leprosy zoonotic transmission pathway in Ecuador or elsewhere.

We present the case of a 10-year-old patient who visited our hospital with prolonged fever, multiple nodular lesions on the skin, and diagnostic studies that con-firmed leprosy. As a complication, there is a type 2 leprosy reaction that does not respond adequately to the use of steroids; therefore, we used thalidomide, a medication that is infrequently used in children. However, we were able to control the inflammatory response.

Background: Several discoveries about leprosy indicate that Mycobacterium leprae transmission mainly occurs by inhalation, and the nose is a major port of entry and exit. Molecular probes have shown certain potential for the detection and identification of M. leprae in patients. The aim of this study was to identify M. leprae in nasal swab specimens using polymerase chain reaction (PCR)-based assays followed by gene sequencing methods. This observational study examines 64 anterior nasal swab samples taken from pretreatment leprosy patients, on-treatment and completed leprosy treatment in Bulukumba, South Sulawesi, Indonesia. Methods: samples were analyzed by molecular detection methods according to the standard methods at the Clinical Microbiology Laboratory of Hasanuddin University. Descriptive statistics were utilized to summarize patient demographics and outcomes. Results: This study uses PCR to detect the M. leprae deoxyribonucleic acid (DNA) from nasal swab specimens. Data were collected from 64 patients with a percentage of male patients 51.54%. Based on the age category, the group 45–46 years was the most frequent (39.05%). PCR detection proline-rich antigen gene of a 531 bp DNA fragment from M. leprae, was positive in eight patients, and they were multibacillary. Furthermore, PCR was positive in 5 (31.25%) of 16 new leprosy patients, 2 (8.69%) of 23 on-treatment patients, and 1 (4%) of 25 treatment completed patients. Based on the results of the phylogenetic tree and analysis of 8 positive results detected by M. leprae from leprosy patients, almost all samples have a level of similarity, except for sample Ua7. Conclusions: M. leprae cannot grow in vitro, so molecular diagnostic tools were used to confirm the disease. This study predominantly of males with the age above 45 years of age being the most common. Eight M. leprae were positive from nasal swab leprosy patients. The sequencing findings provide insight into the genetic diversity of the genus M. leprae, so it is necessary to consider the detection of whole-genome sequence.

Mycobacteria is a diverse genus that includes both innocuous environmental species and serious pathogens like Mycobacterium tuberculosis, Mycobacterium leprae, and Mycobacterium ulcerans, the causative agents of tuberculosis, leprosy, and Buruli ulcer, respectively. This study focuses on Mycobacterium marinum, a closely related species known for its larger genome and ability to infect ectothermic species and cooler human extremities. Utilizing whole-genome sequencing, we conducted a comprehensive pan-genome analysis of 100 M. marinum strains, exploring genetic diversity and its impact on pathogenesis and host specificity. Our findings highlight significant genomic diversity, with clear distinctions in core, dispensable, and unique genes among the isolates. Phylogenetic analysis revealed a broad distribution of genetic lineages, challenging previous classifications into distinct clusters. Additionally, we examined the synteny and diversity of the virulence factor CpnT, noting a wide range of C-terminal domain variations across strains, which points to potential adaptations in pathogenic mechanisms. This study enhances our understanding of M. marinum's genomic architecture and its evolutionary relationship with other mycobacterial pathogens, providing insights that could inform disease control strategies for M. tuberculosis and other mycobacteria. [ABSTRACT FROM AUTHOR]

The article discusses a case study of a 26-year-old female patient with anetoderma, initially presenting as leprosy due to prolonged steroid use. The patient had asymptomatic oval and saccular papules and plaques on her upper limbs, with histopathological evidence confirming indeterminate leprosy. The study highlights the challenges of diagnosing leprosy in patients with prolonged steroid use and emphasizes the importance of a comprehensive diagnostic approach and pharmacovigilance in endemic areas. [Extracted from the article]

Background and Aim: Leprosy is one of the most common skin neglected tropical diseases in Ethiopia posing social stigma, physical disability, deformity, discrimination, loss of social status, and poor quality of life in families. Hence, evidence‐based collaborative inter‐sectoral actions should be performed to reduce and eliminate its burden in endemic areas. Thus, the aim of this study was to assess the acid‐fast positivity rate and associated factors of leprosy among suspected cases in Northeastern Ethiopia: a cross‐sectional study. Method: A cross‐sectional study was conducted from September 2022 to March 2023 among 256 leprosy‐suspected cases selected using a simple random sampling technique. A semi‐structured questionnaire was used to collect socio‐demographic, clinical, and predictor variables of leprosy through face‐to‐face interviews. Skin slit specimens were collected and stained using Ziehl–Neelsen staining technique. STATA 17 was used for analysis. The scale reliability coefficient was checked using Cronbach's α and the goodness‐of‐fit test of the model was assessed by the Hosmer–Lemshow test. Moreover, bivariable and multivariable logistic regression were computed. Finally, variables with an adjusted odds ratio and their p < 0.05 were taken as statistically significant. Result: The mean ± standard deviation of the age of participants was 43.25 ± 16.35. The overall, prevalence of acid‐fast positivity among suspected cases was 19.6% (95% CI: 15.8%, 23.4%). Multivariable logistic regression analysis showed that sex being male (p = 0.045), rural residence (p = 0.047), not eating three times meals frequency (p = 0.014), not eating a balanced diet (p = 0.036), poor personal hygiene (p = 0.028), distant from health facility (p = 0.039), not washing hands usually (p = 0.013), presence of current co‐infection (p = 0.002), type of leprosy (p = 0.004), and close contact with leprosy cases (p = 0.003) were more likely to be positive for leprosy. Conclusion: The prevalence of leprosy was remained high. Thus, early detection and treatment are necessary to reduce delayed diagnosis and hidden transmission of leprosy in the community. By addressing the driving factors through evidence‐based intervention, we can significantly control the burden of leprosy in the affected communities, and improve their health outcomes and quality of life. [ABSTRACT FROM AUTHOR]

Throughout Mycobacterium leprae's (M. leprae) evolutionary trajectory, nearly half of its genome was converted into pseudogenes. Despite this drastic reduction in genetic content, the genome sequence identity among M. leprae isolates worldwide is remarkably high compared to other pathogens. In this study, we investigated the genotype and morphotype of three M. leprae strains: the reference strain Thai-53 (genotype 1A), and two clinical isolates from Brazilian leprosy relapse patients, which were Br014-03 (genotypes 3I) and Br014-01(4N). We compared their genome sequences and their interaction with human Schwann cells from the ST88-14 lineage and with human primary macrophages. On the genetic level, we observed over a hundred missense mutations in the three strains, translated into significant phenotypic changes such as: prolonged doubling time, altered cytokine induction, reduced interaction rates, and decreased intracellular viability in Schwann cells. Our findings underscore the concept that despite their 99.992% identity, even small genomic disparities in M. leprae genomes can elicit substantial alterations in bacilli interaction with host cells and subsequent immune responses. Consequently, our data could lead to better comprehension of correlation between pathogen mutations and the diverse clinical manifestations observed in leprosy patients. [ABSTRACT FROM AUTHOR]

Background: Leprosy is a chronic and disabling infectious disease caused by Mycobacterium leprae. It has a wide clinical spectrum and is operationally classified into paucibacillary (PB) and multibacillary (MB) cases. There is evidence that the 16S rRNA gene can be used in Polymerase Chain Reaction (PCR) for complementary detection with high sensitivity and specificity. However, there is no literature convention on its diagnostic correspondence regarding the particular operational classification of the disease. This study aimed to correlate, through a meta-analysis, the detection rate of leprosy between the PCR method with the 16S rRNA gene in the clinical forms PB and MB in relation to confirmed cases. Methods: This is a systematic review and meta-analysis study conducted according to the PRISMA 2020 guidelines, using the search descriptors with "AND": "Leprosy"; "Polymerase Chain Reaction"; "16S rRNA" in the PUBMED, SciELO, LILACS, and Science Direct databases. The search was limited to original observational articles in Portuguese, English, or Spanish, with no defined time frame. The methodological quality assessment of the selected articles was performed using the JBI checklists. A scientometric approach to the article using used the VOS Viewer and Scimago Graphica software. The meta-analysis was conducted using Comprehensive Meta-Analyses software, under Pearson's Correlation effect test and fixed effect model and subgroup analysis concerning the type of sample analyzed. Results: The study was significant from the perspective of the paucibacillary group (Clinical biopsy: -0.45 [95% CI= -0.63 - -0.22], p < 0.001/Slit smear skin: -0.52 [95% CI= -0.65 - -0.36], p < 0.001 / Overall: -0.50 [95% CI= -0.61 - -0.37], p < 0.001). The PCR diagnostic method for the16S rRNAgene of M. lepraehas low viability and diagnostic sensitivity in both clinical biopsy samples and leprosy skin smears. Conclusion: This implies little validation of it as a PCR target gene for diagnosing the disease, highlighting limitations in the actual technique. [ABSTRACT FROM AUTHOR]

Enzyme-linked immunosorbent assay (ELISA) is a technique to detect the presence of an antigen or antibody in a sample. ELISA is a simple and costeffective method that has been used for evaluating vaccine efficacy by detecting the presence of antibodies against viral/bacterial antigens and diagnosis of disease stages. Traditional ELISA data analysis utilizes a standard curve of known analyte, and the concentration of the unknown sample is determined by comparing its observed optical density against the standard curve. However, in the case of vaccine research for complicated bacteria such as Mycobacterium tuberculosis (Mtb), there is no prior information regarding the antigen against which high-affinity antibodies are generated and therefore plotting a standard curve is not feasible. Consequently, the analysis of ELISA data in this instance is based on a comparison between vaccinated and unvaccinated groups. However, to the best of our knowledge, no robust data analysis method exists for “nonstandard curve” ELISA. In this paper, we provide a straightforward R-based ELISA data analysis method with open access that incorporates end-point titer determination and curve-fitting models. Our modified method allows for direct measurement data input from the instrument, cleaning and arranging the dataset in the required format, and preparing the final report with calculations while leaving the raw data file unchanged. As an illustration of our method, we provide an example from our published data in which we successfully used our method to compare anti-Mtb antibodies in vaccinated vs non-vaccinated mice. [ABSTRACT FROM AUTHOR]

Background: Leprosy is caused by Mycobacterium leprae which affects skin, nerves, eyes, and nasal mucosa. Despite global elimination efforts, Tanzania remains among 13 countries reporting more than 1000 leprosy cases annually. In 2021, Tanzania identified 1,511 new cases, with 10% having grade II disability. Moreover, 14 councils recorded leprosy rates exceeding 10 cases per 100,000 population. This study aimed to assess the burden of leprosy and associated risk factors for disabilities in Tanzania from 2017 to 2020. Methodology: A retrospective cross-sectional study was conducted to investigate all registered treated leprosy patients from January 2017 to December 2020. The Leprosy Burden Score (LBS) was used to assess the disease burden, while binary logistic regression was employed to evaluate the risk factors for disability. Result: A total of 6,963 leprosy cases were identified from 2017 to 2020. During this period, the point prevalence of leprosy declined from 0.32 to 0.25 per 10,000 people, and the new case detection rate decreased from 3.1 to 2.4 per 100,000 people; however, these changes were not statistically significant (p > 0.05). Independent risk factors for leprosy-related disabilities included male sex (Adjusted Odds Ratio (AOR) = 1.38, 95% Confidence Interval (CI) 1.22–1.57), age 15 years and above (AOR = 2.42, 95% CI 1.60–3.67), previous treatment history (AOR = 2.18, 95% CI 1.69–2.82), and positive Human Immunodeficiency Virus (HIV) status (AOR = 1.60, 95% CI 1.11–2.30). Conclusion: This study identified male sex, older age, positive HIV status, and prior treatment history as independent risk factors for leprosy-related disabilities. Additionally, despite the observed decline in point prevalence and new case detection rates, these changes were not statistically significant. To address leprosy-related disabilities, it is crucial to implement specific prevention strategies that focus on high-risk groups. This can be accomplished by enhancing screening and contact tracing efforts for early patient identification to prevent delays in intervention. Further research is warranted to analyze the burden of leprosy over a more extended period and to explore additional risk factors not covered in this study. [ABSTRACT FROM AUTHOR]

Leprosy is a chronic infectious disease that has a slow evolution and is characterized by dermatoneurological involvement. The health challenges surrounding this disease are closely related to the stigma that results from the physical disabilities it causes. This is due to its high rate of late diagnosis and the peculiar deformities that occur in its advanced stage. Evaluate the clinical and epidemiological aspects of patients with plantar lesions who were treated for leprosy in a dermatology referral unit. This is a cross-sectional exploratory field study that was conducted at the Reference Center in Tropical Dermatology and Venereology Alfredo da Matta (FUHAM), in Manaus, Amazonas, Brazil. We evaluated 36 patients with disabilities as a result of leprosy and who had plantar lesions. The most common ulcer site was the medial region of the plantar surface, which presented dryness and maceration with yellowish seropurulent exudate, fibrinous tissue and grade 2 depth. The study made it possible to observe the evolution of plantar ulcers resulting from the disease process, then evaluate them and discuss recommendations regarding the treatment and prevention of this type of physical disability. [ABSTRACT FROM AUTHOR]

Summary: Background: Treatment failure (TF) in leprosy following multidrug therapy (MDT) presents a significant challenge. The current World Health Organization (WHO) fixed-duration MDT regimen, based on lesion count, might not be adequate. Leprosy lacks clear-cut objective cure criteria, and the predictive value of post-MDT histopathological findings remains uncertain. This study aims to identify predictive factors for TF among leprosy patients who have completed the WHO-recommended MDT. Methods: An analysis was conducted on 80 individuals from a national leprosy reference center, comprising 40 TF cases (with a mean relapse at 13.0 months) and 40 controls (with a mean of 113.1 months without disease signs). Various epidemiological and clinical-laboratory parameters were assessed post-MDT. Results: In skin samples, the presence of foamy granuloma (OR = 7.36; 95%CI2.20-24.60; p = 0.0012) and histological bacillary index (hBI) ≥ 1+ (OR = 1.55; 95%CI1. 22-1.99; p = 0.0004) were significantly associated with TF, with odds ratios of 7.36 and 1.55, respectively. Individuals who experienced TF had a mean hBI of 3.02+ (SD ± 2.02), while the control group exhibited a mean hBI of 1.8+ (SD ± 1.88). An hBI ≥ 3 + showed a sensitivity of 73% and a specificity of 78% for TF detection (AUC: 0.75; p = 0.0001). Other histopathological features like epithelioid granulomas, and skin changes did not show significant associations (p > 0.05). Additionally, higher anti-phenolic glycolipid-I (anti-PGL-I) ELISA index (EI) levels were linked to a 1.4-fold increased likelihood for TF (OR = 1.4; 95%CI1.13-1.74; p = 0.0019). A mean EI of 4.48 (SD ± 2.80) was observed, with an EI ≥ 3.95 showing a sensitivity of 79% and a specificity of 59% for TF detection (AUC: 0.74; p = 0.0001). Moreover, the presence of Mycobacterium leprae (M. leprae) DNA in real-time polymerase chain reaction (qPCR) was associated with a 3.43-fold higher likelihood of TF. Multivariate regression analysis indicated that concurrent presentation of neural/perineural lymphocytic infiltrate, foamy granuloma, hBI ≥ 1+, and EI ≥ 1 markedly increased the likelihood of TF by up to 95.41%. Conclusion: Persistence of nerve-selective lymphocytic infiltrate, foamy granulomas, and bacilli in skin biopsies, and elevated EI post-MDT, may serve as predictive factors for identifying individuals at higher probability of TF. [ABSTRACT FROM AUTHOR]

Leprosy or Hansen's disease is caused by Mycobacterium leprae. This disease is having its social stigma and negative cultural values since ancient times as it is related with curse of Gods to the humans. In Maharashtra, the annual new case detection rate' (ANCDR) was 22.36/100,000, adding extra burden to the national PR. Hence, we have undertaken the present study to measure the present burden of the disease on the society especially tribal areas of eastern Maharashtra. Incidence of leprosy in Gadchiroli district in 2022 was 8.25 while in year 2023 it was 7.20 with declining trends amongst newly found cases. Prevalence of leprosy in Gadchiroli dist. Was 738 in year 2022 and 880 in year 2023. G-II Disability among New cases in population <1 per million population was 3.22 in year 2022. But in year 2023 it has fell down to 0.3. ANCDR was targeted to be <10 per 1 lakh population when it was observed to be 83 in year 2022 while for year 2023 it was 73.54. Finally, we conclude that in present study incidence amongst new cases of leprosy has undoubtedly been reduced which throws a light on success rate of leprosy rehabilitation centre on wheels. Which needs more attention and exquisite drive movements across the globe to fight with Leprosy. Also considering the prevalence of the disease prevalence is more near the river belt because of humid atmosphere, but low economic socio-behaviour is also responsible. These budding steps from remote location of Maharashtra like LRC on wheels and RCS for disabilities with timely medications has shown us a new ray of hope towards making a leprosy free India when done unanimously across the country. [ABSTRACT FROM AUTHOR]

Background: Leprosy, a socially stigmatising disease is caused by Mycobacterium leprae. It is a chronic infectious disease mainly affecting the skin and the peripheral nerves. Because of the stigma which is due to lack of knowledge regarding the disease transmission and the disfigurement that is caused, there is an impact on the quality of life in various aspects including employment, marriage and social status. Objectives: 1) To assess the quality of life among leprosy affected persons in Hyderabad, 2) To determine the factors influencing the quality of life among the study subjects. Methods: A cross sectional study was conducted among 125 leprosy affected persons in a Rehabilitation Home in Hyderabad during August and September 2021 . A semistructured questionnaire was used for assessing the sociodemographic factors. With informed consent,Quality of Life was assessed using predesigned WHOQOLBREF questionnaire which has four domains including physical health, psychological, social relationship and environment. Data was entered and analysed using Microsoft Office Excel 2007 and Epi Info version 7.2.2.6. Results: The mean age of the study population was 48.32+16.16. 56% of them were males and 44% were females. The mean scores of all four domains were computed and it was, physical health domain 53.83+12.35, psychological domain 43.54+18.72, social relationship domain 55.28+24.9 and environment domain 51.1+12.46.The mean score of various domains among males was better than that of the females. On assessing the overall quality of life it was found that age, marital status, employment and disease duration are influencing the quality of life among leprosy affected persons. Conclusion: Early diagnosis and treatment can avert the deformities and disabilities in such persons and can improve their quality of life. Care after cure is a must in leprosy [ABSTRACT FROM AUTHOR]

Introduction: Leprosy is a chronic infectious condition and the main cause of neuropathy that occurs brought on by M. leprae. It is known that the biological characteristics of the human host, such as the immunological ones, have a higher influence on the pathology of this disease than the intrinsic mechanisms of the bacterium. The objective of this work was to review the scientific knowledge about the relationship between immunopathology and the severity of leprosy. Methods: A systematic review following the PRISMA 2020 recommendations was conducted in the PUBMED, LILACS, SciELO and Science Direct databases using articles in English, Portuguese or Spanish between January 2011 and May 2022 with the descriptors "Leprosy/Immunology", "Cytokines" and "Mycobacterium leprae". A methodological quality assessment was carried out using the JBI checklists. Results: A total of 49 articles were included. There is a relationship of greater severity of infection associated with lower release of MHC molecules in response to PGL-1 that inhibit the promotion of resolving T lymphocytes arising from dendritic cells (DCs) stimulation. In addition, the differentiation of macrophage phenotypes dependent on the activation of PRRs can define activation and the distinct type of T helper (Th) cells involved according to severity. Activated CD8+ T cells also have distinct types at the appropriate poles of the disease, and B cells show at the most severe pole of the LL, specific induction of IgA and more Treg-type CD8+ T cells that further contribute to T cell anergy. Conclusion: Therefore, the adaptive immune system aggravates nerve damage and defines the type of leprosy, while the innate immune system is considerably more significant in the onset of nerve damage, symptomatic of the initial presentation of illness and in several critical immune responses, including inflammation and elimination of dead M. leprae. [ABSTRACT FROM AUTHOR]

Background: Leprosy, caused by Mycobacterium leprae, affects multiple body systems and can lead to preventable disability if untreated. While multidrug therapy (MDT) has been available since 1982, historical evidence suggests that untreated leprosy can resolve spontaneously. Nevertheless, the prevalence of self-healing worldwide, as well as factors determining self-healing, remain unclear. Methods: A systematic review was conducted in 2023 with data from PubMed, Infolep, and Web of Sciences data bases, along with a google search. Data extraction and analysis followed PRISMA guidelines and were summarized in a separate Excel sheet. Included were English-language studies on self-healing in leprosy, regardless the year of publication. Results: We included six studies spanning from 1938 to 1978 exploring the incidence of self-healing in different countries and continents. Children, paucibacillary (PB) cases, and possibly males showed a higher probability of self-healing with an average healing time of two years. Discussion/Conclusion: Recent research on self-healing in leprosy is scarce and evidence limited. This is primarily due to ethical concerns regarding withholding effective treatment of diagnosed patients, and because of the absence of an agreed definition of self-healing. Nevertheless, self-healing appears to be a plausible phenomenon influenced by geographic and demographic factors, and the type of leprosy. We recommend further research on self-healing in leprosy, as it provides insight into the human immune system and the determinants of this phenomenon. More insight could help adapt clinical practices and public health strategies, thereby contributing to an effective management and control of this disease. Author summary: Leprosy, a chronic infectious disease caused by Mycobacterium leprae, presents significant health challenges worldwide, with the potential for avoidable disabilities if left untreated. While MDT has substantially reduced the disease burden since its introduction in 1982, historical records suggest that some cases of leprosy exhibit spontaneous resolution without medical intervention. However, the prevalence of self-healing globally and the factors influencing this phenomenon remain unclear. The review identified six studies conducted between 1938 and 1978, which examined the occurrence of self-healing in various countries. These studies revealed that children and individuals with PB leprosy demonstrated a higher likelihood of self-healing, typically within an average period of two years. Despite the limited recent evidence due to ethical considerations, self-healing appears to be a plausible phenomenon influenced by patient-specific characteristics and the type of leprosy infection. Ultimately, this paper presents a compelling case for future research on self-healing in leprosy, as it provides an interesting view on the human immune system as well as the determinants of this phenomenon. Our recommendations emphasize the necessity of such investigations to adapt clinical practices and public health strategies, thereby contributing to an effective management and control of this disease. [ABSTRACT FROM AUTHOR]

Leprosy remains a significant neglected tropical disease despite the goal of elimination having been achieved in various endemic nations over the past two decades. Reactional episodes complicate the disease course, resulting in deformities and disability. The main aim of treatment is to kill Mycobacterium leprae and decrease the bacterial load, which could help prevent further bacilli transmission. A major concern in breaking the chain of transmission and possibly for recurrent reactions is the role of drug‐resistant bacilli. Though some data is available on the background prevalence of drug resistance in leprosy, there is a paucity of studies that look for resistance specifically in leprosy reactions. Administration of long‐term steroids or immunosuppressants for chronic and recurrent responses in the presence of drug resistance has the twin effect of perpetuating the multiplication of resistant bacilli and encouraging the dissemination of leprosy. The increasing trend of prescribing second‐line drugs for leprosy or type 2 reactions without prior assessment of drug resistance can potentially precipitate a severe public health problem as this can promote the development of resistance to second‐line drugs as well. A comprehensive multicenter study, including drug resistance surveillance testing in cases of reactions, is necessary, along with the current measures to stop the spread of leprosy. Here, we have detailed the history of drug resistance in leprosy, given pointers on when to suspect drug resistance, described the role of resistance in reactions, methods of resistance testing, and the management of resistant cases with second‐line therapy. [ABSTRACT FROM AUTHOR]

Leprosy is a chronic infectious disease that mainly affects the skin and peripheral nerves, it can also invade deeper tissues and organs, including mucous membranes, lymph nodes, testes, eyes, and internal organs. Severe cases can result in deformities and disabilities. We encountered the case of a 39-year-old male with unexplained fever, headache and rash. The patient's lesions were taken for histopathological examination and slit skin smear analysis. Further, the patient was detected of Mycobacterium leprae (M.leprae) nucleic acid sequences in the cerebrospinal fluid (CSF) and plasma, and M.leprae gene targets in the skin lesion tissue and blood. The patient was eventually diagnosed with multibacillary leprosy and type II leprosy reaction. These results suggest the possibility of bacteremia in patients with leprosy to some extent, and observation implies the potential invasion of CSF by M.leprae or its genetic material. [ABSTRACT FROM AUTHOR]

Background: The high levels of recent transmission of leprosy worldwide demonstrate the necessity of epidemiologic surveillance to understand and control its dissemination. Brazil remains the second in number of cases around the world, indicating active transmission of Mycobacterium leprae (M. leprae) in the population. At this moment, there is a consensus that the bacillus is transmitted by inter‐human contact, however, different serologic, molecular, and histopathological approaches indicate the existence of non‐human transmission sources. Methods and Results: The qPCR assay was used to amplify the molecular targets 16S RNAr and RLEP, in samples of liver, spleen, and ear of wild animals belonging to Didelphimorphia and Rodentia orders, in highly endemic areas of Mato Grosso, Brazil. The RLEP repetitive sequence was positive in 202 (89.0%) samples, with 96 (42.3%) of these also being positive for the 16S gene. Regarding the collection sites, it was observed that the animals were found in areas profoundly deforested, close to urban areas. Conclusions: Our results suggest that wild animals can play an important role in the maintenance of M. leprae in endemic regions with major anthropic action in Brazil. Therefore, integrating human, animal, and environmental health care with the One Health initiative is highly efficient for the development of effective strategies to contain and control leprosy in Brazil. [ABSTRACT FROM AUTHOR]

Mycobacterium Indicus Pranii (MIP) vaccine is a killed vaccine developed in India for leprosy with immunotherapeutic as well as immunoprophylactic effects. MIP, earlier known as Mycobacterium welchii, is a rapidly growing non-pathogenic mycobacterium. The novelty of this bacterium is due to its translational application as an immunotherapeutic agent. When administered intradermally, the vaccine induces cell-mediated immunity in the host towards Mycobacterium leprae. It leads to faster clinical and histopathological improvement, rapid bacillary clearance, and also lepromin conversion in anergic leprosy patients. The beneficial role of the MIP vaccine in augmenting the therapeutic efficacy of Multidrug Therapy (MDT), particularly in highly bacillated leprosy patients, is well documented in various studies from India. The role of the vaccine in reactional states is controversial, with varied results in different studies. Overall, it is found to decrease the frequency of type 2 lepra reactions and is useful in recalcitrant erythema nodosum leprosum. Even though there may be an increased likelihood of type 1 reactions, no additional nerve function impairment is attributed to the vaccine in various studies. In household contacts of leprosy who are administered MIP, it is noted to confer protection from disease lasting up to 10 years. It may prove to be a cost-effective strategy in national leprosy programmes. Apart from local injection site reactions, the vaccine is relatively safe, but it is not recommended in pregnancy and lactation. This article provides an overview of the MIP vaccine's clinical application in the context of leprosy spanning over 40 years. It also considers the vaccine's possible future applications in the management of disease-related complications and achieving the long-term goal of zero leprosy. [ABSTRACT FROM AUTHOR]

Background: Leprosy or Hansen’s Disease caused by Mycobacterium Leprae, a chronic granulomatous disease, is one of the oldest diseases known to mankind. This study highlights utility of Bacteriological Index in slit skin smears in diagnosing and its concordance with clinical & histopathological changes in Hansen’s disease. Materials & Methods: A Crosssectional study of 60 patients clinically suspected of or diagnosed with Leprosy visiting outpatient department of dermatology, venereology and leprology during period of February 2022 to April 2024 was conducted. Demographic data, presenting complaints, clinical diagnosis, slit skin smear reports and histopathological diagnosis of leprosy patients was collected from case-sheets and registers. Bacteriological Index was noted from slit skin smear reports. Histopathological details of skin biopsies was collected. Data was categorised & analysed to assess concordance Aim: To study concordance of histopathological findings and clinical assessment with bacteriological index in slit skin smears in different types of Leprosy Results: 1. Out of 60 clinically suspected patients, maximum of 21 patients (35%) were in third decade and male predominance with 39 cases (65%) 2. On histopathological examination, 57 cases were positive for Hansen’s disease. 19cases were Borderline Tuberculosis (31.6%) 3. Slit skin smears demonstrated AFB in 34 cases (56.6%) and maximum sensitivity of 91.6% in lepromatous leprosy 4. In study, highest concordance of bacillary index with histopathological findings was seen in lepromatous leprosy (90%) followed by borderline cases 5. Clinico-histopathological concordance was maximum in lepromatous leprosy (82%) and borderline tuberculoid (78%) Conclusion: 1. Leprosy patients vary in clinical & histopathological features depending on host immune response. 2. Correlation of histo-morphological findings with slit skin smear will be helpful for better patient management. [ABSTRACT FROM AUTHOR]

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Our patient presented with a 5-year history of chronic, asymptomatic papulonodular lesions on the extremities. The lesions spread to the face and earlobes, with new ulcerative lesions on both legs for the past 8 months. Skin biopsy was compatible with lepromatous leprosy with Lucio phenomenon. Lucio phenomenon is a rare type of leprosy reaction found mostly in neglected lepromatous leprosy cases. Unfortunately, the patient developed pulmonary embolism and passed away. This case report focuses on the clinicopathological characteristics and management of Lucio phenomenon, which is an unusual form of leprosy reaction that often carries a poorer prognosis. Importantly, physicians should be able to differentiate Lucio phenomenon from other types of leprosy reactions for prompt management.

Background Leprosy, also known as Hansen's disease, is an infectious disease caused by Mycobacterium leprae. Despite ongoing efforts to control the disease, leprosy remains a global health concern, with Indonesia ranking third in the world for the highest number of cases. Objective This study aims to identify epitopes that can induce T and B cell immune responses through an in silico approach, to design a multi-epitope vaccine candidate against Mycobacterium leprae. Methods The study used an in silico vaccine design approach utilizing ESAT6, Ag85B, ML2028, ML2380, and ML2055 proteins from Mycobacterium leprae. The process involved sequence alignment, T cell (CTL and HTL) and B cell epitopes identification, and antigenicity, allergenicity, and toxicity assessment. Selected epitopes were constructed into a multi-epitope vaccine candidate using linkers. The tertiary structure of the vaccine was modeled with AlphaFold and evaluated via Prosa-web. The stability and interaction between the vaccine candidate and TLR4 were analyzed using molecular docking. Results The vaccine candidate demonstrated stable interactions with TLR4, with a binding free energy of -13.9 kcal/mol. The vaccine candidate was also predicted to be stable, antigenic, non-allergenic, non-toxic, and hydrophilic. Conclusion This in silico design of a multi-epitope vaccine candidate shows potential for development as a vaccine against leprosy.

OBJECTIVE: To understand the epidemiological behavior and clinical profile of leprosy cases in children under 15 years of age, in the state of Maranhão in Brazil, between 2011 and 2021. METHODOLOGY: Epidemiological, descriptive study with a quantitative approach, based on retrospective data recorded in the Notifiable Diseases Information System / Ministry of Health of Brazil. RESULTS: It was found that in the period between 2011 and 2021, 3,918 cases of leprosy were registered in the age group of 1 to 14 years in the state of Maranhão in Brazil, of which 53.9% were male; 45.4% attended the 5th to 8th grade of elementary school; 69.6% were brown. The dimorphic clinical form was present in 45.7% of cases and 69.6% did not have a reactional episode. Multibacillary cases represented 59.9%; 71.7% had no disabilities while 12% had a Grade I disability. After discharge due to cure, 46.5% had no disability; blank variable represented 35.9% of cases. The polychemotherapy regimen MDT/MB/12 doses was used in 59.7% of participants. CONCLUSION: There is a need to implement educational actions about the disease, so that the population knows about transmission, prevention and treatment, where it is up to the State to mobilize resources that can be invested in public policies aimed at health education, and thus promote the access to adequate diagnosis and treatment.

IntroductionLeprosy, a chronic infectious disease, is closely linked to the host immune response. According to the WHO, leprosy patients (L) and household contacts (HHC) are classified into subgroups: paucibacillary (PB) and multibacillary (MB), witch reflect the degree of infection in patients and the level of exposure of their contacts. The main goal of this study was to: i) establish a comprehensive overview of soluble mediator signatures of PBMCs upon in vitro antigen-specific stimuli and ii) identify whether the chemokine (CH) and cytokine (CY) signatures were associated with distinct clinical manifestations in (L) and immune response profiles in (HHC).MethodsLong-term PBMC cultures were carried out and supernatants collected for 12 CH and CY analisys by Cytometric Beads Array.Results and discussionThe CH and CY analysis, using continuous variable modeling, demonstrated that PBMCs from both L and HHC exhibited high levels of TNF upon M. leprae-stimuli. While lower production of IFN-γ were observed for L, low levels of CXCL8 was found for HHC. Soluble mediator signatures, analyzed using categorical variables, revealed that while high levels of TNF were observed for L, high levels of IFN-γ appeared as a hallmark of HHC. Overall, these analyses demonstrated that CXCL8, IFN-γ, and TNF were key markers differentiating L from HHC and endemic control (EC), especially considering the categorical analysis of the soluble mediator signatures. Data further demonstrated that higher levels of IFN-γ and lower levels CXCL8 was features associated with HHC(MB), whereas high levels of TNF were observed in both L subgroups. Moreover, data from integrative networks, based on correlation amongst soluble mediators, revealed that in M. leprae-stimuli, the number of correlations was lower in HHC(MB) compared to HHC(PB), but higher in L(MB) compared to L(PB). It was noted that the number of correlations decreased in the following order: EC > L > HHC. Our findings contribute to additional immunological features associated with L and HHC, witch can be useful complementary diagnostic/prognostic tools for classification of L and HHC, providing insights to enrich the research agenda about the hypothesis that HHC should be closely monitored as they may present a subclinical infection.

Resumo A hanseníase é uma doença causada pela infecção de Mycobacterium leprae, que compromete principalmente a pele e os nervos periféricos e pode causar inúmeras alterações nos olhos. As manifestações oculares são comuns na forma multibacilar, especialmente na virchowiana. O acometimento ocular ocorre em 50% dos casos e pode afetar diversas estruturas, causando iridociclite, esclerite, neurite óptica, hipoestesia corneana e até cegueira. O objetivo deste trabalho é relatar o caso de um paciente com hanseníase ocular que evoluiu com glaucoma de fechamento angular.

A hanseníase é uma doença infectocontagiosa, crônica, transmissível, de notificação compulsória, que atinge principalmente a pele e os nervos periféricos, com capacidade de ocasionar lesões neurais. A educação em saúde é uma atividade inerente às atividades de extensão universitária, pois possibilita o desenvolvimento de habilidades de comunicação do graduando, bem como o compartilhamento de informações necessárias com a comunidade. Com a pandemia do novo coronavírus, houve a necessidade de criar uma tecnologia educacional para disseminar informações acerca da hanseníase para a população. O objetivo deste trabalho foi descrever o alcance de uma estratégia educativa desenvolvida no Instagram sobre medidas de autocuidado para pessoas atingidas pela hanseníase durante a pandemia por COVID-19. Trata-se de um estudo descritivo, exploratório com caráter analítico, desenvolvido no perfil no Instagram, entre junho de 2020 e agosto de 2021. Foram desenvolvidos três vídeos com os temas: cuidados com a face e saúde mental; cuidados com membros superiores; e cuidados com membros inferiores. A campanha obteve 2.033 visualizações, 176 curtidas, 19 comentários, 56 compartilhamentos e 6 salvamentos. Os episódios atingiram as seguintes taxas de engajamento: episódio 1 (3,64%); episódio 2 (2,76%); e episódio 3 (3,44%), consideradas boas médias de engajamento, constatando-se que os conteúdos postados tiveram uma boa aceitação do público. Desse modo, a campanha mostrou ser uma estratégia eficaz de extensão universitária e de disseminação de informações de grande amplitude, favorecendo a comunicação entre o educador em saúde e a população em um momento de isolamento social. Palavras-chave: Redes Sociais; Relações Comunidade-Instituição; Extensão; Mycobacterium leprae Educational strategy on Instagram to promote self-care in leprosy in the COVID-19 pandemic Abstract: Leprosy is an infectious, chronic, transmissible disease with compulsory notification that mainly affects the skin and peripheral nerves and can cause neural damage. Health education is inherent to university extension activities, as it enables the development of communication skills in graduates and the sharing of necessary information with the community. With the new coronavirus pandemic, there was a need to create educational technology to disseminate information about leprosy to the population. This work aimed to describe the reach of an educational strategy developed on Instagram about self-care measures for people affected by leprosy during the COVID-19 pandemic. This article is a descriptive, exploratory study with an analytical nature, developed on the Instagram profile between June 2020 and August 2021. Three videos were developed with the following themes: facial care and mental health, upper limb care, and lower limb care. The campaign received 2,033 views, 176 likes, 19 comments, 56 shares and 6 saves. The episodes achieved the following engagement rates: Episode 1 (3.64%), Episode 2 (2.76%), and Episode 3 (3.44%), being classified with a good engagement average, noting that the public well received the content posted. In this way, the campaign proved to be an effective strategy for university extension and dissemination of wide-ranging information, favoring communication between health educators and the population during social isolation. Keywords: Social Networking; Community-Institutional Relations; Outreach Program; Mycobacterium leprae

Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) However, the emergence of drug-resistant strains of this bacterium, especially multidrug-resistant (MDR) strains, is a serious concern. This study aimed to evaluate the global prevalence of MDR M. leprae and its implications. Methods: Using PRISMA guidelines, we systematically reviewed ISI Web of Science, MEDLINE, and EMBASE up to August 2023 to assess the prevalence of MDR M. leprae. We included human clinical trials on MDR M. leprae, as well as excluded reviews, animal studies, and unavailable full texts. Data was analyzed using Comprehensive Meta-Analysis software, and publication bias was addressed using Egger’s, Begg’s tests, and the trim-fill method. Results: Overall, 861 articles were initially identified, of which 28 met the methodological criteria for inclusion in the quantitative synthesis. Statistically, the combined prevalence of drug resistant M. leprae was approximated at 11.7 % (95 % CI: 7.7–17.3; I2: 90.79; p value = 0.01). Specific drug resistance rates included 7.4 % to dapsone and 5.1 % to rifampin, among others. The global rate for MDR M. leprae was measured at 2.2 % (95 % CI: 1.2–3.9; I2: 82.68; p value = 0.01). Factors such as bacterial density and the lepromatous phase were associated with elevated DR M. leprae risk (OR: 2.69; 95 % CI: 1.35–2.48). A systematic assessment of publication bias indicated a minimal impact on the general results. Conclusions: The increasing prevalence of MDR M. leprae globally requires urgent and strategic interventions to prevent further spread, which in turn is effective in treating leprosy patients.

Abstract Background Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae) that is responsible for deformities and irreversible peripheral nerve damage and has a broad spectrum of clinical and serological manifestations. Leprosy primarily affects the peripheral nerves and rarely presents with central nervous system involvement. Diagnosing leprosy can still be difficult in some cases, especially when the infection involves uncommon clinical manifestations and extracutaneous sites. Delayed diagnosis and treatment of leprosy may lead to irreversible damage and death. Case Presentation We report a case of a 30-year-old female presenting with “repeated high fever with symptoms of headache for 14 days”. On the day of admission, physical signs of lost eyebrows and scattered red induration patches all over her body were observed. The patient’s diagnosis was based on the clinical characteristics using a combination of metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) and slit-skin smear. After confirming Listeria meningitis and multibacillary leprosy with erythema nodosum leprosum (ENL), a type 2 reaction, she was treated with ampicillin sodium, dapsone, rifampicin, clofazimine, methylprednisolone, and thalidomide. At the 1-year follow-up, the frequency and severity of headaches have significantly decreased and a good clinical response with improved skin lesions was found. Conclusion This case highlights the importance of considering leprosy, which is a rare and underrecognized disease, in the differential diagnosis of skin rashes with rheumatic manifestations, even in areas where the disease is not endemic, and physicians should be alerted about the possibility of central nervous system infections. In addition, mNGS can be used as a complementary diagnostic tool to traditional diagnostic methods to enhance the diagnostic accuracy of leprosy.

Background and aim: Leprosy (Hansen's disease) is a chronic granulomatous infection by Mycobacterium leprae, an acid-fast rod-shaped bacillus, predominantly affecting skin and peripheral nerves. The clinical and pathological manifestations are variable, depending on the immune status of the individual. It could lead to disabilities in a small proportion of patients in the absence of proper treatment. India has eliminated Leprosy as a public health problem, defined as less than 1 case per 10,000 people, at the national level in January 2006. However, cases are still being reported from different regions in varying prevalence. The present study was undertaken to study the clinicopathological spectrum of Leprosy and correlate it with the Bacillary Index (BI). Material and methods: This study was conducted in a tertiary care center teaching hospital. It was a retrospective and prospective study from January 2018 to July 2022 (four and a half years). Fifty skin biopsies of clinically suspicious cases received in our histopathology department were processed and stained with Hematoxylin, and Eosin (H & E) and Fite-Faraco stain. The cases were subtyped based on the findings and correlated with clinical diagnosis. Results: The cases ranged from 11 to 73 years of age, with male predominance. The most common subtype was Borderline Tuberculoid (BT) (32%), followed by Borderline Lepromatous (BL) (20%). The maximum clinicopathological correlation was observed in Lepromatous Leprosy. Conclusions: Accurate and timely diagnosis of Leprosy can be achieved through histopathological examination and clinical correlation.

Background: Leprosy affects various organs in addition to skin, eyes, and peripheral nerves. Testicular involvement in leprosy patients is common and causes disturbance in endocrine function of the testis and results in hypogonadism. Hypogonadism is frequently undiagnosed and underreported. Objective: This study aimed to assess hypogonadism and associated factors among leprosy patients at Alert Comprehensive Specialized Hospital, Ethiopia. Methods: A cross-sectional study design was used in which consecutive 146 male leprosy patients aged between 18 to 65 years attending outpatient follow-up at leprosy outpatient clinic were included. Data was gathered both from patient charts and through patients' interviews. Androgen deficiency symptoms were assessed by androgen deficiency in the aging male questionnaire, and 5ml of blood samples were taken from study participants and serum total testosterone, LH, and FSH were analyzed by Electrochemiluminescence method. Statistical correlation was assessed by Spearman correlation. A multivariable binary logistic regression model was used to identify the independent factors associated with hypogonadism and P-value <0.05 was used to declare statistical significance. Results: The prevalence of hypogonadism was 39 (26.7%). Out of this, 34 (87.2%) had primary hypogonadism, whereas 5 (12.8%) had secondary hypogonadism. Total testosterone was inversely correlated with Body mass index (r = -0.37, p = 0.002), Luteinizing hormone (r = -0.43, p <0.001), and Follicular stimulating hormone (r = -0.42, p< 0.001). However, Total testosterone was not significantly correlated with age (r = -0.019, p = 0.81). BMI [AOR = 1.32, 95%CI (1.16–1.51)] and grade-II disability [AOR = 3.80, 95%CI (1.23–11.64)] were identified as independent risk factors for hypogonadism. Conclusion: Nearly one-fourth of male leprosy patients had hypogonadism. Overweight and grade-II disability were independent risk factors for hypogonadism. Author summary: Leprosy affects various organs in addition to skin, eyes and peripheral nerves. Testicular involvement in leprosy patients is common and causes disturbance in endocrine function of the testis and results in hypogonadism. Mycobacterium leprae reach the testicles through skin tissue invasion, blood or the lymphatic system, and the testes can serve as a reservoir for Mycobacterium leprae. A lower testicular temperature than internal body temperature may promote M. leprae growth in the testicle. It causes thickening and constriction of vessels, interstitial fibrosis, hyalinization and obliteration of seminiferous tubules and Leydig cells. These cause low testosterone productions among leprosy patients. The prevalence and risk factors of hypogonadism among male leprosy patients vary in different settings. In this study area the prevalence of hypogonadism was 26.7%. Overweight and grade-II disability were identified as independent risk factors for hypogonadism. [ABSTRACT FROM AUTHOR]

Background: Leprosy has been historically associated with social stigma and discrimination. Leprosy, also known as Hansen’s disease, is indeed a chronic infectious disease caused by the bacterium Mycobacterium leprae. Diagnosis of leprosy is usually done by clinically and classified as multibacillary (MB) and paucibacillary (PB). The disease was also classified into different types based on histopathological findings, such as tuberculoid, borderline tuberculoid (BT), mid-borderline, borderline lepromatous, and lepromatous. Aims and Objectives: The aim of the study was the clinicohistopathological correlation of all clinically diagnosed cases of Hansen’s disease. Materials and Methods: The study was done at Bankura Sammilani Medical College and Hospital for a period of 18 months. Ethical approval was taken from the Institutional Ethics committee. All new patients 66 in number clinically diagnosed as leprosy attending the Dermatology Outpatient Department were included in the study. The skin biopsy and staining were done with hematoxylin and eosin staining and Fite-Faraco stain for every patient. The skin biopsy was reported according to the Ridley-Jopling classification. Results: Males were more commonly affected than females. Most of the leprosy cases in the study were classified as MB (86.4%) and the upper extremities were the most commonly affected sites. Bacterial index was observed negative in clinically PB cases. The most common histological subtype of leprosy identified in the study was BT, Regarding bacterial index, all clinically diagnosed MB cases were smear positive and PB cases were smear negative. Out of nine clinically diagnosed PB cases, inflammatory cells were found in 3 (33.4%). Conclusion: In a large country like India where resources are limited, no need for skin biopsy for every patient. Biopsy should do if there is any confusion with other skin lesions. [ABSTRACT FROM AUTHOR]

Objective: Morbus Hansen (MH), caused by Mycobacterium leprae, is marked by neuropathic pain. Prior studies link low vitamin D levels to diabetic neuropathic pain, yet research on its role in MH-related neuropathic pain is limited. This study investigates the role of vitamin D deficiency in MH-related neuropathic pain. Materials and Methods: An analytical cross-sectional study was conducted among multibacillary (MB) MH patients at Prof. Dr. I.G.N.G. Ngoerah Hospital, Bali from April to August 2023. Neuropathic pain was assessed using the Douleur Neuropathique 4 (DN4) questionnaire, while serum 25(OH)D levels determined vitamin D status. The cutoff for deficiency was determined via ROC curve analysis. Results: Among 42 participants, those without neuropathic pain exhibited higher mean serum vitamin D levels than those with neuropathic pain (28.69 ± 8.16 vs. 22.11 ± 9.54 ng/ml; p=0.021). The ROC curve identified a cutoff value of 30.25 ng/ml, categorizing participants into vitamin D deficiency (<30.25 ng/ml) and non-deficiency (≥30.25 ng/ml) groups. Bivariate analysis revealed a heightened incidence of neuropathic pain among MH patients with serum vitamin D levels below the designated cutoff point (OR: 6.60; 95%CI: 1.484-29.355; p=0.022). Multivariate analysis indicated that two variables significantly correlated with neuropathic pain in MH patients: vitamin D deficiency (OR: 14.337; 95%CI: 2.431-84.542; p=0.003) and peripheral nerve enlargement (OR: 12.564; 95%CI: 2.096-75.307; p=0.006). Conclusion: Disparities in average vitamin D levels were observed between MH patients with and without neuropathic pain. Vitamin D deficiency, alongside peripheral nerve enlargement, emerged as significant risk factors for neuropathic pain in MH patients. [ABSTRACT FROM AUTHOR]

Nontuberculous mycobacterial pulmonary disease (NTM-PD) results from opportunistic lung infections by mycobacteria other than Mycobacterium tuberculosis or Mycobacterium leprae species. Similar to many other countries, the incidence of NTM-PD in the United Kingdom (UK) is on the rise for reasons that are yet to be determined. Despite guidelines established by the American Thoracic Society (ATS), the Infectious Diseases Society of America, and the British Thoracic Society, NTM-PD diagnosis and management remain a significant clinical challenge. In this review article, we comprehensively discuss key challenges in NTM-PD diagnosis and management, focusing on the UK healthcare setting. We also propose countermeasures to overcome these challenges and improve the detection and treatment of patients with NTM-PD. [ABSTRACT FROM AUTHOR]

Background: There are several studies on thyroid functions and thyroid gland features in patients with leprosy in the literature. The relationship between them have not been clarified yet. These studies are time-expired and don't contain ultrasonography examination. The purpose of the study is to investigate thyroid functions and gland characteristics in leprosy patients by ultrasonography (US) and current laboratory techniques. Patients and Methods: This retrospective study was conducted by collecting the data of patients with lepramatous leprosy. Serum thyroid-stimulating hormone, free triiodothyronine, free thyroxine, anti-thyroid peroxidase, antithyroglobulin, and thyroglobulin values and thyroid ultrasonography reports were collected from previous records. Results: The mean age is 75.12±9.89 years of total 17 subjects and 10 patients (58.8%) were male. Thyroid US was performed on 14 of the patients, nodules were detected in a total of 7 (50%) patients. The mean FT3, FT4, TSH, Anti-Tpo, Anti-TG, and TG values of the patients were found to be within normal limits. Conclusion: In the present study, no changes were detected in the thyroid functions and structures of the patients with Lepromatous Leprosy. We consider that prospective randomized studies that will include larger sample sizes are needed to determine whether there is a relationship between leprosy and thyroid disease. Author summary: Leprosy is also known as Hansen's disease, caused by the bacillus Mycobacterium leprae. This ancient disease continues to be a serious healt problem worldwide. Currently it is more common in subtropical regions. Although leprosy cases are decreasing, they are still seen in Turkey. Mycobacterium Leprae lead to an chronic granulamatous infection mainly on skin and peripheral nerves however, it can also affect other tissues such as eyes, mucous membranes, bones and testicles, and may occur different clinical manifestations. It has been shown that it also causes changes in endocrine organ functions. There are some studies on thyroid functions, but the effects of leprosy on thyroid functions and structure are not clear. In this study, we examined the structural features and functional status of the thyroid gland, in a small number of patients because of Leprosy is non endemic common in our country. No changes were detected in the thyroid functions and structures of the patients with Lepromatous Leprosy in a thyroid-endemic region in this study. We consider that it is necessary prospective randomized studies included larger sample sizes on this topic [ABSTRACT FROM AUTHOR]