الفهرس | Only 14 pages are availabe for public view |
Abstract Leprosy presents across wide range of symptoms defined into 5-6 categories within the Ridley- Jopling scale, although for treatment purposes these are simplified to either multi or paucibacillary (MB and PB, respectively). Diagnosis of leprosy is not simple, not surprisingly, many professionals have neither the experience to recognize the various signs and symptoms of the disease nor the ability to differentiate them from other diseases (Duthie et al., 2014). Antibody responses to specific M.leprae antigens can be evaluated by several tests. Among these are serological test that was used in our present study that measure the level of immunoglobulin G (Ig G) against LID-1. Individuals living in leprosy endemic areas which are typically impoverished and have high population densities are commonly infected with M. leprae (Barreto et al., 2014). Thus the possibility that asymptomatically infected individuals may be involved in the M. leprae transmission chain should not be overlooked (Araujo et al., 2012). Subclinical M.leprae infection in endemic population is traditionally assessed using either ELISA or lateral flow tests to detect specific antibodies. This assay may enable earlier identification and treatment of patients, and thus contribute to both the prevention of physical disabilities and the reduced transmission of M. leprae (Goulart et al., 2008). The current study was done on 60 household contacts of leprosy patients and 30 as a control. With complete general and clinical examination, different clinical signs suggestive of leprosy were present in 3HHC-MB who had the highest mean of Anti-LID-1. Therefore, we ascertain the Summary 89 importance of complete clinical examination of household contacts for early diagnosis especially in endemic areas. We found highly significant difference between level of anti- LID -1 Ab in HHC- MB with HHC- PB and also between HHC- MB with control and HHC- PB with control. In the current study, as regards demographic criteria, the aged groups 20:30 y showed the highest mean of anti- LD -1 level with a negative significant relation between the age and the level of anti –LID-1 (r= 0.371) When clinical classification of the index cases was analyzed, there was a significant relationship between the number of damaged nerves in the index leprosy cases and the Anti-LID-1 Ab levels in the HHC. 22 HHC of MB cases who had more than damaged nerves at the time of diagnosis had the highest mean of 0.14± 0.13 OD unit. As regards the degree of disability of the index leprosy case at the time of diagnosis, HHC of cases with Grade 2 disability were of the highest mean of 0.13± 0.14 OD unit. Family health program should do active search of cases, through examination of skin and neurological examination during household visits to those people. The objectives are to increase the detection rate of suspected cases and, consequently, increasing rates of early diagnosis and treatment. The results suggest a useful role for the measurement of serum M.leprae specific Anti-LID-1 Ab as an easy, non-invasive and inexpensive adjunct method for the detection of leprosy in the population. As seropositivity might be a risk factor of developing leprosy. Those persons of seropositive results should be monitored by clinical examination, determination of the immune response and bacteriologic state for leprosy detection. |