ABSTRACT
Os programas de controle da hanseníase se beneficiariam de um método fácil para estimar prevalência e avaliar o impacto das ações de controle na prevalência da doença. A determinação da soroprevalência de anticorpos contra PGL-I através de estudos com crianças em idade escolar foi sugerida como indicador útil da taxa de prevalência da hanseníase a nível municipal.Para investigar se a soropositividade estaria associada aos coeficientes de detecção da hanseníase e se poderia ser usada como indicador da prevalência em outras áreas, 7.073 crianças em três estados endêmicos de hanseníase no Brasil foram testadas. Resultados mostram uma considerável variação da distribuição de soropositividade nas comunidades, independente do número de casos de hanseníase detectados. A soroprevalência foi significativamente menor nos colégios. Nenhuma diferença na distribuição da soropositividade determinada por ELISA ou dipstick foi observada. Nenhuma correlação entre o coeficiente de detecção da hanseníase e soropositividade pôde ser estabelecida.
Leprosy control programs would benefit expressively from an easy method to estimate disease prevalence and to assess the effect of leprosy control measures on disease prevalence. Determination of the seroprevalence of antibodies to PGL-I through school children surveys might be a useful indicator of leprosy prevalence at the district level. To investigate whether seropositivity rates could be related to leprosy detection rates and whether seropositivity could be used as a proximal indicator to predict the leprosy incidence in other areas, 7,073 school children in three different leprosy-endemic states in Brazil were tested. The results show a widely varying distribution of seropositivity in the communities independent of the number of leprosy cases detected. Seroprevalence was significantly lower at private schools. No differences in the patterns of seropositivity between ELISA and dipstick were observed. No correlation between leprosy detection rate and seropositivity rates could be established.
Subject(s)
Child , Female , Humans , Male , Antibodies, Bacterial/blood , Antigens, Bacterial/immunology , Glycolipids/immunology , Leprosy/epidemiology , Mycobacterium leprae/immunology , Antigens, Bacterial , Brazil/epidemiology , Enzyme-Linked Immunosorbent Assay , Epidemiologic Methods , Glycolipids , Immunoglobulin M/blood , Leprosy/diagnosis , Students/statistics & numerical dataABSTRACT
N-acetyl-L-cysteine (NAC) has been proposed as an additional therapeutic agent for AIDS patients because it reduces human immunodeficiency virus type 1 (HIV-1) replication in stimulated CD4+ lymphocytes, and it ameliorates immunological reactivity. In a randomized, 180-day, double-blind, placebo-controlled trial performed with HIV-infected patients classified as A2 and A3 according to the criteria of the Center for Disease Control and Prevention, we investigated the effects of oral administration of NAC on HIV-infected patients undergoing their first anti-retroviral therapy; viral load, CD4+ lymphocyte, lymphocyte viability and apoptosis, and TNF-alpha and IL-8 levels were determined. Sixteen patients who received anti-retroviral therapy plus a placebo formed the control group and the study group consisted of 14 patients who received anti-retroviral therapy and NAC supplementation. A significant decrease was seen in viral load, TNF-alpha and IL-8 levels, and lymphocyte apoptosis, and a significant increase was found in levels of CD4+ lymphocytes and lymphocyte viability in both groups after anti-retroviral treatment, but no measurable benefits of anti-retroviral therapy plus NAC oral supplementation (600 mg/day) were found in relation to anti-retroviral therapy alone, and the baseline levels of cysteine and glutathione in plasma were not recovered by this treatment. In conclusion, the daily doses of NAC necessary for the total recuperation of plasma cysteine and glutathione levels in HIV-infected patients and the additional benefits following the supplementation of NAC in patients submitted to anti-retroviral therapy, need to be studied further.