Memories and history of Hansens disease in Brazil told by witnesses (1960-2000)

Este trabalho é um resultado preliminar de pesquisa sobre a memória e história da hanseníase, deseenvolvida pela Fundação Oswaldo Cruz (Fiocruz) e Universidade Federal do Rio de Janeiro (UFRJ), através de depoimentos de quem padeceu da doença ou atuou contra ela. Apresenta as opções metodológicas adotadas pelos autores, um sucinto histórico da hanseníase no Brasil e dados a respeito do estágio em que se encontra a pesquisa, com extratos de depoimentos que constituem o acervo gerado. Na década de 1980 houve avanços, como a adoção do tratamento através da poliquimioterapia, que provocou a redução do índice de prevalência da doença, que passou de 16,3 casos por dez mil habitantes em 1985, para 4,57 casos para dez mil habitantes em 2000, em nosso país. A gênese e as atividades do Movimento de Reintegração das Pessoas Atingidas pela Hanseníase (Morban) são reveladas pelos testemunhos de Thomas Frist, cientista social norte-americano que trabalhou no Brasil nas décadas de 1970 e 1980, período de reestruturação das antigas colônias, e pelo de Cristiano Torres, ex-paciente, com passagens por preventórios e leprosários no Pará, personagem atuante, inclusive na proposição de políticas de controle da hanseníase

Two multidrug fixed-dosage treatment regimens with multibacillary leprosy patients.

This study compares the clinical, bacilloscopic, and histopathological evolution of 140 patients classified as having multibacillary leprosy with no previous specific treatment who were submitted to two multidrug treatment regimens with a fixed dose. Regimen I-Group 1: 70 cases received 600 mg rifampicin (RMP) + 100 mg dapsone (DDS) daily for three consecutive months followed by 100 mg DDS daily, self-administered doses for 21 months. Regimen II-Group II: 70 cases received 600 mg RMP + 300 mg clofazimine (CLO) once a month under supervision plus self-administered doses of 50 mg CLO + 100 mg DDS daily for 24 months. The bacilloscopic, histopathological and neuromotor evaluation parameters showed no statistically meaningful differences (P > 0.05) between the two groups except for reaction frequency (P < 0.05) in that group II patients presented the least number of reactional episodes during the treatment and in the dermatological examination at discharge. Follow-up after treatment was carried out for a consecutive four year period. During routine clinical examination one case submitted to regimen I developed nodular skin lesion over the right arm. Skin biopsy was done for histopathological examination and mouse foot-pad experiment by Shepard technique. The drug susceptibility test with DDS and RPM showed that M. leprae strain isolated was susceptible to both the drugs.

The dot-ELISA test for the detection of anti-PGL-1 IgM in leprosy patients and their contacts

Since dot-ELISA has recently been reported to be a sensitive, simple and method, we have compared it with the conventional microplate ELISA method. Sera of 124 leprosy patients, 136 household and professional contacts, and 92 controls were tested for a antibodies against a Mycobacterium leprae antigen using dot-ELISA on nitrocellulose membrane filters and microplate ELISA. The sensitive of the techniques was similar for multibacillary patients, but dot-ELISA was less sensitive for paucibacillary patients although it was more specific (100%) than ELISA (93,4%). Of 21 household contacts that gave a response by ELISA, 3 were also positive by dot-ELISA; one of these 3 developed indeterminate leprosy 12 months later and the other was diagnosed as borderline lepromatous after 28 months. These data indicate that dot-ELISA has a high spedificity and can be a useful tool in field evaluation

Use of the anti-PGL-I antibody ELISA and the Mitsuda reaction in early diagnosis of leprosy

Cutaneous reaction to the Mitsuda antigen and anti-PGL-I IgM antibodies (ELISA) were determined in 134 leprosy patients, 290 household contacts, 52 healthy controls and 43 tuberculous individuals. The multibacillary patients did nort developed cell-mediated immunity (CMI), although they presented high levels of IgM (absorbance at 492 m > 0.5). The paucibacillatry patients presented CMI, although in varying degrees, and IgM levels did not exceed 0.5 absorbance units. Most of the contacts (107) showed a Mitsuda-postive test, and 25 of then were anti-PGL-I IgM seropositive (absorbance < 0.5 but > 0.22), although none became ill during the twoyear follow-up. Of the 17 Mitsuda-negative contacts, two wxhibited an immunological status of lepromatous leprosy (negative Mitsuda test and positive serology; absorvance > 0.05) and became ill (one borderline lepromatous and one indeterminate leprosy). These results show that the immunological status of lepromatous leprosy can appear prior to clinical symptoms, and thus serology for anti-PGL-I IgM together with the Mitsuda test can be useful in an activbe search for new preclinical cases among high risk populations

IgM immunoglobulins reacting with the phenolic glycolipid-1 antigen from Mycobacterium leprae in sera of leprosy patients and their contacts

For the first time in Brazil it was investigated the occurrence of IgM anti-PGL-1 in the sera of household contacts of leprozy patients using the ELISA methodology. The sera of the multipatients. It was observed a high subclinical infection incidence among household contacts (19.4%). The percentage of leprosy development was 5% (1/21) among the seropositive contact group. This finding suggests that serology could be useful as prognostic test, but for better definition is necessary to tet a population from endemic area for long period time

Estudo dos dermatoglifos digitais em portadores de hanseniase. / Digital dermatoglyphics in leprosy

Foram analisadas 100 alteracoes nas impressoes digitais de hansenianos controlados no Ambulatorio Souza Araujo.Comparamos as impressoes digitais de cada paciente com as individuais arquivadas no Instituto de Identificacao Felix Pacheco, tomadas na epoca da identificacao civil.Os resultados obtidos sugerem o uso da tecnica de tomada de impressoes digitais como mais uma forma de se observar a evolucao clinica do paciente, atraves da regressao ou manutencao das alteracoes durante o tratamento e como possivel metodo de triagem, descobrindo portador real ou potencial da doenca