%A Martelli CMT
%A Stefan MM
%A Gomes MK
%A Rebello PFB
%A Peninni S
%A Narahashi K


%T Single lesion paucibacillary leprosy: baseline profile of the Brazilian multicenter cohort study

%0 Journal Article

%D 2000

%J International Journal of Leprosy and other Mycobacterial Diseases

%P 0148-916X

%V 68

%N 3

%X In Brazil, there is little information  about the clinical and epidemiological characteristics of paucibacillary,  single skin lesion leprosy patients (SSL-PB). Only recently has the official  notification system distinguished leprosy patients with a single lesion as a clinical entity,  for whom the singledose ROM (rifampin,  ofloxacin and minocycline) regimen has been recommended. In  this paper, we describe the baseline clinical  features and the immunological background  of a multicenter cohort of SSLPB  leprosy cases enrolled between December 1997-1998. Patients were  recruited at health centers located in the following regions: Southeast = Rio de Janeiro; North = Amazon and Rondônia states and CenterWest = Goiás state. Eligible cases  were  newly  detected, untreated single-lesion leprosy patients without thickened nerve involvement,  and were assessed by clinical, bacilloscopic and histopathological exams. The Mitsuda skin test  and anti-PGL-I serology (ELISA) were also performed. Of the 299 SSL-PB leprosy patients, 259 (86.6%)  fulfilled  the criteria for single-dose ROM intervention. Our results showed that patients  recruited from different sites had similar features, considering the clinical  and  immunological  profiles. There was a predominance of adults (mean age 32.4; S.D. 16.0), and a BCG scar was  detected in 76.7% of the children (<15 years old). Only 7 cases were diagnosed as the multibacillary type,  representing less than 3% of the patients being misclassified. Our data indicate  that in Brazil SSL-PB case ascertainment based on clinical and bacilloscopic criteria can be  accurately defined under a routine control program; 75.0% of SSL-PB cases were Mitsuda  positive (>5 mm) and seropositivity for anti-PGL-I was detected in 17.3% of the patients. These  data are compatible with effective cell-mediated immunity and low bacillary  load, suggesting favorable clinical outcomes for most SSLPB participants of  this cohort.