| dc.description.abstract | Leprosy is a contagious infectious disease that has a long incubation period, 2 to 7 years on average. The diagnosis is essentially clinical and, despite the reduction in the number of cases, it persists as a public health issue. Serological tests for the detection of Mycobacterium leprae's specific antibodies have been shown to be useful in identifying individuals at higher risk of disease and subclinical infection, which may also be actively involved in the dissemination and propagation of bacilli to susceptible individuals. Thus, the use of specific serological markers of leprosy may contribute to the strategy of epidemiological surveillance of the disease and the early detection of new cases. The objective of this study was to analyze the influence of specific serological markers to predict disease in leprosy in a population of an endemic region of Minas Gerais. This is a retrospective cohort study done with a population sample of 2,553 individuals in seven counties in the Almenara microregion. Home visits were done with a questionnaire application and blood collection for the analysis of serological markers of leprosy infection, performed by the Enzyme-linked Immunosorbent Assay technique. For statistical analysis, initially, was performed the univariate analysis using Chi-square test of Pearson, Fisher's exact test and Mann-Whitney test, and later, multivariate Logistic Regression models. In order to verify if the four adjusted models tested were suitable and if they had a good predictive capacity, adjustment quality measures were calculated. The software used in the analyzes was Stata and R. The study was approved by COEP-UFMG, opinion no. ETIC 158/09. In the univariate analysis, the variables seropositivity, the presence of BCG scar, age, marital status, schooling, and family income were significantly associated with leprosy. These variables composed the initial model of the multivariate analysis, which showed better quality in the prediction of illness when compared to the other models tested. The final model, which was composed only by age, had a significant association in the multivariate analysis but showed a decrease in the quality of the prediction of illness and lower homogeneity in sensitivity and specificity. The alternative model 1, composed of the variables serology and age, showed improvement of quality when compared to the final model. The alternative model 2, composed only by the serology, presented the worst quality in comparison to the other models tested. Thus, the use of specific serological markers of leprosy may improve the predictive potential of disease in a population in an endemic region. However, it is necessary to concomitantly use of epidemiological surveillance actions, improve the socioeconomic conditions of the population and vaccinate BCG to reach the goal of eliminating leprosy. Keywords: Leprosy. Epidemiological Monitoring. Serologic Tests. Mycobacterium leprae. | |
