Article
Anti-PGL-1 positivity as a risk marker for the development of Leprosy among contacts of Leprosy cases: systematic review and meta-analysis
Registro en:
PENNA, Maria Lucia F. et al. Anti-PGL-1 positivity as a risk marker for the development of Leprosy among contacts of Leprosy cases: systematic review and meta-analysis. Plos Neglected Tropical Diseases, [San Francisco], v. 10, n. 5, p.1-11, may 2016.
1935-2727
10.1371/journal.pntd.0004703
Autor
Penna, Maria Lucia Fernandes
Penna, Gerson Oliveira
Iglesias, Paula Cristina
Natal, Sonia
Rodrigues, Laura Cunha
Resumen
Gerson Oliveira Penna - Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta à informação no documento. DECIT-MS / CAPES / CNPq / London School of Tropical Medicine and Tropical Medicine Background: There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection. Methods: A systematic review of all cohort studies, which classified healthy leprosy contacts, at entry, according to anti-PGL1 positivity, and had at least one year follow up. The outcome was clinical diagnosis of leprosy by an experienced physician. The meta-analysis used a fixed model to estimated OR for the association of PGL-1 positivity and clinical leprosy. A fixed model also estimated the sensibility of PGL-1 positivity and positive predictive value. Results: Contacts who were anti PGL-1 positive at baseline were 3 times as likely to develop leprosy; the proportion of cases of leprosy that were PGL-1 positive at baseline varied but was always under 50%.
Conclusions: Although there is a clear and consistent association between positivity to anti PGL-1 and development of leprosy in healthy contacts, selection of contacts for prophylaxis based on anti PGL1 response would miss more than half future leprosy cases. Should chemoprophylaxis of controls be incorporated into leprosy control programmes, PGL1 appears not to be a useful test in the decision of which contacts should receive chemoprophylaxis.