Risk factor for Mycobacterium leprae detection in household contacts with leprosy patients: a study in Papua, East Indonesia

  • Hana Krismawati Department of Microbiology, National Institute of Health Research and Development of Papua, Jayapura, Indonesia https://orcid.org/0000-0003-1952-1802
  • Antonius Oktavian Department of Microbiology, National Institute of Health Research and Development of Papua, Jayapura, Indonesia
  • Yustinus Maladan Department of Microbiology, National Institute of Health Research and Development of Papua, Jayapura, Indonesia
  • Tri Wahyuni Department of Microbiology, National Institute of Health Research and Development of Papua, Jayapura, Indonesia
Keywords: household, leprosy, Mycobacterium leprae, polymerase chain reaction
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BACKGROUND In the era of leprosy eradication, Jayapura is still one of the biggest leprosy pockets in Papua, Indonesia. The trend for leprosy case detection rate has remained relatively stable over recent years. This study was aimed to detect Mycobacterium leprae in household contacts and to evaluate the associated factors with the detection.

METHODS This cross-sectional study recruited household contacts of leprosy patients who were diagnosed consecutively from March to August 2015 in Hamadi Point of Care, Jayapura. The leprosy patients were diagnosed using polymerase chain reaction (PCR). For each leprosy patient, up to four household contacts that had no symptom were included. Every household contact received screening through DNA detection of M. leprae extracted from nasal swab specimens and examined using PCR. Factors for bacteria detection included intensity, time duration and number of contacts living together in the same house, and random blood glucose levels were evaluated. Bivariate analysis was used to associate them with M. leprae detection in household contacts.

RESULTS From 107 household contacts of 35 patients who had leprosy, M. leprae was detected in 19.6%. Household contacts with leprosy patients for >1 year was a risk factor for detection (OR = 12.45; 95% CI = 1.595–97.20; p = 0.002). Blood glucose (p = 0.444), ethnic (p = 0.456), sleeping proximity to leprosy case (p = 0.468) and relatives (p = 0.518) give no effect to M. leprae detection in household contacts.

CONCLUSIONS Among the various risk factors studied, duration of living together with the patient significantly increased the risk of M. leprae transmission.


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  1. World Health Organization. Integrating neglected tropical diseases into global health and development: fourth WHO report on neglected tropical diseases. Geneva: World Health Organization; 2017. Available from: https://unitingtocombatntds.org/wp-content/uploads/2017/11/4th_who_ntd_report.pdf.

  2. Purnomo, Giyai A, Rumainum A, editors. Leprosy annual report 2014. 1st ed. Papua Provincial Health Office. Leprosy annual report 2014. 1st ed. Purnomo, Giyai A, Rumainum A, editors. Jayapura: Provincial Health Office of Papua; 2014. p. 3-5.

  3. Düppre NC, Camacho LA, Sales AM, Illarramendi X, Nery JA, Sampaio EP. Impact of PGL-I seropositivity on the protective effect of BCG vaccination among leprosy contacts: a cohort study. PLoS Negl Trop Dis. 2012;6(6):e1711. https://doi.org/10.1371/journal.pntd.0001711

  4. Job CK, Jayakumar J, Kearney M, Gillis TP. Transmission of leprosy: a study of skin and nasal secretions of household contacts of leprosy patients using PCR. Am J Trop Med Hyg. 2008;78(3):518-21. https://doi.org/10.4269/ajtmh.2008.78.518

  5. Scollard DM, Adams LB, Gillis TP, Krahenbuhl JL, Truman RW, Williams DL. The continuing challenges of leprosy. Clin Microbiol Rev. 2006;19(2):338-81. https://doi.org/10.1128/CMR.19.2.338-381.2006

  6. Sarno EN, Duppre NC, Sales AM, Hacker MA, Nery JA, de Matos HJ. Leprosy exposure, infection and disease: a 25- year surveillance study of leprosy patient contacts. Mem Inst Oswaldo Cruz. 2012;107(8):1054-9. https://doi.org/10.1590/S0074-02762012000800015

  7. Saraya MA, Al-Fadhli MA, Qasem JA. Diabetic status of patients with leprosy in Kuwait. J Infect Public Health. 2012;5(5):360-5. https://doi.org/10.1016/j.jiph.2012.08.001

  8. Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: a review of pathogenesis. Indian J Endocrinol Metab. 2012;16 Suppl 1(Suppl 1):S27-36. https://doi.org/10.4103/2230-8210.94253

  9. Williams DL, Pittman TL, Deshotel M, Oby-Robinson S, Smith I, Husson R. Molecular basis of the defective heat stress response in Mycobacterium leprae. J Bacteriol. 2007;189(24):8818-27. https://doi.org/10.1128/JB.00601-07

  10. Caleffi KR, Hirata RD, Hirata MH, Caleffi ER, Siqueira VL, Cardoso RF. Use of the polymerase chain reaction to detect Mycobacterium leprae in urine. Braz J Med Biol Res. 2012;45(2):153-7. https://doi.org/10.1590/S0100-879X2012007500011

  11. van Helden PD, Victor TC, Warren RM, van Helden EG. Isolation of DNA from Mycobacterium tuberculosis. In: Parish T, Stoker N, editors. Methods in Molecular Medicine. 2nd ed. New Jersey: Humana Press Inc; 2001. p. 19-29.

  12. Imaeda T, Kirchheimer WF, Barksdale L. DNA isolated from Mycobacterium leprae: genome size, base ratio, and homology with other related bacteria as determined by optical DNA-DNA reassociation. J Bacteriol. 1982;150(1):414-7. https://doi.org/10.1128/JB.150.1.414-417.1982

  13. Donoghue HD, Holton J, Spigelman M. PCR primers that can detect low levels of Mycobacterium leprae DNA. J Med Microbiol. 2001;50(2):177-82. https://doi.org/10.1099/0022-1317-50-2-177

  14. Parkash O, Singh HB, Rai S, Pandey A, Katoch VM, Girdhar BK. Detection of Mycobacterium leprae DNA for 36kDa protein in urine from leprosy patients: a preliminary report. Rev Inst Med Trop Sao Paulo. 2004;46(5):275-7. https://doi.org/10.1590/S0036-46652004000500008

  15. Almeida EC, Martinez AN, Maniero VC, Sales AM, Duppre NC, Sarno EN, et al. Detection of Mycobacterium leprae DNA by polymerase chain reaction in the blood and nasal secretion of Brazilian household contacts. Mem Inst Oswaldo Cruz. 2004;99(5):509-11. https://doi.org/10.1590/S0074-02762004000500009

  16. Rosa FB, Souza VC, Almeida TA, Nascimento VA, Vásquez FG, Cunha M, et al. Detection of Mycobacterium leprae in saliva and the evaluation of oral sensitivity in patients with leprosy. Mem Inst Oswaldo Cruz. 2013;108(5):572-7. https://doi.org/10.1590/S0074-02762013000500006

  17. Suzuki K, Takigawa W, Tanigawa K, Nakamura K, Ishido Y, Kawashima A, et al. Detection of Mycobacterium leprae DNA from archaeological skeletal remains in Japan using whole genome amplification and polymerase chain reaction. PLoS One. 2010;5(8):e12422. https://doi.org/10.1371/journal.pone.0012422

  18. da Costa Martins AC, Miranda A, de Oliveira MLW del R, Bührer- Sékula S, Martinez A. Nasal mucosa study of leprosy contacts with positive serology for the phenolic glycolipid 1 antigen. Braz J Otorhinolaryngol. 2010;76(5):579-87. https://doi.org/10.1590/S1808-86942010000500008

  19. Pattyn SR, Ursi D, Ieven M, Grillone S, Raes V. Detection of Mycobacterium leprae by the polymerase chain reaction in nasal swabs of leprosy patients and their contacts. Int J Lepr Other Mycobact Dis. 1993;61(3):389-93.

  20. de Wit MY, Douglas JT, McFadden J, Klatser P. Polymerase chain reaction for detection of Mycobacterium leprae in nasal swab specimens. J Clin Microbiol. 1993;31(3):502-6. https://doi.org/10.1128/JCM.31.3.502-506.1993

  21. Klatser PR, van Beers S, Madjid B, Day R, de Wit MY. Detection of Mycobactenium leprae nasal carriers in populations for which leprosy is endemic. J Bacteriol. 1993;31(11):2947-51. https://doi.org/10.1128/JCM.31.11.2947-2951.1993

  22. Gama RS, Gomides T, Gama C, Moreira S, de Neves Manta FS, de Oliveira L, et al. High frequency of M. leprae DNA detection in asymptomatic household contacts. BMC Infect Dis. 2018;18(1):153. https://doi.org/10.1186/s12879-018-3056-2

  23. Cordona-Castro N, Beltran-Alzate J, Manrique-Hernández R. Survey to identify Mycobacterium leprae -infected household contacts of patients from prevalent regions of leprosy in Colombia. Mem Inst Oswaldo Cruz. 2008;103(4):332-6. https://doi.org/10.1590/S0074-02762008000400003

  24. Romero-Montoya M, Beltran-Alzate JC, Cardona-Castro N. Evaluation and monitoring of Mycobacterium leprae transmission in household contacts of patients with Hansen's disease in Colombia. PLoS Negl Trop Dis. 2017;11(1):e0005325. https://doi.org/10.1371/journal.pntd.0005325

  25. Martinez AN, Talhari C, Moraes MO, Talhari S. PCR-based techniques for leprosy diagnosis: from the laboratory to the clinic. PLoS Negl Trop Dis. 2014;8(4):e2655. https://doi.org/10.1371/journal.pntd.0002655

  26. Mieras LF, Taal AT, van Brakel WH, Cambau E, Saunderson PR, Smith WC, et al. An enhanced regimen as post-exposure chemoprophylaxis for leprosy: PEP++. BMC Infect Dis. 2018;18:506. https://doi.org/10.1186/s12879-018-3402-4

  27. Pescarini JM, Strina A, Nery JS, Skalinski LM, Andrade K, Penna M, et al. Socioeconomic risk markers of leprosy in high-burden countries: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2018;12(7):e0006622. https://doi.org/10.1371/journal.pntd.0006622

  28. Moet F, Meima A, Oskam L, Richardus JH. Risk factors for the development of clinical leprosy among contacts, and their relevance for targeted interventions. Lepr Rev. 2004;75(4):310- 326.

How to Cite
Krismawati H, Oktavian A, Maladan Y, Wahyuni T. Risk factor for <em>Mycobacterium leprae</em&gt; detection in household contacts with leprosy patients: a study in Papua, East Indonesia. Med J Indones [Internet]. 2020Mar.26 [cited 2024Jun.20];29(1):64-0. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/2962
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