Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/41360
Title: Incidence of and factors associated with Leprosy among household contacts of patients with Leprosy in Brazil
Authors: Teixeira, Camila Silveira Silva
Pescarini, Júlia Moreira
Alves, Flávia Jôse Oliveira
Nery, Joilda Silva
Sanchez, Mauro Niskier
Teles, Carlos
Ichihara, Maria Yury
Ramond, Anna
Smeeth, Liam
Penna, Maria Lucia Fernandes
Rodrigues, Laura Cunha
Brickley, Elizabeth B.
Penna, Gerson Oliveira
Barreto, Maurício Lima
Silva, Rita de Cássia Ribeiro
Affilliation: Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, DF, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, DF, Brasil.
Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade de Brasília. Faculdade de Medicina. Núcleo de Medicina Tropical. Brasília, DF, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, United Kingdom.
London School of Hygiene & Tropical Medicine. Department of Non-communicable Disease Epidemiology. London, United Kingdom.
Universidade Federal Fluminense. Departamento de Epidemiologia e Bioestatística. Niterói, RJ, Brasil.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, United Kingdom.
London School of Hygiene & Tropical Medicine. Department of Infectious Disease Epidemiology. London, United Kingdom.
Universidade de Brasília. Faculdade de Medicina. Núcleo de Medicina Tropical. Brasília, DF, Brasil / Fundação Oswaldo Cruz. Fiocruz Brasília. Brasília, DF, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, DF, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Escola de Nutrição. Salvador, BA, Brasil.
Abstract: Importance: Despite progress toward reducing global incidence, leprosy control remains a challenge in low- and middle-income countries. Objective: To estimate new case detection rates of leprosy among household contacts of patients with previously diagnosed leprosy and to investigate its associated risk factors. Design, Setting, and Participants: This population-based cohort study included families registered in the 100 Million Brazilian Cohort linked with nationwide registries of leprosy; data were collected from January 1, 2007, through December 31, 2014. Household contacts of patients with a previous diagnosis of leprosy from each household unit were followed up from the time of detection of the primary case to the time of detection of a subsequent case or until December 31, 2014. Data analysis was performed from May to December 2018. Exposures: Clinical characteristics of the primary case and sociodemographic factors of the household contact. Main Outcomes and Measures: Incidence of leprosy, estimated as the new case detection rate of leprosy per 100 000 household contacts at risk (person-years at risk). The association between occurrence of a subsequent leprosy case and the exposure risk factors was assessed using multilevel mixed-effects logistic regressions allowing for state- and household-specific random effects. Results: Among 42 725 household contacts (22 449 [52.5%] female; mean [SD] age, 22.4 [18.5] years) of 17 876 patients detected with leprosy, the new case detection rate of leprosy was 636.3 (95% CI, 594.4-681.1) per 100 000 person-years at risk overall and 521.9 (95% CI, 466.3-584.1) per 100 000 person-years at risk among children younger than 15 years. Household contacts of patients with multibacillary leprosy had higher odds of developing leprosy (adjusted odds ratio [OR], 1.48; 95% CI, 1.17-1.88), and the odds increased among contacts aged 50 years or older (adjusted OR, 3.11; 95% CI, 2.03-4.76). Leprosy detection was negatively associated with illiterate or preschool educational level (adjusted OR, 0.59; 95% CI, 0.38-0.92). For children, the odds were increased among boys (adjusted OR, 1.70; 95% CI, 1.20-2.42). Conclusions: and Relevance The findings in this Brazilian population-based cohort study suggest that the household contacts of patients with leprosy may have increased risk of leprosy, especially in households with existing multibacillary cases and older contacts. Public health interventions, such as contact screening, that specifically target this population appear to be needed.
Keywords: Leprosy
Cohort studies
Incidence
Epidemiological monitoring
Multibacillary leprosy
DeCS: Hanseníase
Estudos de Coortes
Incidência
Monitoramento Epidemiológico
Issue Date: 2020
Publisher: American Medical Association
Citation: TEIXEIRA, Camila Silveira Silva et al. Incidence of and factors associated with Leprosy among household contacts of patients with Leprosy in Brazil. JAMA Dermatology, [Chicago], p. e1-e10, 15 Apr. 2020.
DOI: 10.1001/jamadermatol.2020.0653
ISSN: 2168-6068
Copyright: restricted access
Appears in Collections:BSB - Artigos de Periódicos
BA - IGM - Artigos de Periódicos

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