Sero-Epidemiology of Leprosy

摘要

Delay in diagnosis and treatment of leprosy is one of the main reasons why thedisease has not been eradicated. However, recent advances in understanding the biochemical structure of mycobacterium leprae and human serological responses to infection have raised the possibility of using serologic methods for early detection of leprosy. This longitudinal study conducted in Thailand from 8/88 to 12/93 of 1,340 household contacts of persons with leprosy evaluates the efficacy of an ELISA test for antibodies to the M. leprae-specific antigen NT-O-BSA. The study found the test to be highly specific (94.4%), although it was not sensitive (36.4%) and had low predictive value (5.1%). Seropositive contacts had a 9.1-fold higher risk of developing the disease than seronegatives. A few contacts were found to be seropositive several months before recognition of the disease.