Perfil clínico, sociodemográfico e laboratorial dos indivíduos com suspeição diagnóstica de hanseníase atendidos no CREDEN-PES no período de 2017 a 2021

Abstract

Early diagnosis of leprosy is a vital strategy to interrupt the chain of transmission of M. leprae and prevent physical disability. However, the diagnosis is essentially clinical, and, in many cases, the symptoms are subtle and sometimes go unnoticed even by specialists. Bacilloscopy and histopathology exams help in the clinical diagnosis, spectral categorization, and treatment of the disease. In regions where endemicity is higher, serological and molecular methods should be used, especially among household contacts, to identify contacts of patients with the possibility of becoming ill. In this sense, we proposed to trace the clinical, sociodemographic, and laboratory profiles of individuals with suspected leprosy treated at CREDEN-PES. Ear dermal scraping samples from study participants were collected and preserved in 70% alcohol. Subsequently, the genetic material was extracted and quantified. Then, the qPCR assay was performed targeting the RLEP gene (Repetitive Elements) to identify the presence of M. leprae DNA. in said samples. Samples from 411 individuals were analyzed. Of this total, 158 samples were classified as cases and 253 as individuals with suspected leprosy. A significant number of patients aged between 40 and 69 years (n=85), with 58.86% being male and 83.87% presenting positive qPCR, indicating the presence of M. leprae DNA in the dermal scraping samples collected. As for education, among those who had incomplete 1st to 4th grade, the qPCR reaction was positive at 89.66%. Most of the reported cases were classified as multibacillary (63.92%). However, the qPCR test was positive in 75.44% of the patients classified as paucibacillary and 86.14% of the multibacillary cases. Regarding individuals with suspected leprosy, of the 253 samples collected, 100% had a negative bacillary index (BI=0. However, the results of the qPCR test indicated that 120 samples (47.43%) were positive for the RLEP gene. Our results reinforce the need to implement more sensitive laboratory methods to diagnose leprosy. In addition, it is worth highlighting the identification of two cases of patients (lepromatous and borderline clinical form) with zero BI and positive qPCR results. The study indicates the possibility of illness in those individuals referred to CREDENPES with suspected leprosy, who presented positive results for M. leprae DNA in the qPCR, although with BI zero.