Infecção por Mycobacterium leprae em contatos sociais de hanseníase em escolares

Abstract

to Analyze the presence of infection by Mycobacterium leprae in school social contacts of cases of multibacillary leprosy, in the city of Cuiaba, Mato Grosso. Method: cross-sectional epidemiological study structured in three manuscripts according to the goals: Characterize the profile of 250 schools, 13 cases of multibacillary leprosy being notified and registered on reportable diseases information system of Notification (SINAN/MT), during the period of July to December 2015 and 2016 237 healthy social contacts, both aged 5 to 14 years; Investigate the positivity of Mycobacterium leprae for Nasal Swab PCR and its associated factors in social contacts, where they used the prevalence ratio (RP) in bivariate analyses and Poisson regression with robust variance in adjusted to the level of statistical significance of 5% and the Pearson correlation coefficient (r) for numeric variables; and analyze the spatial distribution of the school contacts the PCR positive nasal swab through the georeferencing of the region of origin. Results: in the first study there was a predominance of the age group of 10 to 14 years. The race/color Brown was the most autodeclared (61.2%), 24% of the residences of the participants were given/rented and 66.4% fit in the most unfavorable economic classes. As immunological variables, 9.7% of contacts were born prematurely and 5.1% did not present scar of BCG. It was found that 67.9% of social contacts come in the northern region and 8.0% live in rural areas of the municipality. The second study found after setting by means of the Poisson regression that infection with m. Leprae in population reported associated with the residence requirement (leased/ceded) (RP set: 1.07; CI 1.01-1.14; p = 0.022). Positive correlation was observed between the positivity to the PCR and the number of individuals who presented two BCG scars (r = 0.553) and race/color yellow and indigenous (r = 0.306; r = 0.451) respectively. Race/black school were correlated with the number of people with leprosy cases in the family and suggestive lesions of the disease. The third and last study identified greater agglomeration of individuals flow schoolneighborhood in located in the North and East. The Address of the mountain district (Northern region) accounted for 20.5% (n = 07) of schools with infectivity. Among the positives, 41.17% (n = 14) reside in low-income localities, 44.2% (n = 15) belonging to the class C and 14.7% at the most unfavorable classes (D/E); 63.6% had five or more residents per household. Only 29.4% reported sewer network and most (97.2%) reported fate of trash collection. Conclusions: identified the presence of m. leprae through nasal swab PCR social contacts that coexist with multibacillary thus children diagnosed with leprosy can act as potential sources of infection within the environment schools. The spatial distribution of these schools found that in areas of social vulnerability there is a greater risk of transmission of infection and living conditions in which the individual is inserted may favor the illness.