Mycobacterium leprae: A historical study on the origins of leprosy and its social stigma

Health Education Method on Leprosy Prevention: Integrative Review

Leprosy is still found mainly in lower-middle-income countries. Breaking the chain of leprosy transmission requires various ways, especially by increasing knowledge of leprosy prevention through health education. Although several studies have mentioned the effectiveness of health education, there is still uncertainty about the best method to use. Therefore, the review question should be answered: what forms of health education have been developed about Leprosy in the community? This review study complies with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) version 2020. The search for relevant literature involved PubMed, ScienceDirect, ERIC, Cochrane, and ProQuest databases for the studies published in the 2000 to 2023 period with the inclusion criteria such as increasing knowledge, changing attitudes and behavior, and increasing positive stigma. The quality of the study was assessed using the Critical Appraisal Skills Program, and the Risk of Bias using the Cochrane RoB tool. Overall search on databases resulted in a total of 184,681 articles. Only six studies were eligible to be included in this review. Various educational methods were used in the eligible studies, including MH Mobile, the myth or truth on Leprosy game, posters, leaflets, community meetings, tele-education the web, discussion lists, chats, activity diaries, iconographic 3D videos, classes on video streaming, video conference, case simulation, lecture, and the contact intervention (education, testimonies (direct contact), videos, and comics). All of the methods used had the potential to improve knowledge, attitude, and practice and reduce negative stigma regarding Leprosy. There is no method of health education superior to another on Leprosy prevention.

Mpox (Formally Known as Monkeypox)

This article reviews Mpox, including its epidemiology, transmission, clinical presentation, diagnosis, prevention, and management and treatment of the virus. This article also investigates the current outbreak of Mpox in nonendemic countries, including the United States. It discusses the high prevalence of Mpox affecting the men who have sex with men community. It examines the social stigma related to disease outbreaks of the past and it provides strategies that should be implemented to prevent stigmatization of the men who have sex with men community with the present-day outbreak of Mpox.

Leprosy among children in an area without primary health care coverage in Caratateua Island, Brazilian Amazon

Introduction

The detection of leprosy in children is an important epidemiological marker of the disease, indicating the community's early exposure to Mycobacterium leprae and active transmission of the infection.

Methods

In order to detect new cases among children by combining clinical evaluation and laboratory tests, we conducted an active case finding among individuals under 15 years old on Caratateua Island, located in the city of Belém, in the Pará state, an endemic region in the Amazon. Dermato-neurological examination, collection of 5 mL of peripheral blood for IgM anti-PGL-I antibody titration, and intradermal scraping for bacilloscopy and amplification of the specific RLEP region by qPCR were performed.

Results

Out of the 56 examined children, 28/56 (50%) new cases were identified. At the time of evaluation, 38/56 (67.8%) children presented one or more clinical alterations. Seropositivity was detected in 7/27 (25.9%) new cases and 5/24 (20.8%) undiagnosed children. DNA amplification of Mycobacterium leprae was observed in 23/28 (82.1%) of new cases and in 5/26 (19.2%) of non-cases. Out of the total cases, 11/28 (39.2%) were exclusively diagnosed by clinical evaluation performed during the active case finding. Seventeen new cases (60.8%) were detected considering the clinical alterations found in addition to positive results for qPCR. In this group, 3/17 (17.6%) qPCR-positive children presented significant clinical changes 5.5 months after the first evaluation.

Discussion

Our research detected a number of cases 5.6 times higher compared to the total number of pediatric cases recorded throughout the year 2021 in the municipality of Belém, which shows a critical scenario of underdiagnosing of leprosy among children under 15 years old in the region. We propose the use of qPCR technique to identify new cases among children with oligosymptomatic or early disease in endemic areas, in addition to the training of Primary Health Care professionals and the implementation of the Family Health Strategy coverage in the visited area.