Back

Mauricio Lisboa Nobre

Mauricio Lisboa Nobre

Federal University of Rio Grande do Norte, Brazil

Title: A new strategy to halt leprosy transmission: A Brazilian experience

Biography

Mauricio Lisboa Nobre is a Physician specialized in Dermatology and Leprology. He has completed his PhD in Tropical Medicine by the Oswaldo Cruz Foundation (Rio de Janeiro). His main activities include the training of doctors and nurses from the Brazilian Family Health Program on Leprosy Management. He also supports field researches conducted by the Tropical Medicine Institute of Rio Grande do Norte Federal University, especially on leprosy epidemiology and contact tracing. He acts as an Adviser for the Brazilian Ministry of Health, Pan-American Health Organization (PAHO) and ILEP agencies

Abstract

Leprosy is an important public health problem in Brazil, where 25,218 new cases were reported in 2016. Patients with weak resistance against Mycobacterium leprae develop Multibacillary (MB) types of disease and spread the infection. We analyzed 541,090 cases notified in Brazil from 2003-2013, observing that New Cases Detection Rates (NCDR) for MB leprosy increased with age, especially for men, reaching 44.8 new cases/100,000 male population in 65-69-year-old group, while overall NCDR was 2-fold lower. Males had twice the odds of MB leprosy than females (OR=2.36, CI95%=2.33-2.38); the same was observed for patients older than 59 years (OR=1.99, CI 95%=1.96-2.02) compared to youngers. These findings were reported only in areas where leprosy was declining and exposure to infection was reduced, promoting a later onset of disease. However, we observed this pattern for MB leprosy in all Brazilian states, either with the highest NCDR (104.5 new cases/100,000) or the lowest NCDR (1.7 cases/100,000). Additionally, we selected a highly endemic urban area to search for MB leprosy cases among elderly population. As a result, 80% of all residents aged 60 or more years old (531 people) were checked for ML specific antibodies and three new cases of MB leprosy were detected among 188 men (NCDR=1.6%). No new case was detected among 316 women tested. These results suggest that age-specific campaigns should be addressed to increase earlier detection and treatment of MB cases among elderly men in endemic areas, as an important tool to effectively halt leprosy transmission in Brazil