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dc.contributor.authorFontes, Amanda N. B-
dc.contributor.authorLima, Luana Nepomuceno Gondim Costa-
dc.contributor.authorMota, Rosa M. S-
dc.contributor.authorAlmeida, Rosa L. F-
dc.contributor.authorPontes, Maria A-
dc.contributor.authorGonçalves, Heitor de S-
dc.contributor.authorFrota, Cristiane C-
dc.contributor.authorVissa, Varalakshmi D-
dc.contributor.authorBrennan, Patrick J-
dc.contributor.authorGuimarães, Ricardo José de Paula Souza e-
dc.contributor.authorKendall, Carl-
dc.contributor.authorKerr, Ligia R. F. S-
dc.contributor.authorSuffys, Philip N-
dc.date.accessioned2018-02-06T12:31:31Z-
dc.date.available2018-02-06T12:31:31Z-
dc.date.issued2017-
dc.identifier.citationFONTES, Amanda N. B. et al. Genotyping of Mycobacterium leprae for better understanding of leprosy transmission in Fortaleza, Northeastern Brazil. PLoS Neglected Tropical Diseases, v. 11, n. 12, p. e0006117, Dec. 2017.pt_BR
dc.identifier.issn1935-2727-
dc.identifier.urihttp://patua.iec.gov.br//handle/iec/2922-
dc.description.abstractLeprosy is endemic in large part of Brazil with 28,761 new patients in 2015, the second largest number worldwide and reaches 9/10.000 in highly endemic regions and 2.7/10.000 in the city of Fortaleza, Ceará, Northeast Brazil. For better understanding of risk factors for leprosy transmission, we conducted an epidemiologic study supplemented by 17 locus VNTR and SNP 1–4 typing of Mycobacterium leprae in skin biopsy samples from new multibacillary (MB) patients diagnosed at a reference center in 2009 and 2010. Among the 1,519 new patients detected during the study period, 998 (65.7%) were MB and we performed DNA extraction and genotyping on 160 skin biopsy samples, resulting in 159 (16%) good multilocus VNTR types. Thirty-eight of these patients also provided VNTR types from M. leprae in nasal swabs. The SNP-Type was obtained for 157 patients and 87% were of type 4. Upon consideration all VNTR markers, 156 different genotypes and three pairs with identical genotypes were observed; no epidemiologic relation could be observed between individuals in these pairs. Considerable variability in differentiating index (DI) was observed between the different markers and the four with highest DI [(AT)15, (TA)18, (AT)17 and (GAA)21] frequently demonstrated differences in copy number when comparing genotypes from both type of samples. Excluding these markers from analysis resulted in 83 genotypes, 20 of which included 96 of the patients (60.3%). These clusters were composed of two (n = 8), three (n = 6), four (n = 1), five (n = 2), six (n = 1), 19 (n = 1) and 23 (n = 23) individuals and suggests that recent transmission is contributing to the maintenance of leprosy in Fortaleza. When comparing epidemiological and clinical variables among patients within clustered or with unique M. leprae genotypes, a positive bacterial index in skin biopsies and knowledge of working with someone with the disease were significantly associated with clustering. A tendency to belong to a cluster was observed with later notification of disease (mean value of 3.4 months) and having disability grade 2. A tendency for lack of clustering was observed for patients who reported to have lived with another leprosy case but this might be due to lack of inclusion of household contacts in the study. Although clusters were spread over the city, kernel analysis revealed that some of the patients belonging to the two major clusters were spatially related to some neighborhoods that report poverty and high disease incidence in children. Finally, inclusion of genotypes from nasal swabs might be warranted. A major limitation of the study is that sample size of 160 patients from a two year period represents only 15% of the new patients and this could have weakened statistical outcomes. This is the first molecular epidemiology study of leprosy in Brazil and although the high clustering level suggests that recent transmission is the major cause of disease in Fortaleza; the existence of two large clusters needs further investigation.pt_BR
dc.description.sponsorshipThis project was supported by the following funding agencies: "Ministe´rio de Ciência e Tecnologia (MCT)/Conselho Nacional de Desenvolvimento Cientı´fico e Tecnolo´gico (CNPq)/ Ministe´rio de Sau´de (MS)- Secretaria de Ciência, Tecnologia e Insumos Estrate´gicos (SCTIE)— Departamento de Ciência e Tecnologia (DECIT) (410573/2006-0)(LRFSKP); Fundac¸ão Cearense de Apoio ao Desenvolvimento Cientı´fico e Tecnolo´gico (FUNCAP) (CI1-0050-00057.01.00/11—003/2011 PNP-0058-00121.01.01/11—007/201)(LRFSKP); Damien Foundation—International Federation of Anti-Leprosy Associations (ILEP) (PNS); National Institute of Health NIH (NIH)/ National Institute of Allergy and Infectious Diseases (NIAID) (grant AI 47197) (PJB VDV PNS) and Conselho Nacional de Desenvolvimento Cientı´fico e Tecnolo´gico (CNPq)/ Programa Estrate´gico de Apoio à Pesquisa em Sau´de (PAPES) (407624/2012-0) (PNS).pt_BR
dc.language.isoengpt_BR
dc.publisherPublic Library of Sciencept_BR
dc.rightsAcesso Abertopt_BR
dc.titleGenotyping of Mycobacterium leprae for better understanding of leprosy transmission in Fortaleza, Northeastern Brazilpt_BR
dc.typeArtigopt_BR
dc.subject.decsPrimaryHanseníasept_BR
dc.subject.decsPrimaryHanseníase / transmissãopt_BR
dc.subject.decsPrimaryMycobacterium leprae / patogenicidadept_BR
dc.subject.decsPrimaryTécnicas de Genotipagem / métodospt_BR
dc.subject.decsPrimaryFortaleza (CE)pt_BR
dc.creator.affilliationOswaldo Cruz Institute. Laboratory of Molecular Biology Applied to Mycobacteria. Rio de Janeiro, RJ, Brazil.pt_BR
dc.creator.affilliationState Health Office. Department of Pathology. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationFederal University of Ceará. Department of Statistics and Applied Mathematics. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationUniversity of Fortaleza. Post Graduation Program of Public Health. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationState Health Office. Reference Center on Dermatology Dona Libânia. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationState Health Office. Reference Center on Dermatology Dona Libânia. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationFederal University of Ceará. Department of Pathology. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationColorado State University. Department of Microbiology, Immunology and Pathology. Fort Collins, CO, United States.pt_BR
dc.creator.affilliationColorado State University. Department of Microbiology, Immunology and Pathology. Fort Collins, CO, United States.pt_BR
dc.creator.affilliationMinistério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Geoprocessamento. Belém, PA, Brasil.pt_BR
dc.creator.affilliationTulane School of Public Health and Tropical Medicine. Department of Global Community Health and Behavioral Sciences. New Orleans, LA, United States / Federal University of Ceará. College of Medicine. Department of Community Health. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationFederal University of Ceará. College of Medicine. Department of Community Health. Fortaleza, CE, Brazil.pt_BR
dc.creator.affilliationOswaldo Cruz Institute. Laboratory of Molecular Biology Applied to Mycobacteria. Rio de Janeiro, RJ, Brazil / Tropical Institute of Medicine. Department of Biomedical Sciences. Mycobacteriology Unit. Antwerp, Belgium.pt_BR
dc.identifier.doi10.1371/journal.pntd.0006117-


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