02547nas a2200409   4500000000100000008004100001260001300042653001500055653002600070653002400096653002800120653001100148653001000159653002800169653003800197653001100235653001600246653001100262653002800273653002800301653000900329653002500338653003000363653001300393100001400406700001800420700002100438700001100459700001500470245011000485856004800595300000900643490001600652050001700668520143800685022001402123       2012                            d  c2012 Dec10aAdolescent10aAntibodies, Bacterial10aAntigens, Bacterial10aAsymptomatic infections10aBrazil10aChild10aCross-Sectional Studies10aEnzyme-Linked Immunosorbent Assay10aFemale10aGlycolipids10aHumans10aLeprosy, Multibacillary10aLeprosy, Paucibacillary10aMale10aMycobacterium leprae10aSeroepidemiologic Studies10aStudents1 aBarreto J1 aGuimarães LS1 aCipriani Frade M1 aRosa P1 aSalgado CG00aHigh rates of undiagnosed leprosy and subclinical infection amongst school children in the Amazon Region.  uhttp://www.scielo.br/pdf/mioc/v107s1/11.pdf  a60-70 v107 Suppl 1  aBARRETO 20123 a<p>Leprosy in children is correlated with community-level factors, including the recent presence of disease and active foci of transmission in the community. We performed clinical and serological examinations of 1,592 randomly selected school children (SC) in a cross-sectional study of eight hyperendemic municipalities in the Brazilian Amazon Region. Sixty-three (4%) SC, with a mean age of 13.3 years (standard deviation = 2.6), were diagnosed with leprosy and 777 (48.8%) were seropositive for anti-phenolic glycolipid-I (PGL-I). Additionally, we evaluated 256 house-hold contacts (HHCs) of the students diagnosed with leprosy; 24 (9.4%) HHC were also diagnosed with leprosy and 107 (41.8%) were seropositive. The seroprevalence of anti-PGL-I was significantly higher amongst girls, students from urban areas and students from public schools (p < 0.0001). Forty-five (71.4%) new cases detected amongst SC were classified as paucibacillary and 59 (93.6%) patients did not demonstrate any degree of physical disability at diagnosis. The results of this study suggest that there is a high rate of undiagnosed leprosy and subclinical infection amongst children in the Amazon Region. The advantages of school surveys in hyperendemic areas include identifying leprosy patients at an early stage when they show no physical disabilities, preventing the spread of the infection in the community and breaking the chain of transmission.</p>  a1678-8060