02335nas a2200253   4500000000100000008004100001653003600042653001200078653001000090653003800100653001400138653002100152100001500173700001000188700001700198700001400215700001300229245014800242856007800390300001300468490000700481520157900488022001402067       2016                            d10aPolymerase Chain Reaction (PCR)10aleprosy10aNepal10aSlit Skin Smear Examination (SSS)10adiagnosis10aDiagnostic Tests1 aSiwakoti S1 aRai K1 aBhattarai NR1 aAgarwal S1 aKhanal B00aEvaluation of Polymerase Chain Reaction (PCR) with Slit Skin Smear Examination (SSS) to Confirm Clinical Diagnosis of Leprosy in Eastern Nepal.  uhttp://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005220  ae00052200 v103 a<p><strong>BACKGROUND: </strong>Detection of Mycobacterium leprae in slit skin smear (SSS) is a gold standard technique for the leprosy diagnosis. Over recent years, molecular diagnosis by using PCR has been increasingly used as an alternative for its diagnosis due to its higher sensitivity. This study was carried out for comparative evaluation of PCR and SSS microscopy in a cohort of new leprosy cases diagnosed in B. P. Koirala Institute of health Sciences, Dharan, Nepal.</p>

<p><strong>METHODOLOGY/PRINCIPAL FINDINGS: </strong>In this prospective crossectional study, 50 new clinically diagnosed cases of leprosy were included. DNA was extracted from SSS and PCR was carried out to amplify 129 bp sequence of M. leprae repetitive element. Sensitivity of SSS and PCR was 18% and 72% respectively. Improvement of 54% case detection by PCR clearly showed its advantage over SSS. Furthermore, PCR could confirm the leprosy diagnosis in 66% of AFB negative cases indicating its superiority over SSS. In the paucibacillary (PB) patients, whose BI was zero; sensitivity of PCR was 44%, whereas it was 78% in the multibacillary patients.</p>

<p><strong>CONCLUSIONS/SIGNIFICANCE: </strong>Our study showed PCR to be more sensitive than SSS microscopy in diagnosing leprosy. Moreover, it explored the characteristic feature of PCR which detected higher level of early stage(PB) cases tested negative by SSS. Being an expensive technique, PCR may not be feasible in all the cases, however, it would be useful in diagnosis of early cases of leprosy as opposed to SSS.</p>
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