02942nas a2200529   4500000000100000008004100001260001300042653001500055653001000070653002100080653000900101653002600110653001000136653001900146653002000165653001900185653001100204653001100215653001400226653001400240653001100254653002000265653001200285653000900297653001600306653002500322653001600347653003000363653002800393653003200421653001700453653001600470100001400486700001200500700001400512700002000526700001300546700001400559700001200573245008700585856005100672300001000723490000700733050001600740520164200756022001402398       2006                            d  c2006 Mar10aAdolescent10aAdult10aAge Distribution10aAged10aAntibodies, Bacterial10aChild10aCohort Studies10aContact Tracing10aDNA, Bacterial10aFemale10aHumans10aIncidence10aIndonesia10aInfant10aInfant, Newborn10aleprosy10aMale10aMiddle Aged10aMycobacterium leprae10aNasopharynx10apolymerase chain reaction10aPopulation Surveillance10aProportional Hazards Models10aRisk Factors10aSex Factors1 aBakker MI1 aHatta M1 aKwenang A1 aVan Mosseveld P1 aFaber WR1 aKlatser P1 aOskam L00aRisk factors for developing leprosy--a population-based cohort study in Indonesia.  uhttps://leprosyreview.org/article/77/1/04-8061  a48-610 v77  aBAKKER 20063 a<p>We identified risk factors associated with increased yearly incidence rates of leprosy in five island populations. Age, sex, household size and Mycobacterium leprae-specific antibodies as well as contact factors were studied. Of 94 index patients (patients diagnosed in 2000), 43 (46%) were classified as multibacillary (MB), 17 (19%) were seropositive for PGL-1 [corrected] antibodies and 6 (7%) had M. leprae DNA in nasal swabs as determined by polymerase chain reaction (PCR) testing. All PCR positive patients were also seropositive. Forty-four of 4903 initially symptom free persons developed leprosy within 4 years, giving an incidence rate of 298 per 1000 person-years. Men had a 22 times higher risk [95% confidence interval (CI): 1.2-4.1] of developing leprosy than women. People living in households with more than 7 members had a 3.1 times higher risk (95% CI: 1.3-7.3) than households of 1-4 members. Persons who were seropositive in 2000 had a 3.8 times higher risk (95% CI: 1.1-12.6) than seronegative persons. Household contacts of MB patients had an adjusted hazard ratio (aHR) of 4.6 (95% CI: 1.6-12.9) and household contacts of PCR positive patients an aHR of 9.36 (95% CI: 2.5-34.9) compared with non-contacts. Patients with PCR positive nasal swabs, suggesting nasal excretion of M. leprae, are probably the patients with the highest transmission potential. Since all index patients who were PCR positive were also seropositive, serology seems an adequate tool to identify these patients. Preventing seropositive persons from becoming seropositive and infectious patients might break the chain of transmission.</p>  a0305-7518