02495nas a2200433 4500000000100000008004100001260001700042653001500059653001000074653000900084653002600093653001800119653001000137653002100147653002100168653001100189653002200200653001100222653001400233653001200247653000900259653001600268653002500284653000900309653003000318653001500348100001200363700001400375700001300389700001400402700001200416700001600428245013300444300001000577490000700587050001500594520143800609022001402047 1995 d c1995 Jul-Aug10aAdolescent10aAdult10aAged10aAntibodies, Bacterial10aCarrier State10aChild10aChild, Preschool10aCluster Analysis10aFemale10aFollow-Up Studies10aHumans10aIndonesia10aleprosy10aMale10aMiddle Aged10aMycobacterium leprae10aNose10apolymerase chain reaction10aPrevalence1 aHatta M1 aBeers S M1 aMadjid B1 aDjumadi A1 aWit M Y1 aKlatser P R00aDistribution and persistence of Mycobacterium leprae nasal carriage among a population in which leprosy is endemic in Indonesia. a381-50 v89 aHATTA1995A3 a

In order to understand better the relationship among Mycobacterium leprae, its transmission and the human host or the chain of infection which may lead to the development of leprosy, we performed a population survey in which nasal carriage of M. leprae was determined by a specific polymerase chain reaction (PCR), 2 years after an earlier survey in the same population. 1923 persons were registered, 1171 were clinically examined for signs of leprosy, and 418 were tested by PCR. The detection rate of leprosy in the study area had not changed significantly during the 2 years' observation period since the introduction of multi-drug therapy, i.e. 6/1000 compared to 7.7/1000 2 years before. Of 6 newly detected cases, 5 were diagnosed as having paucibacillary leprosy. The presence of M. leprae could be demonstrated by PCR in 2.9% (12/418) of the persons. PCR positivity was not persistent over the 2 years. All the PCR positive persons identified in the first survey were negative in the second, indicating that M. leprae nasal carriage is transient. As in the previous survey, we found evidence for widespread M. leprae nasal carriage as determined by PCR among the general population in an area in which leprosy is endemic. In addition, our data indicated that PCR positivity can occur in certain clusters in the community. This clustering seems to be time-dependent, not necessarily related to the presence of patients.

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