02369nas a2200361   4500000000100000008004100001260001700042653001500059653001000074653001100084653001000095653002100105653002000126653002700146653001100173653001100184653001400195653001200209653000900221653002800230653001500258100001400273700001300287700002200300700001800322700001600340245007200356300001000428490000700438050003200445520151600477022001401993       2007                            d  c2007 Jan-Mar10aAdolescent10aAdult10aBrazil10aChild10aChild, Preschool10aContact Tracing10aFamily Characteristics10aFemale10aHumans10aIncidence10aleprosy10aMale10aPopulation Surveillance10aPrevalence1 aIgnotti E1 aBayona M1 aAlvarez-Garriga C1 aAndrade V L G1 aValente J G00aTransmission of Hansen's disease and unscreened household contacts.  a11-250 v79  aInfolep Library - available3 a<p><b>INTRODUCTION: </b>Leprosy household contact investigation has been recommended as an epidemiological surveillance strategy for more than 50 years.</p><p><b>OBJECTIVE: </b>The purpose of this study was to estimate the yield that could be achieved in case detection if four contacts could be examined for every case found.</p><p><b>METHODS: </b>For the estimation of the number of cases not detected (lost) and yield per contact investigation in Mato Grosso, the incidence rates and yield calculations from a cohort study conducted in Rio de Janeiro by Matos et al (1999) were applied to data from the state of Mato Grosso. Also, to identify high-risk groups for leprosy, a cross-sectional study was conducted in which leprosy cases found as a result of a contact investigation were compared with index cases detected by other means.</p><p><b>RESULTS: </b>The lost cases among household contacts were at least 4 per every 10 new cases detected. This is the result of insufficient contact investigations--it being 0.8 instead of 4 contact investigations per each case as recommended by the Brazilian Ministry of Health. Up to 60% of the incidence of leprosy could be explained by the high number of lost cases among household contacts not examined. Women and children are more likely to be contacts.</p><p><b>CONCLUSION: </b>The lost cases due to insufficient contact investigation represent lost opportunities in early detection and treatment, thus losing the opportunity to reduce leprosy transmission.</p>  a0254-9395