02245nas a2200469 4500000000100000008004100001260001300042653001500055653001000070653001000080653003300090653003800123653001100161653001100172653002200183653001000205653002300215653001200238653000900250653001600259653002500275653001700300653003000317653002800347653001500375653001100390100001300401700001200414700001100426700001400437700001600451700001400467700001200481700001300493700001400506245014800520856004100668300001100709490000700720520103400727022001401761 2004 d c2004 Sep 10 aAdolescent 10 aAdult 10 aChild 10 aCommunicable Disease Control 10 aEnzyme-Linked Immunosorbent Assay 10 aFemale 10 aHumans 10 aImmunity, Mucosal 10 aIndia 10 aLeprostatic Agents 10 aleprosy 10 aMale 10 aMiddle Aged 10 aMycobacterium leprae 10 aNasal Mucosa 10 apolymerase chain reaction 10 aPopulation Surveillance 10 aPrevalence 10 aSaliva 1 aSmith WC 1 aSmith C 1 aCree I 1 aJadhav RS 1 aMacdonald M 1 aEdward VK 1 aOskam L 1 aBeers SM 1 aKlatser P 00 aAn approach to understanding the transmission of Mycobacterium leprae using molecular and immunological methods: results from the MILEP2 study. uhttp://ila.ilsl.br/pdfs/v72n3a02.pdf a269-77 0 v72 3 aBACKGROUND: The current strategy for leprosy control using case detection and treatment has greatly reduced the prevalence of leprosy, but has had no demonstrable effect on interrupting transmission.
METHODS: Three leprosy endemic communities in India were recruited, examined, and followed up sequentially over 2 yrs using nasal swabs and saliva collections. The nasal swabs were tested by polymerase chain reaction for the presence of M. leprae and the saliva was assayed for anti-M. leprae IgA.
FINDINGS: Only 1.6% of 2552 nasal swabs were PCR positive, and 68% of saliva samples were positive for ML-IgA. BCG and household contact status was associated with the mucosal immune response, but not with PCR positivity. PCR positivity did not persist and most PCR positive results were in the wet season.
INTERPRETATION: The findings contribute to our understanding of the epidemiology of M. leprae and the possible periods of greatest likelihood of exposure and transmission.
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