Mycobacterium leprae-helminth co-infections and vitamin D deficiency as potential risk factors for leprosy: A case-control study in south-eastern Brazil.

Autor:	Dennison CL; Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA., de Oliveira LB; Programa Multicêntrico de Bioquímica e Biologia Molecular, Universidade Federal de Juiz de Fora, Campus GV, Governador Valadares, Brazil., Fraga LAO; Programa Multicêntrico de Bioquímica e Biologia Molecular, Universidade Federal de Juiz de Fora, Campus GV, Governador Valadares, Brazil., E Lima RS; Universidade Vale do Rio Doce, Governador Valadares, Brazil., Ferreira JA; Faculdade da Saúde e Ecologia Humana, Vespasiano, Brazil., Clennon JA; Emory University, Atlanta, GA, USA., de Mondesert L; Hubert Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA, USA., Stephens J; Department of Epidemiology, Emory Rollins School of Public Health, Atlanta, GA, USA., Magueta EB; Universidade Federal de Juiz de Fora, Campus GV, Governador Valadares, Brazil., Castelo Branco A; CREDENPES, Centro de Referencia em Doenças Endêmicas e Programas Especiais, Governador Valadares, Brazil., Rezende MC; Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., Negrão-Corrêa D; Universidade Federal de Minas Gerais, Belo Horizonte, Brazil., de Faria Grossi MA; Faculdade da Saúde e Ecologia Humana, Vespasiano, Brazil., Fairley JK; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, 550 Peachtree Street, NE 7th Floor, Atlanta, GA, USA. Electronic address: jessica.fairley@emory.edu.
Jazyk:	angličtina
Zdroj:	International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2021 Apr; Vol. 105, pp. 261-266. Date of Electronic Publication: 2021 Feb 13.
DOI:	10.1016/j.ijid.2021.02.048
Abstrakt:	Background: Evidence suggests that biological mechanisms involved in helminth infections and vitamin deficiencies increase susceptibility to other infections. The aim of this study was to investigate the associations of helminth co-infection and select micronutrient deficiencies with leprosy using a case-control design. Methods: From 2016 to 2018, individuals aged ≥3 years were recruited at clinics in and around Governador Valadares, Minas Gerais, Brazil in three groups: cases of leprosy, household contacts and community-matched (non-contact) controls. Helminths were diagnosed through stool Kato Katz examination and serum reactivity to anti-soluble adult worm antigen preparation IgG4. Serum ferritin, 25-OH vitamin D and retinol concentrations were measured. Multi-variate logistic regression was conducted to identify associations with active leprosy. Results: Seventy-nine cases of leprosy, 96 household contacts and 81 non-contact controls were recruited; 48.1% of participants were male with a median age of 40 years. Helminths were found in 7.1% of participants on Kato Katz test, all but one of which were Schistosoma mansoni, and 32.3% of participants were positive for S. mansoni serology. On multi-variate analysis, cases were more likely to be infected with helminths (diagnosed by stool) than household contacts [adjusted odds ratio (aOR) 8.69, 95% confidence interval (CI) 1.50-50.51]. Vitamin D deficiency was common, and was more likely in cases compared with non-contact controls (aOR 4.66, 95% CI 1.42,-15.33). Iron deficiency was not associated with leprosy, and vitamin A deficiency was not detected. Conclusion: These associations suggest that the immune consequences of schistosomiasis and vitamin D deficiency may increase the risk of active leprosy. Comorbid conditions of poverty deserve further study as addressing co-infections and nutritional deficiencies could be incorporated into programmes to improve leprosy control. (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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