Leprosy reactions: the effect of gender and household contacts
| Autor: | Luca Cegolon, Gilberto Valentim da Silva, Emanuela Fadda, Joaquim da Silva Neto, Giuseppe Mastrangelo, Luca Scoizzato, Monique Dallapicola, Ana Luiza Folleto |
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| Přispěvatelé: | Mastrangelo, G., da Silva Neto, J., da Silva, G. V., Scoizzato, L., Fadda, E., Dallapicola, M., Folleto, A. L., Cegolon, L. |
| Rok vydání: | 2011 |
| Předmět: |
Gerontology
Male Binomial regression lcsh:QR1-502 Sex Factor Chemoprophylaxis lcsh:Microbiology Models Risk Factors Healthy carriers Household contacts Leprosy Reactions Female Humans Middle Aged Models Biological Regression Analysis Sex Factors Family Characteristics Mycobacterium leprae Univariate analysis biology Absolute risk reduction Regression analysis household contacts leprosy Human Microbiology (medical) lcsh:Arctic medicine. Tropical medicine reactions lcsh:RC955-962 Reaction Regression Analysi Healthy carrier healthy carriers Chemoprophylaxi medicine business.industry Risk Factor chemoprophylaxis Biological medicine.disease biology.organism_classification Household contact Confidence interval Multicollinearity business Demography |
| Zdroj: | Memórias do Instituto Oswaldo Cruz, Volume: 106, Issue: 1, Pages: 92-96, Published: FEB 2011 Memórias do Instituto Oswaldo Cruz., Vol 106, Iss 1, Pp 92-96 (2011) |
| Popis: | Various host-related factors have been reported as relevant risk factors for leprosy reactions. To support a new hypothesis that an antigenic load in local tissues that is sufficient to trigger the immune response may come from an external supply of Mycobacterium leprae organisms, the prevalence of reactional leprosy was assessed against the number of household contacts. The number of contacts was ascertained at diagnosis in leprosy patients coming from an endemic area of Brazil. The prevalence of reactions (patients with reactions/total patients) was fitted by binomial regression and the risk difference (RD) was estimated with a semi-robust estimation of variance as a measure of effect. Five regression models were fitted. Model 1 included only the main exposure variable "number of household contacts"; model 2 included all four explanatory variables ("contacts", "fertile age", "number of skin lesions" and "bacillary index") that were found to be associated with the outcome upon univariate analysis; models 3-5 contained various combinations of three predictors. Male and female patients were analyzed separately. In females, household contacts were a significant predictor for leprosy reactions in model 1 [crude RD = 0.06; 95% confidence interval (CI) = 0.01; 0.12] and model 5 (RD = 0.05; CI = 0.02; 0.09), which included contacts, bacillary index and skin lesions as predictors. Other models were unsatisfactory because the joint presence of fertile age and bacillary index was a likely source of multicollinearity. No significant results were obtained for males. The likely interpretation of our findings might suggest that in female patients, leprosy reactions may be triggered by an external spreading of M. leprae by healthy carrier family members. The small number of observations is an obvious limitation of our study which requires larger confirmatory studies. |
| Databáze: | OpenAIRE |
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