de Matos H J, Duppre N, Alvim M F, MachadoVieira L M, Sarno E N, Struchiner C J
Departamento de Informática Médica, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Av. Prof. Manoel de Abreu 148, 20 andar, Rio de Janeiro, RJ 20560-000 Brasil.
Cad Saude Publica. 1999 Jul-Sep;15(3):533-42. doi: 10.1590/s0102-311x1999000300010.
This study aimed to identify factors influencing the development of leprosy (Hansen's disease) in household contacts. A dynamic cohort was analyzed from 1987 to 1991 at the Hansen's Disease Department of the Oswaldo Cruz Foundation in Rio de Janeiro. The incidence rate was 0.01694 person-years of follow-up. Nevertheless, for subjects at the end of the first year of follow-up the incidence rate was 0.06385 (end of second year, 0.03299; end of third year, 0.02370; end of fourth year, 0.018622; and end of observation period, 0.01694). A stepwise multivariate logistic regression model was proposed to study the risk of developing leprosy, including co-prevalent cases, totaling 758 contacts. In the final model, the risk was associated with a negative Mitsuda skin test (OR = 3.093; CI 95% = 1.735-5.514), prior BCG vaccination (OR = 0.3802; CI 95% = 0.2151-0.66719), and multibacillary primary clinical form (OR = 2.547; CI 95% = 1.249-5.192). The results showed that both multibacillary leprosy and specific immune status are significant indicators for developing the disease in a cohort of household contacts.
本研究旨在确定影响家庭接触者麻风病(汉森病)发病的因素。1987年至1991年,对里约热内卢奥斯瓦尔多·克鲁兹基金会麻风病科的一个动态队列进行了分析。随访的人年发病率为0.01694。然而,对于随访第一年结束时的受试者,发病率为0.06385(第二年结束时为0.03299;第三年结束时为0.02370;第四年结束时为0.018622;观察期结束时为0.01694)。提出了一个逐步多变量逻辑回归模型来研究患麻风病的风险,其中包括共患病例,共有758名接触者。在最终模型中,风险与米氏皮肤试验阴性(比值比=3.093;95%置信区间=1.735 - 5.514)、既往卡介苗接种(比值比=0.3802;95%置信区间=0.2151 - 0.66719)以及多菌型初发临床类型(比值比=2.547;95%置信区间=1.249 - 5.192)相关。结果表明,多菌型麻风病和特定免疫状态都是家庭接触者队列中发病的重要指标。