Stanley Browne Laboratory, TLM Community Hospital, Nand Nagari, Delhi, India.
Clin Microbiol Infect. 2013 Oct;19(10):970-4. doi: 10.1111/1469-0691.12087. Epub 2013 Jan 18.
Leprosy continues to be a significant health problem in certain pockets in developing countries. Better understanding of the transmission and source of the infection would help to decipher the transmission link, leading to control of the spread of the disease. The nose is considered to be a portal of entry, suggesting an aerial route for transmission through droplet infection. The evidence suggests that many individuals from endemic countries carry Mycobacterium leprae in their nasal cavities without having obvious symptoms of leprosy. The objective of the present study was to assess the presence of M. leprae on the nasal mucosa in the general population from a leprosy-endemic pocket. M. leprae detection was carried out using PCR targeting RLEP. Four hundred subjects from an area highly endemic for leprosy were included in the study and followed up during three different seasons--winter, summer, and monsoon--for evidence of nasal exposure to M. leprae. PCR positivity for M. leprae was observed in 29%, 21% and 31% of the samples collected in winter, summer and the monsoon season, respectively. Twenty-six individuals from the cohort showed amplification for M. leprae for all seasons. Our results are consistent with reports in the literature showing widespread exposure to M. leprae in the endemic community. The results also suggest possible association of the environmental conditions (climate) with the transmission pattern and levels of exposure to M. leprae. However, the present study indicated that the population from highly endemic pockets will have exposure to M. leprae irrespective of season.
麻风病在某些发展中国家的特定地区仍然是一个重大的健康问题。更好地了解传播途径和感染源将有助于解析传播途径，从而控制疾病的传播。鼻子被认为是感染的门户，表明飞沫感染可能通过空气传播。有证据表明，许多来自流行地区的人鼻腔内携带麻风分枝杆菌，但没有明显的麻风病症状。本研究的目的是评估麻风病流行地区普通人群鼻腔黏膜中麻风分枝杆菌的存在情况。使用针对 RLEP 的 PCR 检测麻风分枝杆菌。研究纳入了来自高度流行麻风病地区的 400 名受试者，并在冬季、夏季和季风三个不同季节进行随访，以观察鼻腔暴露于麻风分枝杆菌的证据。在冬季、夏季和季风季节采集的样本中，分别有 29%、21%和 31%的样本检测到麻风分枝杆菌 PCR 阳性。26 名队列成员在所有季节均扩增出麻风分枝杆菌。我们的结果与文献报道一致，表明在流行社区中广泛接触麻风分枝杆菌。结果还表明，环境条件（气候）可能与传播模式和接触麻风分枝杆菌的水平有关。然而，本研究表明，无论季节如何，来自高度流行地区的人群都将接触麻风分枝杆菌。
