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Open Access Research article

Multiplex PCR technique could be an alternative approach for early detection of leprosy among close contacts - a pilot study from India

Surajita Banerjee1, Kamalesh Sarkar2, Soma Gupta3, Prasanta Sinha Mahapatra1, Siddhartha Gupta1, Samudra Guha1, Debasis Bandhopadhayay1, Chaitry Ghosal1, Suman Kalyan Paine1, Rathindra Nath Dutta4, Nibir Biswas5 and Basudev Bhattacharya1*

Author Affiliations

1 Department Of Biochemistry, IPGME&R, Kolkata, India

2 National Institute Of Cholera and Enteric Diseases, Kolkata, India

3 Department Of Biochemistry, N.R.S. Medical College, Kolkata, India

4 Department of Dermatology, IPGME&R, Kolkata, India

5 Department of Dermatology, Calcutta Medical College, Kolkata, India

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BMC Infectious Diseases 2010, 10:252  doi:10.1186/1471-2334-10-252

Published: 24 August 2010

Abstract

Background

Implementation of Multi drug Therapy (MDT) regimen has resulted in the decline of the total number of leprosy cases in the world. Though the prevalence rate has been declining, the incidence rate remains more or less constant and high in South East Asian countries particularly in India, Nepal, Bangladesh, Pakistan and Srilanka. Leprosy, particularly that of multibacillary type spreads silently before it is clinically detected. An early detection and treatment would help to prevent transmission in the community. Multiplex PCR (M-PCR) technique appears to be promising towards early detection among contacts of leprosy cases.

Methods

A total of 234 paucibacillary (PB) and 205 multibacillary (MB) leprosy cases were studied in a community of an endemic area of Bankura district of West Bengal (Eastern India). They were assessed by smear examination for acid-fast bacilli (AFB) and M-PCR technique. These patients were treated with Multidrug Therapy (MDT) as prescribed by WHO following detection. A total of 110 MB and 72 PB contacts were studied by performing M-PCR in their nasal swab samples.

Results

83.4% of MB patients were observed to be positive by smear examination for AFB and 89.2% by M-PCR. While 22.2% of PB patients were found to be positive by smear examination for AFB, 80.3% of these patients were positive by M-PCR. Among leprosy contacts (using M-PCR), 10.9% were found to be positive among MB contacts and 1.3% among PB contacts. Interestingly, two contacts of M-PCR positive MB cases developed leprosy during the period of two years follow up.

Conclusion

The M-PCR technique appears to be an efficient tool for early detection of leprosy cases in community based contact tracing amongst close associates of PB and MB cases. Early contact tracing using a molecular biology tool can be of great help in curbing the incidence of leprosy further.