Models for predicting the risk of illness in leprosy contacts in Brazil: Leprosy prediction models in Brazilian contacts

Trop Med Int Health. 2024 Aug;29(8):680-696. doi: 10.1111/tmi.14020. Epub 2024 Jul 4.

Abstract

Objective: This study aims to develop and validate predictive models that assess the risk of leprosy development among contacts, contributing to an enhanced understanding of disease occurrence in this population.

Methods: A cohort of 600 contacts of people with leprosy treated at the National Reference Center for Leprosy and Health Dermatology at the Federal University of Uberlândia (CREDESH/HC-UFU) was followed up between 2002 and 2022. The database was divided into two parts: two-third to construct the disease risk score and one-third to validate this score. Multivariate logistic regression models were used to construct the disease score.

Results: Of the four models constructed, model 3, which included the variables anti-phenolic glycolipid I immunoglobulin M positive, absence of Bacillus Calmette-Guérin vaccine scar and age ≥60 years, was considered the best for identifying a higher risk of illness, with a specificity of 89.2%, a positive predictive value of 60% and an accuracy of 78%.

Conclusions: Risk prediction models can contribute to the management of leprosy contacts and the systematisation of contact surveillance protocols.

Keywords: BCG vaccine scar; contact surveillance; leprosy; predictive value of tests; risk factors; serology.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • BCG Vaccine
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Cohort Studies
  • Contact Tracing
  • Female
  • Humans
  • Immunoglobulin M / blood
  • Leprosy* / epidemiology
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Young Adult

Substances

  • BCG Vaccine
  • Immunoglobulin M