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Clinical and Diagnostic Laboratory Immunology, September 2004, p. 897-900, Vol. 11, No. 5
1071-412X/04/$08.00+0     DOI: 10.1128/CDLI.11.5.897-900.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Prospective Study of Serological Conversion as a Risk Factor for Development of Leprosy among Household Contacts

Department of Microbiology, University of Hawaii, Honolulu, Hawaii,¹ Clinical Laboratory Branch, Leonard Wood Memorial Center for Leprosy Research, Cebu City, The Philippines,² KIT Biomedical Research, KIT (Koninklijk Instituut voor de Tropen/Royal Tropical Institute), Amsterdam, The Netherlands³

Received 6 May 2004/ Returned for modification 14 June 2004/ Accepted 9 July 2004

Although the prevalence of leprosy has declined over the years, there is no evidence that incidence rates are falling. A method of early detection of those people prone to develop the most infectious form of leprosy would contribute to breaking the chain of transmission. Prophylactic treatment of serologically identified high-risk contacts of incident patients should be an operationally feasible approach for routine control programs. In addition, classification of high-risk household contacts will allow control program resources to be more focused. In this prospective study, we examined the ability of serology used for the detection of antibodies to phenolic glycolipid I of Mycobacterium leprae to identify those household contacts of multibacillary leprosy patients who had the highest risk of developing leprosy. After the start of multidrug therapy for the index case, a new case of leprosy developed in one in seven of the 178 households studied. In households where new cases appeared, the seropositivity rates were significantly higher (P < 0.001) than those in households without new cases. Seropositive household contacts had a significantly higher risk of developing leprosy (relative hazard adjusted for age and sex [aRH], 7.2), notably multibacillary leprosy (aRH = 24), than seronegative contacts.