Marcos Virmond | Universidade Estadual de Campinas (original) (raw)

Papers by Marcos Virmond

Research paper thumbnail of Views and Experiences of Overweight and Obese Adults on the Barriers and Facilitators to Weight Loss in Southeast Brazil: A Qualitative Study

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Research paper thumbnail of HANSENÍASE E TESTES DIAGNÓSTICOS RÁPIDOS: DESAFIOS E GESTÃO DE CIÊNCIA, TECNOLOGIA & INOVAÇÃO EM SAÚDE

Sanare, Jul 3, 2023

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Research paper thumbnail of “Projeto Textos Completos Em Hanseníase”: Relato De Experiência Do Processo De Digitalização e Publicação Online Da Revista Leprosy Review De 1928-2001

Trata-se de um relato de experiencia cujo objetivo e compartilhar o processo da execucao da digit... more Trata-se de um relato de experiencia cujo objetivo e compartilhar o processo da execucao da digitalizacao e disponibilizacao em meio eletronico da Revista Leprosy Review, acao que faz parte do Projeto Textos Completos em Hanseniase, e divulgar este trabalho na comunidade cientifica, a fim de dar visibilidade aos estudos sobre hanseniase em âmbito nacional e internacional. Constitui-se de um relato baseado na observacao dos profissionais envolvidos na execucao do projeto. Os resultados parciais evidenciam que os principais objetivos do projeto foram alcancados, pois a revista ja esta operando em meio eletronico em carater de acesso aberto, mesmo com a fase de indexacao nao finalizada, e ate o momento todas as etapas foram concluidas dentro dos criterios estabelecidos inicialmente no projeto.

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Research paper thumbnail of Resultados De Neurolise De Nervo Ulnar Em Neurite Hansênica

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Research paper thumbnail of 19th International Leprosy Congress: Welcome Note

Leprosy Review, Jun 1, 2016

The International Leprosy Association is glad to announce that the last details are being arrange... more The International Leprosy Association is glad to announce that the last details are being arranged by the Scientific Committee and the China Organizing Committee to finalize the preparation of the 19th International Leprosy Congress. From September 18 to 20, 2016, Beijing will be the center of leprosy science making the 19th ILC the largest scientific gathering around the world to discuss exciting themes related to the congress moto: Unfinished business: stopping leprosy transmission, preventing disability and promoting inclusion. There will be 2 special presentations; 60 years of leprosy control in China by the Professor Zhang Guocheng and The immune response at the site of infection in leprosy by Robert Modlin (USA). There will be four stimulating Plenary Sessions focused on A Global Strategy for Leprosy Control fit for Purpose, Innovations to reduce transmission, Advances in clinical management of leprosy and Promoting inclusion of people affected by leprosy. A remarkable number of 730 abstracts were submitted. After the peer review 470 abstract were approved for poster presentation and around 260 titles were selected for oral presentation by the Scientific Committee. The presentations will be organized into the following sessions: Best clinical practice, health systems, training and referral, Chemotherapy, Reactions and nerve injury, Dermatology. Ophthalmology. History, Human rights and Discrimination, Social aspects, Participation, Immunology and vaccines, Microbiology, Molecular biology and Genetics, Epidemiology, Leprosy Control, Prevention – prophylaxis, Transmission and diagnostics, Neglected Tropical Diseases and other mycobacterial diseases, Nerve function and impairments, Prevention of disability and Rehabilitation. There will also be 16 Workshops on focused topics such as U-MDT, Diagnostic Tests, GIS and Mapping, Leprosy Control in Francophone Africa, ENL, Discriminatory Legislation, Drug Resistance, Enabling Participation, Data Systems, Leprosy and Migration in the United States, and 3 Symposia from the Leprosy Research Initiative. The International Leprosy Association is one of the oldest scientific associations and its aim is to encourage collaboration between persons of all nationalities concerned in leprosy work; to facilitate the dissemination of knowledge of leprosy and its control and to help in any other practicable manner the fight against the leprosy endemic throughout the world. In this connection, the 19th International Leprosy Congress is being organized to offer opportunities of interaction and live discussion to a variety of participants from many areas involved in the efforts to help those affected by leprosy and in the challenge of preventing further transmission of the disease. You are cordially invited to participate in this exciting congress. We aim to provide a scientifically stimulating and socially enjoyable forum to meet and discuss results and ideas aiming to achieve world without leprosy related problems. Marcos Virmond ILA President W. Cairns Smith Chair–Scientific Committee 19th ILC Guacheng Zhang President–China Leprosy Association

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Research paper thumbnail of Evaluation of quality of life, depression and satisfaction in patients treated at the Physiotherapy teaching clinic of the State University of Northern Paraná (Uenp)

Fisioterapia em Movimento, 2019

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Research paper thumbnail of Estudo comparativo da ocorrência de incapacidades e de dor neuropática em portadores de hanseníase submetidos à poliquimioterapia ou à monoterapia

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Research paper thumbnail of Seroprevalência para VIH-1 e associação com sífilis no COAS (Centro de Orientação e Apoio Sorológico)

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Research paper thumbnail of O caminho para a renovação de um discurso: Carlos Gomes e Maria Tudor no cenário da ópera italiana

Opus

Neste artigo propomos uma dupla discussão sobre a estética de Gomes em sua ópera Maria Tudor. Pri... more Neste artigo propomos uma dupla discussão sobre a estética de Gomes em sua ópera Maria Tudor. Primeiramente, desejamos atualizar as pesquisas musicológicas sobre as novas descobertas da contribuição de Carlos Gomes como artífice privilegiado de um período de profundas transformações pelas quais passou a ópera italiana na segunda metade do século XIX. O sucesso conquistado por Gomes por meio de algumas de suas óperas ainda eclipsa suas maiores contribuições contidas em óperas esquecidas. Em um segundo momento, propomos revisitar Maria Tudor (1879), considerada seu maior fracasso. Se Maria Tudor permanece na história como ópera ultrapassada pelos procedimentos usados em sua época, por outro lado esconde muito das modificações que a geração de Gomes pretendia para o novo formato de ópera. Consideramos necessário retomar os primeiros autores que publicaram sobre o assunto, como Nicolaisen (1980), Kimbell (1991) e Budden (2002), até autores mais recentes, como Faustini (2007) e Baragwana...

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Research paper thumbnail of Views and Experiences of Adults who are Overweight and Obese on the Barriers and Facilitators to Weight Loss in Southeast Brazil: A Qualitative Study

International Journal of Qualitative Studies on Health and Well-being, 2020

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Research paper thumbnail of Prolaxis post-exposición para lepra con dosis única de rifampicina: manual para su implementación

Fontilles, Rev. leprol, 2020

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Research paper thumbnail of Neurophysiological comparative response to clinical and surgical treatment of the ulnar neuropathy in leprosy

Acta Fisiátrica, 2020

Leprosy neuropathy may develop into subacute and chronic inflammatory scenarios, called ... more Leprosy neuropathy may develop into subacute and chronic inflammatory scenarios, called reactions, which may cause entrapments in the anatomic tunnels. Objective: This study describes the late nerve conduction findings in patients with ulnar neuropathy at the elbow that were submitted to clinical and surgery treatments. Methods: A total of 27 nerves of 21 patients with borderline leprosy during type 1 (reversal) reaction were selected in a non- competing retrospective cohort for three years. The nerves with treated clinically active neuropathy (Group A1) were randomized for inclusion of surgical treatment (Group A2) after one month of clinical treatment without clear signs of clinical and neurophysiological improvement. Fifteen nerves were randomly chosen for surgery while 12 were clinically treated, after steroids treatment without expected response. Nerve conduction was measured before and after treatment on four occasions. Results...

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Research paper thumbnail of Leprosy post-exposure prophylaxis risks not adequately assessed – Author's reply

The Lancet Global Health, 2021

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Research paper thumbnail of Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

The Lancet Global Health, 2021

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Research paper thumbnail of Aceitabilidade da quimioprofilaxia em área endêmica para a hanseníase: projeto PEP-Hans Brasil

Cadernos de Saúde Pública, 2020

Resumo: O objetivo deste artigo foi analisar a aceitabilidade da quimioprofilaxia com rifampicina... more Resumo: O objetivo deste artigo foi analisar a aceitabilidade da quimioprofilaxia com rifampicina em dose única (PEP) entre os contatos, casos índices de hanseníase e profissionais da saúde e fatores relacionados que possam influenciar na adesão. Realizou-se um estudo qualitativo de análise de conteúdo após aplicação de entrevistas semiestruturadas segundo protocolo proposto no programa LPEP (2016), realizado em Alta Floresta, Mato Grosso, Brasil, em julho de 2016. Participaram do estudo indivíduos notificados com hanseníase, contatos e profissionais da saúde. Utilizou-se o software QRS NVivo versão 10. Foram contatados 80 indivíduos, sendo 54 (67%) contatos, 11 (14%) casos índices e 15 (19%) profissionais de saúde. Dentre os contatos, 94% (51/54) tomaram PEP. Foram identificadas 3 categorias quanto à PEP: compreensão, aceitação e expectativa da intervenção. A compreensão se mostrou relacionada ao cuidado da equipe de saúde. Aceitar ou não a medicação revelou-se relacionada ao medo,...

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Research paper thumbnail of Human Genetic Susceptibility of Leprosy Recurrence

Scientific Reports, 2020

Host genetic susceptibility to leprosy has been intensively investigated over the last decades; h... more Host genetic susceptibility to leprosy has been intensively investigated over the last decades; however, there are no studies on the role of genetic variants in disease recurrence. A previous initiative identified three recurrent cases of leprosy for which none of the M. leprae strains, as obtained in the first and the second diagnosis, had any known genomic variants associated to resistance to Multidrug therapy; in addition, whole genome sequencing indicated that the same M. leprae was causing two out of the three recurrences. Thus, these individuals were suspected of being particularly susceptible to M. leprae infection, either as relapse or reinfection. To verify this hypothesis, 19 genetic markers distributed across 11 loci (14 genes) classically associated with leprosy were genotyped in the recurrent and in three matching non-recurrent leprosy cases. An enrichment of risk alleles was observed in the recurrent cases, suggesting the existence of a particularly high susceptibility...

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Research paper thumbnail of Emergence and Transmission of Drug-/Multidrug-resistant Mycobacterium leprae in a Former Leprosy Colony in the Brazilian Amazon

Clinical Infectious Diseases, 2019

BackgroundLeprosy has been treated with multidrug therapy, which has been distributed for free ac... more BackgroundLeprosy has been treated with multidrug therapy, which has been distributed for free across the globe and regarded as highly efficient. However, the impossibility of growing Mycobacterium leprae in axenic media has historically impaired assessments of M. leprae resistance, a parameter only recently detectable through molecular methods.MethodsA systematic, population-based search for M. leprae resistance in suspected leprosy relapse cases and contacts was performed in Prata Village, an isolated, hyperendemic, former leprosy colony located in the Brazilian Amazon. Results led to an extended active search involving the entire Prata population. Confirmed leprosy cases were investigated for bacterial resistance using a combination of in vivo testing and direct sequencing of resistance genes folP1, rpoB, and gyrA. A molecular epidemiology analysis was performed using data from 17 variable number tandem repeats (VNTR).ResultsMycobacterium leprae was obtained from biopsies of 37 l...

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Research paper thumbnail of An enhanced regimen as post-exposure chemoprophylaxis for leprosy: PEP+

BMC infectious diseases, Jan 5, 2018

The ongoing transmission of Mycobacterium (M.) leprae reflected in a very slow decline in leprosy... more The ongoing transmission of Mycobacterium (M.) leprae reflected in a very slow decline in leprosy incidence, forces us to be innovative and conduct cutting-edge research. Single dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for contacts of leprosy patients, reduces their risk to develop leprosy by 60%. This is a promising new preventive measure that can be integrated into routine leprosy control programmes, as is being demonstrated in the Leprosy Post-Exposure Programme that is currently ongoing in eight countries.The limited (60%) effectiveness of SDR is likely due to the fact that some contacts have a preclinical infection beyond the early stages for which SDR is not sufficient to prevent the development of clinical signs and symptoms of leprosy. An enhanced regimen, more potent against a higher load of leprosy bacteria, would increase the effectiveness of this preventive measure significantly.The Netherlands Leprosy Relief (NLR) is developing a multi-country study aimi...

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Research paper thumbnail of Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Pain reports, 2018

Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially pres... more Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially present in "pharmacologically cured" patients. The presence of neuropathic pain in leprosy poses a supplementary burden in patient's quality of life, daily activities, and mood. The aim of this study was to assess whether neuropathic pain in leprosy has similar symptom profile as neuropathic pain of other etiologies and to retrospectively assess the efficacy of neuropathic pain medications regularly prescribed to leprosy. Leprosy and nonleprosy patients had their neuropathic pain characterized by the neuropathic pain symptom inventory (NPSI, ranges from 0 to 100, with 100 being the maximal neuropathic pain intensity) in a first visit. In a second visit, leprosy patients who had significant pain and received pharmacological treatment in the first evaluation were reassessed (NPSI) and had their pain profile and treatment response further characterized, including information on dr...

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Research paper thumbnail of Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases

PLoS neglected tropical diseases, Jan 15, 2017

Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monito... more Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monitor recurrent cases for drug resistance and to distinguish between relapse and reinfection as a means of assessing therapeutic efficacy. All three objectives can be reached with single nucleotide resolution using next generation sequencing and bioinformatics analysis of Mycobacterium leprae DNA present in human skin. DNA was isolated by means of optimized extraction and enrichment methods from samples from three recurrent cases in leprosy patients participating in an open-label, randomized, controlled clinical trial of uniform MDT in Brazil (U-MDT/CT-BR). Genome-wide sequencing of M. leprae was performed and the resultant sequence assemblies analyzed in silico. In all three cases, no mutations responsible for resistance to rifampicin, dapsone and ofloxacin were found, thus eliminating drug resistance as a possible cause of disease recurrence. However, sequence differences were detected bet...

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Research paper thumbnail of Views and Experiences of Overweight and Obese Adults on the Barriers and Facilitators to Weight Loss in Southeast Brazil: A Qualitative Study

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Research paper thumbnail of HANSENÍASE E TESTES DIAGNÓSTICOS RÁPIDOS: DESAFIOS E GESTÃO DE CIÊNCIA, TECNOLOGIA & INOVAÇÃO EM SAÚDE

Sanare, Jul 3, 2023

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Research paper thumbnail of “Projeto Textos Completos Em Hanseníase”: Relato De Experiência Do Processo De Digitalização e Publicação Online Da Revista Leprosy Review De 1928-2001

Trata-se de um relato de experiencia cujo objetivo e compartilhar o processo da execucao da digit... more Trata-se de um relato de experiencia cujo objetivo e compartilhar o processo da execucao da digitalizacao e disponibilizacao em meio eletronico da Revista Leprosy Review, acao que faz parte do Projeto Textos Completos em Hanseniase, e divulgar este trabalho na comunidade cientifica, a fim de dar visibilidade aos estudos sobre hanseniase em âmbito nacional e internacional. Constitui-se de um relato baseado na observacao dos profissionais envolvidos na execucao do projeto. Os resultados parciais evidenciam que os principais objetivos do projeto foram alcancados, pois a revista ja esta operando em meio eletronico em carater de acesso aberto, mesmo com a fase de indexacao nao finalizada, e ate o momento todas as etapas foram concluidas dentro dos criterios estabelecidos inicialmente no projeto.

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Research paper thumbnail of Resultados De Neurolise De Nervo Ulnar Em Neurite Hansênica

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Research paper thumbnail of 19th International Leprosy Congress: Welcome Note

Leprosy Review, Jun 1, 2016

The International Leprosy Association is glad to announce that the last details are being arrange... more The International Leprosy Association is glad to announce that the last details are being arranged by the Scientific Committee and the China Organizing Committee to finalize the preparation of the 19th International Leprosy Congress. From September 18 to 20, 2016, Beijing will be the center of leprosy science making the 19th ILC the largest scientific gathering around the world to discuss exciting themes related to the congress moto: Unfinished business: stopping leprosy transmission, preventing disability and promoting inclusion. There will be 2 special presentations; 60 years of leprosy control in China by the Professor Zhang Guocheng and The immune response at the site of infection in leprosy by Robert Modlin (USA). There will be four stimulating Plenary Sessions focused on A Global Strategy for Leprosy Control fit for Purpose, Innovations to reduce transmission, Advances in clinical management of leprosy and Promoting inclusion of people affected by leprosy. A remarkable number of 730 abstracts were submitted. After the peer review 470 abstract were approved for poster presentation and around 260 titles were selected for oral presentation by the Scientific Committee. The presentations will be organized into the following sessions: Best clinical practice, health systems, training and referral, Chemotherapy, Reactions and nerve injury, Dermatology. Ophthalmology. History, Human rights and Discrimination, Social aspects, Participation, Immunology and vaccines, Microbiology, Molecular biology and Genetics, Epidemiology, Leprosy Control, Prevention – prophylaxis, Transmission and diagnostics, Neglected Tropical Diseases and other mycobacterial diseases, Nerve function and impairments, Prevention of disability and Rehabilitation. There will also be 16 Workshops on focused topics such as U-MDT, Diagnostic Tests, GIS and Mapping, Leprosy Control in Francophone Africa, ENL, Discriminatory Legislation, Drug Resistance, Enabling Participation, Data Systems, Leprosy and Migration in the United States, and 3 Symposia from the Leprosy Research Initiative. The International Leprosy Association is one of the oldest scientific associations and its aim is to encourage collaboration between persons of all nationalities concerned in leprosy work; to facilitate the dissemination of knowledge of leprosy and its control and to help in any other practicable manner the fight against the leprosy endemic throughout the world. In this connection, the 19th International Leprosy Congress is being organized to offer opportunities of interaction and live discussion to a variety of participants from many areas involved in the efforts to help those affected by leprosy and in the challenge of preventing further transmission of the disease. You are cordially invited to participate in this exciting congress. We aim to provide a scientifically stimulating and socially enjoyable forum to meet and discuss results and ideas aiming to achieve world without leprosy related problems. Marcos Virmond ILA President W. Cairns Smith Chair–Scientific Committee 19th ILC Guacheng Zhang President–China Leprosy Association

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Research paper thumbnail of Evaluation of quality of life, depression and satisfaction in patients treated at the Physiotherapy teaching clinic of the State University of Northern Paraná (Uenp)

Fisioterapia em Movimento, 2019

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Research paper thumbnail of Estudo comparativo da ocorrência de incapacidades e de dor neuropática em portadores de hanseníase submetidos à poliquimioterapia ou à monoterapia

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Research paper thumbnail of Seroprevalência para VIH-1 e associação com sífilis no COAS (Centro de Orientação e Apoio Sorológico)

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Research paper thumbnail of O caminho para a renovação de um discurso: Carlos Gomes e Maria Tudor no cenário da ópera italiana

Opus

Neste artigo propomos uma dupla discussão sobre a estética de Gomes em sua ópera Maria Tudor. Pri... more Neste artigo propomos uma dupla discussão sobre a estética de Gomes em sua ópera Maria Tudor. Primeiramente, desejamos atualizar as pesquisas musicológicas sobre as novas descobertas da contribuição de Carlos Gomes como artífice privilegiado de um período de profundas transformações pelas quais passou a ópera italiana na segunda metade do século XIX. O sucesso conquistado por Gomes por meio de algumas de suas óperas ainda eclipsa suas maiores contribuições contidas em óperas esquecidas. Em um segundo momento, propomos revisitar Maria Tudor (1879), considerada seu maior fracasso. Se Maria Tudor permanece na história como ópera ultrapassada pelos procedimentos usados em sua época, por outro lado esconde muito das modificações que a geração de Gomes pretendia para o novo formato de ópera. Consideramos necessário retomar os primeiros autores que publicaram sobre o assunto, como Nicolaisen (1980), Kimbell (1991) e Budden (2002), até autores mais recentes, como Faustini (2007) e Baragwana...

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Research paper thumbnail of Views and Experiences of Adults who are Overweight and Obese on the Barriers and Facilitators to Weight Loss in Southeast Brazil: A Qualitative Study

International Journal of Qualitative Studies on Health and Well-being, 2020

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Research paper thumbnail of Prolaxis post-exposición para lepra con dosis única de rifampicina: manual para su implementación

Fontilles, Rev. leprol, 2020

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Research paper thumbnail of Neurophysiological comparative response to clinical and surgical treatment of the ulnar neuropathy in leprosy

Acta Fisiátrica, 2020

Leprosy neuropathy may develop into subacute and chronic inflammatory scenarios, called ... more Leprosy neuropathy may develop into subacute and chronic inflammatory scenarios, called reactions, which may cause entrapments in the anatomic tunnels. Objective: This study describes the late nerve conduction findings in patients with ulnar neuropathy at the elbow that were submitted to clinical and surgery treatments. Methods: A total of 27 nerves of 21 patients with borderline leprosy during type 1 (reversal) reaction were selected in a non- competing retrospective cohort for three years. The nerves with treated clinically active neuropathy (Group A1) were randomized for inclusion of surgical treatment (Group A2) after one month of clinical treatment without clear signs of clinical and neurophysiological improvement. Fifteen nerves were randomly chosen for surgery while 12 were clinically treated, after steroids treatment without expected response. Nerve conduction was measured before and after treatment on four occasions. Results...

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Research paper thumbnail of Leprosy post-exposure prophylaxis risks not adequately assessed – Author's reply

The Lancet Global Health, 2021

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Research paper thumbnail of Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

The Lancet Global Health, 2021

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Research paper thumbnail of Aceitabilidade da quimioprofilaxia em área endêmica para a hanseníase: projeto PEP-Hans Brasil

Cadernos de Saúde Pública, 2020

Resumo: O objetivo deste artigo foi analisar a aceitabilidade da quimioprofilaxia com rifampicina... more Resumo: O objetivo deste artigo foi analisar a aceitabilidade da quimioprofilaxia com rifampicina em dose única (PEP) entre os contatos, casos índices de hanseníase e profissionais da saúde e fatores relacionados que possam influenciar na adesão. Realizou-se um estudo qualitativo de análise de conteúdo após aplicação de entrevistas semiestruturadas segundo protocolo proposto no programa LPEP (2016), realizado em Alta Floresta, Mato Grosso, Brasil, em julho de 2016. Participaram do estudo indivíduos notificados com hanseníase, contatos e profissionais da saúde. Utilizou-se o software QRS NVivo versão 10. Foram contatados 80 indivíduos, sendo 54 (67%) contatos, 11 (14%) casos índices e 15 (19%) profissionais de saúde. Dentre os contatos, 94% (51/54) tomaram PEP. Foram identificadas 3 categorias quanto à PEP: compreensão, aceitação e expectativa da intervenção. A compreensão se mostrou relacionada ao cuidado da equipe de saúde. Aceitar ou não a medicação revelou-se relacionada ao medo,...

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Research paper thumbnail of Human Genetic Susceptibility of Leprosy Recurrence

Scientific Reports, 2020

Host genetic susceptibility to leprosy has been intensively investigated over the last decades; h... more Host genetic susceptibility to leprosy has been intensively investigated over the last decades; however, there are no studies on the role of genetic variants in disease recurrence. A previous initiative identified three recurrent cases of leprosy for which none of the M. leprae strains, as obtained in the first and the second diagnosis, had any known genomic variants associated to resistance to Multidrug therapy; in addition, whole genome sequencing indicated that the same M. leprae was causing two out of the three recurrences. Thus, these individuals were suspected of being particularly susceptible to M. leprae infection, either as relapse or reinfection. To verify this hypothesis, 19 genetic markers distributed across 11 loci (14 genes) classically associated with leprosy were genotyped in the recurrent and in three matching non-recurrent leprosy cases. An enrichment of risk alleles was observed in the recurrent cases, suggesting the existence of a particularly high susceptibility...

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Research paper thumbnail of Emergence and Transmission of Drug-/Multidrug-resistant Mycobacterium leprae in a Former Leprosy Colony in the Brazilian Amazon

Clinical Infectious Diseases, 2019

BackgroundLeprosy has been treated with multidrug therapy, which has been distributed for free ac... more BackgroundLeprosy has been treated with multidrug therapy, which has been distributed for free across the globe and regarded as highly efficient. However, the impossibility of growing Mycobacterium leprae in axenic media has historically impaired assessments of M. leprae resistance, a parameter only recently detectable through molecular methods.MethodsA systematic, population-based search for M. leprae resistance in suspected leprosy relapse cases and contacts was performed in Prata Village, an isolated, hyperendemic, former leprosy colony located in the Brazilian Amazon. Results led to an extended active search involving the entire Prata population. Confirmed leprosy cases were investigated for bacterial resistance using a combination of in vivo testing and direct sequencing of resistance genes folP1, rpoB, and gyrA. A molecular epidemiology analysis was performed using data from 17 variable number tandem repeats (VNTR).ResultsMycobacterium leprae was obtained from biopsies of 37 l...

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Research paper thumbnail of An enhanced regimen as post-exposure chemoprophylaxis for leprosy: PEP+

BMC infectious diseases, Jan 5, 2018

The ongoing transmission of Mycobacterium (M.) leprae reflected in a very slow decline in leprosy... more The ongoing transmission of Mycobacterium (M.) leprae reflected in a very slow decline in leprosy incidence, forces us to be innovative and conduct cutting-edge research. Single dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for contacts of leprosy patients, reduces their risk to develop leprosy by 60%. This is a promising new preventive measure that can be integrated into routine leprosy control programmes, as is being demonstrated in the Leprosy Post-Exposure Programme that is currently ongoing in eight countries.The limited (60%) effectiveness of SDR is likely due to the fact that some contacts have a preclinical infection beyond the early stages for which SDR is not sufficient to prevent the development of clinical signs and symptoms of leprosy. An enhanced regimen, more potent against a higher load of leprosy bacteria, would increase the effectiveness of this preventive measure significantly.The Netherlands Leprosy Relief (NLR) is developing a multi-country study aimi...

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Research paper thumbnail of Neuropathic pain in leprosy: symptom profile characterization and comparison with neuropathic pain of other etiologies

Pain reports, 2018

Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially pres... more Previous studies reported a high prevalence of neuropathic pain in leprosy, being especially present in "pharmacologically cured" patients. The presence of neuropathic pain in leprosy poses a supplementary burden in patient's quality of life, daily activities, and mood. The aim of this study was to assess whether neuropathic pain in leprosy has similar symptom profile as neuropathic pain of other etiologies and to retrospectively assess the efficacy of neuropathic pain medications regularly prescribed to leprosy. Leprosy and nonleprosy patients had their neuropathic pain characterized by the neuropathic pain symptom inventory (NPSI, ranges from 0 to 100, with 100 being the maximal neuropathic pain intensity) in a first visit. In a second visit, leprosy patients who had significant pain and received pharmacological treatment in the first evaluation were reassessed (NPSI) and had their pain profile and treatment response further characterized, including information on dr...

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Research paper thumbnail of Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases

PLoS neglected tropical diseases, Jan 15, 2017

Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monito... more Since leprosy is both treated and controlled by multidrug therapy (MDT) it is important to monitor recurrent cases for drug resistance and to distinguish between relapse and reinfection as a means of assessing therapeutic efficacy. All three objectives can be reached with single nucleotide resolution using next generation sequencing and bioinformatics analysis of Mycobacterium leprae DNA present in human skin. DNA was isolated by means of optimized extraction and enrichment methods from samples from three recurrent cases in leprosy patients participating in an open-label, randomized, controlled clinical trial of uniform MDT in Brazil (U-MDT/CT-BR). Genome-wide sequencing of M. leprae was performed and the resultant sequence assemblies analyzed in silico. In all three cases, no mutations responsible for resistance to rifampicin, dapsone and ofloxacin were found, thus eliminating drug resistance as a possible cause of disease recurrence. However, sequence differences were detected bet...

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