Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.

<h4>Background</h4>There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection.<h4>Methods</h4>A systematic review of all cohort studies, which classif...

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Main Authors: Maria Lucia F Penna, Gerson O Penna, Paula C Iglesias, Sonia Natal, Laura C Rodrigues
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-05-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0004703
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author Maria Lucia F Penna
Gerson O Penna
Paula C Iglesias
Sonia Natal
Laura C Rodrigues
author_facet Maria Lucia F Penna
Gerson O Penna
Paula C Iglesias
Sonia Natal
Laura C Rodrigues
author_sort Maria Lucia F Penna
collection DOAJ
description <h4>Background</h4>There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection.<h4>Methods</h4>A systematic review of all cohort studies, which classified healthy leprosy contacts, at entry, according to anti-PGL1 positivity, and had at least one year follow up. The outcome was clinical diagnosis of leprosy by an experienced physician. The meta-analysis used a fixed model to estimated OR for the association of PGL-1 positivity and clinical leprosy. A fixed model also estimated the sensibility of PGL-1 positivity and positive predictive value.<h4>Results</h4>Contacts who were anti PGL-1 positive at baseline were 3 times as likely to develop leprosy; the proportion of cases of leprosy that were PGL-1 positive at baseline varied but was always under 50%.<h4>Conclusions</h4>Although there is a clear and consistent association between positivity to anti PGL-1 and development of leprosy in healthy contacts, selection of contacts for prophylaxis based on anti PGL1 response would miss more than half future leprosy cases. Should chemoprophylaxis of controls be incorporated into leprosy control programmes, PGL1 appears not to be a useful test in the decision of which contacts should receive chemoprophylaxis.
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institution Kabale University
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language English
publishDate 2016-05-01
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spelling doaj-art-e1f55d15eb0340ce8b2ad7c4d1fb1dca2025-08-20T03:24:55ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352016-05-01105e000470310.1371/journal.pntd.0004703Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.Maria Lucia F PennaGerson O PennaPaula C IglesiasSonia NatalLaura C Rodrigues<h4>Background</h4>There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection.<h4>Methods</h4>A systematic review of all cohort studies, which classified healthy leprosy contacts, at entry, according to anti-PGL1 positivity, and had at least one year follow up. The outcome was clinical diagnosis of leprosy by an experienced physician. The meta-analysis used a fixed model to estimated OR for the association of PGL-1 positivity and clinical leprosy. A fixed model also estimated the sensibility of PGL-1 positivity and positive predictive value.<h4>Results</h4>Contacts who were anti PGL-1 positive at baseline were 3 times as likely to develop leprosy; the proportion of cases of leprosy that were PGL-1 positive at baseline varied but was always under 50%.<h4>Conclusions</h4>Although there is a clear and consistent association between positivity to anti PGL-1 and development of leprosy in healthy contacts, selection of contacts for prophylaxis based on anti PGL1 response would miss more than half future leprosy cases. Should chemoprophylaxis of controls be incorporated into leprosy control programmes, PGL1 appears not to be a useful test in the decision of which contacts should receive chemoprophylaxis.https://doi.org/10.1371/journal.pntd.0004703
spellingShingle Maria Lucia F Penna
Gerson O Penna
Paula C Iglesias
Sonia Natal
Laura C Rodrigues
Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.
PLoS Neglected Tropical Diseases
title Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.
title_full Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.
title_fullStr Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.
title_full_unstemmed Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.
title_short Anti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.
title_sort anti pgl 1 positivity as a risk marker for the development of leprosy among contacts of leprosy cases systematic review and meta analysis
url https://doi.org/10.1371/journal.pntd.0004703
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