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Sample records for leprosy control program

  1. Leprosy control in Sri Lanka.

    Science.gov (United States)

    Dewapura, D R

    1994-01-01

    Even though health workers have treated all registered cases of leprosy in Sri Lanka with multiple drug therapy since 1982, it continues to be transmitted. The government has launched a social marketing and social mobilization campaign to reduce the incidence of leprosy. It has expanded the network of leprosy services. A national advertising program included mass media ads, posters, stickers on buses, and radio and television serials to create awareness of the early signs of leprosy and to reduce fear to leprosy. Health workers distributed leaflets and booklets to the general public and to new patients. The Anti-Leprosy Campaign of Sri Lanka organized 1-week health education programs for administrative officer, village leaders, religious leaders, teachers, and voluntary workers. Skin camps were set up to detect leprosy cases and to treat minor skin disorders. Teachers received flip charts on leprosy to help them teach colleagues and children about leprosy. All primary level staff, medical officers in hospital staff, and estate medical and paramedical staff have undergone special training on diagnosing leprosy and on reducing their fear of it. Almost every district has at least 1 leprosy control specialist. 2 leprosy control specialists work in those districts where leprosy is endemic Each district has a trained medical laboratory technician, who stains and interprets leprosy smears. In 1992, school, contact, and mass surveys have found 31, 149, and 225 new cases, respectively. Active case findings methods found 16.5% of new cases. 50% of new cases are self- reported, compared to less than 10% in 1989, suggesting increased awareness of early signs of leprosy and a reduced fear of it. 25 more clinics opened in 1991 to meet the demand for leprosy services.

  2. Historical Overview of Leprosy Control in Cuba.

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    Beldarraín-Chaple, Enrique

    2017-01-01

    INTRODUCTION Leprosy, an infectious disease caused by Mycobacterium leprae, affects the nervous system, skin, internal organs, extremities and mucous membranes. Biological, social and environmental factors influence its occurrence and transmission. The first effective treatments appeared in 1930 with the development of dapsone, a sulfone. The main components of a control and elimination strategy are early case detection and timely administration of multidrug therapy. OBJECTIVES Review the history of leprosy control in Cuba, emphasizing particularly results of the National Leprosy Control Program, its modifications and influence on leprosy control. EVIDENCE ACQUISITION The historiological method was applied using document review, complemented by interviews with experts on leprosy and its control. Archived documents, medical records, disease prevalence censuses conducted since 1942, and incidence and prevalence statistics for 1960-2015 from the Ministry of Public Health's National Statistics Division were reviewed. Reports and scientific literature published on the Program and the history of leprosy in Cuba were also reviewed. DEVELOPMENT Leprosy has been documented in Cuba since 1613. In 1938, the Leprosy Foundation was created with ten dispensaries nationwide for diagnosis and treatment. The first National Leprosy Control Program was established in 1962, implemented in 1963 and revised five times. In 1972, leper colonies were closed and treatment became ambulatory. In 1977, rifampicin was introduced. In 1988, the Program instituted controlled, decentralized, community-based multidrug treatment and established the criteria for considering a patient cured. In 2003, it included actions aimed at early diagnosis and prophylactic treatment of contacts. Since 2008, it prioritizes actions directed toward the population at risk, maintaining five-year followup with dermatological and neurological examination. Primary health care carries out diagnostic and treatment

  3. Assessment of the implementation of the Leprosy Control Program in Camaragibe, Pernambuco State, Brazil.

    Science.gov (United States)

    Souza, Monique Feitosa de; Vanderlei, Lygia Carmen de Moraes; Frias, Paulo Germano de

    2017-01-01

    to assess the implementation of the actions of the Leprosy Control Program in Camaragibe, Pernambuco State, Brazil. evaluative research with 'implementation analysis', based on criteria, indicators and parameters guided from the construction of the Logic Model; four components were assessed - management, health care, epidemiological surveillance, health education and communication -; direct observation/questionnaire was used, as well as data from the Information System for Notifiable Diseases. the implementation of the program was incipient (58.3%); the estimate for the components varied from 'not implemented' (health education and communication, 48.0%), 'incipient' (management, 53.3%; health care, 57.2%) to 'partially implemented' (epidemiological surveillance, 73.0%); in 2012, it was observed low proportion of examined contacts (28.4%), treatment dropout (34.1%), limited standardization of patient care flow, and poor resolution of problems by managers. the level of implementation found was related to the organization of services, with negative repercussions regarding the result indicators.

  4. Review of leprosy control activities in Yemen.

    Science.gov (United States)

    al-Qubati, Y; al-Dobai, A B

    1999-06-01

    Leprosy control activities in Yemen are reviewed historically and up to the present time. Since 1983 the World Health Organization's multidrug therapy has been used in the National Leprosy Control Programme. Current activities are carried out in 63 leprosy clinics distributed all over the country and staffed by trained primary health care workers and medical assistants. In Yemen leprosy prevalence has declined from 1400 per 10,000 population in 1990 to 647 in 1997. Over the same period, new case detection rates per 10,000 population increased from 185 to 517. A backlog of leprosy cases continues to transmit the disease in Yemen.

  5. The Impact of Leprosy Control: Epidemiological and modelling studies

    NARCIS (Netherlands)

    A. Meima

    2004-01-01

    textabstractThis thesis addresses the impact of leprosy control on the occurrence of leprosy and its associated impairments. Chapter 1 introduces leprosy, an infectious disease. Its manifestations vary widely: from mild self-healing forms to chronic and destructive disease. Knowledge regarding

  6. Leprosy

    Science.gov (United States)

    ... antibiotic is best for me? Will the treatment cure my leprosy? We caught the leprosy early, but will I have any complications later in my life? Is there any way to heal the sores on my body? Is there anything that can treat the numbness in my feet and hands? Should I have regular eye exams, in case ...

  7. A historical overview of leprosy epidemiology and control activities in Amazonas, Brazil.

    Science.gov (United States)

    Cunha, Carolina; Pedrosa, Valderiza Lourenço; Dias, Luiz Carlos; Braga, Andréa; Chrusciak-Talhari, Anette; Santos, Mônica; Penna, Gerson Oliveira; Talhari, Sinésio; Talhari, Carolina

    2015-01-01

    Leprosy is an ancient infectious disease caused by Mycobacterium leprae. According to comparative genomics studies, this disease originated in Eastern Africa or the Near East and spread with successive human migrations. The Europeans and North Africans introduced leprosy into West Africa and the Americas within the past 500 years. In Brazil, this disease arrived with the colonizers who disembarked at the first colonies, Rio de Janeiro, Salvador and Recife, at the end of the sixteenth century, after which it was spread to the other states. In 1854, the first leprosy cases were identified in State of Amazonas in the north of Brazil. The increasing number of leprosy cases and the need for treatment and disease control led to the creation of places to isolate patients, known as leprosaria. One of them, Colonia Antônio Aleixo was built in Amazonas in 1956 according to the most advanced recommendations for isolation at that time and was deactivated in 1979. The history of the Alfredo da Matta Center (AMC), which was the first leprosy dispensary created in 1955, parallels the history of leprosy in the state. Over the years, the AMC has become one of the best training centers for leprosy, general dermatology and sexually transmitted diseases in Brazil. In addition to being responsible for leprosy control programs in the state, the AMC has carried out training programs on leprosy diagnosis and treatment for health professionals in Manaus and other municipalities of the state, aiming to increase the coverage of leprosy control activities. This paper provides a historical overview of leprosy in State of Amazonas, which is an endemic state in Brazil.

  8. Leprosy Elimination: Progress and Challenges in Nigeria; Kaduna State TB and Leprosy Control Programme as a Case Study.

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    Mustapha, Gidado; Olusegu, Obasanya Joshua; Mustapha, Sani; Clement, Adesigbin; Dahiru, Tahir; Gagere, J; Olusola, Adejumo Adeleji

    2012-01-01

    The study aims at describing the achievements and challenges of Leprosy control in Kaduna State using appropriate indicators. The study was a five year (2004-2008) retrospective review of the Leprosy records and annual reports of all the twenty three LGAs in Kaduna State. Various Leprosy indicators were calculated and presented in different graphic presentations. Focus group discussions were organised with the aim of identifying current challenges of Leprosy control in the State. There was a decline in the new Leprosy cases detected annually from 226 cases in 2004 to 140 cases in 2008. The prevalence rate ranged between 0.3-0.4 per 10,000 population within the five year period. The proportion of children among new cases dropped from 12% in 2004 to 5% in 2007 and increased to 9% in 2008. Grade 2 disability among new cases was very high (between 21%-27%) within the same period. Leprosy elimination target has been achieved in Kaduna State, but new cases with high proportion of children and WHO grade 2 disability were still been reported.

  9. Leprosy (Hansen's Disease)

    Science.gov (United States)

    ... for Leprosy Research Priorities for research in leprosy today include genetic probes for molecular epidemiology, and new ... Career Stage Postdocs' Guide to Gaining Independence Small Business Programs Compare NIAID’s Small Business Programs High-Priority ...

  10. Leprosy control in the post leprosaria abolition years in Nigeria ...

    African Journals Online (AJOL)

    A questionnaire was administered to all patients with leprosy seen at the four leprosy clinics in Anambra State in a face-to-face interview. The questions covered among other items, the clinic attendance behavior and the single most important reason for absenteeism in the previous year. The total and individual reasons for ...

  11. Effect of the Brazilian conditional cash transfer and primary health care programs on the new case detection rate of leprosy.

    Directory of Open Access Journals (Sweden)

    Joilda Silva Nery

    2014-11-01

    Full Text Available Social determinants can affect the transmission of leprosy and its progression to disease. Not much is known about the effectiveness of welfare and primary health care policies on the reduction of leprosy occurrence. The aim of this study is to evaluate the impact of the Brazilian cash transfer (Bolsa Família Program-BFP and primary health care (Family Health Program-FHP programs on new case detection rate of leprosy.We conducted the study with a mixed ecological design, a combination of an ecological multiple-group and time-trend design in the period 2004-2011 with the Brazilian municipalities as unit of analysis. The main independent variables were the BFP and FHP coverage at the municipal level and the outcome was new case detection rate of leprosy. Leprosy new cases, BFP and FHP coverage, population and other relevant socio-demographic covariates were obtained from national databases. We used fixed-effects negative binomial models for panel data adjusted for relevant socio-demographic covariates. A total of 1,358 municipalities were included in the analysis. In the studied period, while the municipal coverage of BFP and FHP increased, the new case detection rate of leprosy decreased. Leprosy new case detection rate was significantly reduced in municipalities with consolidated BFP coverage (Risk Ratio 0.79; 95% CI  =0.74-0.83 and significantly increased in municipalities with FHP coverage in the medium (72-95% (Risk Ratio 1.05; 95% CI  =1.02-1.09 and higher coverage tertiles (>95% (Risk Ratio 1.12; 95% CI  =1.08-1.17.At the same time the Family Health Program had been effective in increasing the new case detection rate of leprosy in Brazil, the Bolsa Família Program was associated with a reduction of the new case detection rate of leprosy that we propose reflects a reduction in leprosy incidence.

  12. Is Leprosy Control In Urban Slums Possible ? - A Study In Bombay

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    Ganapati R

    1989-01-01

    Full Text Available Effectiveness of community-based leprosy control operations spanning almost a decade in two locations, a small self settled leprosy colony (I of about 800 subjects as well as a large slum (II with a population of about 20,000 in the metropolitan city of Bombay are compared. New case detection through survey in location I and voluntary reporting in location II during the period 1982-86 is taken as an index of the impact of the intervention, which consisted of field based administration of multi-drug therapy. Though the leprosy colony concentrates an abnormal reservoir of infectious cases in a small population, it was relatively easier to achieve success in reducing the transmission rate through field-based chemotherapy programme. The same degree of success however, could not be achieved in a normal slum. Health care delivery system in relation to leprosy eradication at the grass-root levels has to be planned giving maximum importance to cost-effective methods of identification of multi-bacillary leprosy patients and monitoring their movements carefully during the treatment phase.

  13. Retrospective active case finding in Cambodia: An innovative approach to leprosy control in a low-endemic country.

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    Fürst, Thomas; Cavaliero, Arielle; Lay, Sambath; Dayer, Chrystel; Chan, Saren; Smrekar, Ajda; So, Visal; Barth-Jaeggi, Tanja; Steinmann, Peter

    2018-04-01

    Currently, leprosy control relies on the clinical diagnosis of leprosy and the subsequent administration of multidrug therapy (MDT). However, many health workers are not familiar with the cardinal signs of leprosy, particularly in low-endemic settings including Cambodia. In response, a new approach to early diagnosis was developed in the country, namely retrospective active case finding (RACF) through small mobile teams. In the frame of RACF, previously diagnosed leprosy patients are traced and their contacts screened through "drives". According to the available records, 984 of the 1,463 (67.3%) index patients diagnosed between 2001 and 2010 and registered in the national leprosy database were successfully traced in the period 2012-2015. Migration (8.4%), death (6.7%), operational issues (1.6%) and unidentified other issues (16.0%) were the main reasons for non-traceability. A total of 17,134 contacts of traced index patients (average: 2.2 household members and 15.2 neighbors) and another 7,469 contacts of the untraced index patients could be screened. Among them, 264 new leprosy patients were diagnosed. In the same period, 1,097 patients were diagnosed through the routine passive case detection system. No change was observed in the relation between the rate at which new patients were identified and the number of years since the diagnosis of the index patient. Similar to leprosy patients diagnosed through passive case detection, the leprosy patients detected through RACF were predominantly adult males. However, the fraction of PB leprosy patients was higher among the patients diagnosed through RACF, suggesting relatively earlier diagnosis. It appears that RACF is a feasible option and effective in detecting new leprosy patients among contacts of previously registered patients. However, a well-maintained national leprosy database is essential for successful contact tracing. Hence, passive case detection in the frame of routine leprosy surveillance is a precondition

  14. Bone island and leprosy

    Energy Technology Data Exchange (ETDEWEB)

    Carpintero, P.; Garcia-Frasquet, A. [Department of Orthopaedic Surgery, Cordoba University, Medical School, Reina Sofia University Hospital, Cordoba (Spain); Tarradas, E. [Department of Imaging, Cordoba University, Medical School, Cordoba (Spain); Logrono, C. [Department of Dermatology, Reina Sofia University Hospital, Cordoba (Spain); Carrascal, A. [Department of Radiology, Infanta Elena Hospital, Huelva (Spain); Carreto, A. [Department of Radiology, Reina Sofia University Hospital, Cordoba (Spain)

    1998-06-01

    Objective. To determine the incidence of bone islands in leprosy patients. Design. X-rays of feet and hands of patients with Hansen`s disease (leprosy) were reviewed retrospectively. A second group of related age- and sex-matched patients who did not have Hansen`s disease was used for control purposes. Controls had undergone hand or foot X-rays during diagnosis of other pathologies. The patients with Hansen`s disease were compared with the control group, and were also analyzed as subgroups with different types of leprosy. The results were subjected to statistical analysis. Patients. Ninety patients with Hansen`s disease were randomly selected for this study. Patients who had had ulcers on hands or feet were excluded from the study. Results and conclusions. Bone islands were demonstrated in 20 patients with Hansen`s disease; no bone islands were observed in the controls. This was statistically significant (P<0.01). Bone islands were only seen in patients with lepromatous leprosy and borderline types but were not demonstrated in patients with tuberculoid leprosy. There was also a statistically significant relationship for a disease duration of 15 years or more. The cause of this raised incidence of enostosis in leprosy patients is not clear, but there may be a genetic predisposition in patients with leprosy, or it may be a side effect of leprosy, especially the lepromatous form. (orig.) With 4 figs., 2 tabs., 9 refs.

  15. Simple and fast lateral flow test for classification of leprosy patients and identification of contacts with high risk of developing leprosy

    NARCIS (Netherlands)

    Bührer-Sékula, S.; Smits, H. L.; Gussenhoven, G. C.; van Leeuwen, J.; Amador, S.; Fujiwara, T.; Klatser, P. R.; Oskam, L.

    2003-01-01

    The interruption of leprosy transmission is one of the main challenges for leprosy control programs since no consistent evidence exists that transmission has been reduced after the introduction of multidrug therapy. Sources of infection are primarily people with high loads of bacteria with or

  16. Decentralisation of leprosy control activities in the municipality of Betim, Minas Gerais State, Brazil.

    Science.gov (United States)

    Fuzikawa, Priscila Leiko; De Acúrcio, Francisco Assis; Velema, Johan P; Cherchiglia, Mariangela Leal

    2010-09-01

    The present study aims at evaluating the decentralisation of the leprosy control activities in the municipality of Betim, Minas Gerais, Brazil. A quantitative study was undertaken using data from SINAN (Sistema Nacional de Agravos de Notificação) and patient records. The study included 435 new cases registered and living in Betim. The pre (1995-2000) and post (2001-2005) decentralisation periods were compared using the chi-square test. Besides this, units which already had leprosy control activities were compared to those which implemented them from 2001 on. There was a decrease in the percentage of cases diagnosed with deformities after decentralisation, as well as an increase in the number of cases detected through self-reporting. More patients were notified closer to home after decentralisation. The selected indicators did not show any difference between the quality of assistance regarding prevention of disabilities when comparing health units which already had leprosy activities to those which implemented them from 2001 onwards. Decentralisation, in Betim, did not lead to an increase in the number of cases, but led to earlier diagnosis and patients being treated closer to their homes. The study did not show evidence of decrease in the quality of care after decentralisation.

  17. The decentralization of the health system in Colombia and Brazil and its impact on leprosy control.

    Science.gov (United States)

    Kalk, Andreas; Fleischer, Klaus

    2004-03-01

    Decentralization policies are an integrated component of health sector reform in an increasing number of countries. The ability of such policies to improve the health system's quality and efficiency is backed up by limited scientific evidence. This study intends to evaluate the impact of decentralization on a specialized field of disease control (leprosy control) in Colombia and Brazil. It analyses the respective juridical base, epidemiological indicators and local publications. Furthermore, 39 semi-structured interviews with key informants were conducted. In both countries, the devolution of technical responsibility and financial resources to the municipalities was the implemented form of decentralization. Access to preventive and curative health care and the community participation in decision-making improved clearly only in Brazil. The decentralization to private providers in Colombia had dubious effects on service quality in general and still more on public health. The flow of finances (including finance collection through state-owned taxes instead of insurance companies) seemed to be better controlled in Brazil. Leprosy control in Brazil took advantage of the decentralization process; in Colombia, it came close to a collapse.

  18. Introducing leprosy post-exposure prophylaxis into the health systems of India, Nepal and Indonesia: a case study.

    Science.gov (United States)

    Tiwari, A; Mieras, L; Dhakal, K; Arif, M; Dandel, S; Richardus, J H

    2017-09-29

    Leprosy has a wide range of clinical and socio-economic consequences. India, Indonesia and Nepal contribute significantly to the global leprosy burden. After integration, the health systems are pivotal in leprosy service delivery. The Leprosy Post Exposure Prophylaxis (LPEP) program is ongoing to investigate the feasibility of providing single dose rifampicin (SDR) as post-exposure prophylaxis (PEP) to the contacts of leprosy cases in various health systems. We aim to compare national leprosy control programs, and adapted LPEP strategies in India, Nepal and Indonesia. The purpose is to establish a baseline of the health system's situation and document the subsequent adjustment of LPEP, which will provide the context for interpreting the LPEP results in future. The study followed the multiple-case study design with single units of analysis. The data collection methods were direct observation, in-depth interviews and desk review. The study was divided into two phases, i.e. review of national leprosy programs and description of the LPEP program. The comparative analysis was performed using the WHO health system frameworks (2007). In all countries leprosy services including contact tracing is integrated into the health systems. The LPEP program is fully integrated into the established national leprosy programs, with SDR and increased documentation, which need major additions to standard procedures. PEP administration was widely perceived as well manageable, but the additional LPEP data collection was reported to increase workload in the first year. The findings of our study led to the recommendation that field-based leprosy research programs should keep health systems in focus. The national leprosy programs are diverse in terms of organizational hierarchy, human resource quantity and capacity. We conclude that PEP can be integrated into different health systems without major structural and personal changes, but provisions are necessary for the additional monitoring

  19. Evaluation of the Primary Care in leprosy control: proposal of an instrument for users

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    Fernanda Moura Lanza

    2014-12-01

    Full Text Available Objective Developing an instrument to evaluate the performance of primary health care in the leprosy control actions, from the perspective of users and do the face and content validation. Method This is a methodological study carried out in four stages: development of instrument, face and content validation, pre-test, and analysis of test-retest reliability. Results The initial instrument submitted to the judgment of 15 experts was composed of 157 items. The face and content validation and pre-test of instrument were essential for the exclusion of items and adjustment of instrument to evaluate the object under study. In the analysis of test-retest reliability, the instrument proved to be reliable. Conclusion The instrument is considered adequate, but further studies are needed to test the psychometric properties.

  20. Evaluation of the economic burden of leprosy among migrant and resident patients in Guangdong Province, China.

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    Xiong, Mingzhou; Li, Ming; Zheng, Daocheng; Wang, Xiaohua; Su, Ting; Chen, Yongfeng; Yang, Bin

    2017-12-11

    A lot of time and money was needed during the diagnosis and treatment process of leprosy, the delayed leprosy would also impair the labor capability of patients as well, and these put a heavy burden for the leprosy patients. The migrant leprosy patient is a special group and need more concern. Our goal was to assess the economic burden of leprosy on migrant and resident patient populations in Guangdong province, China. We conducted a population-based cross-sectional survey from February to July of 2016. A self-designed questionnaire was administered to leprosy patients who: (1) had registered in Leprosy Management Information System in China (LEPMIS) by the end of February 2016, (2) had received multiple drug treatment (MDT) drugs at a local leprosy control institution for three consecutive months or had had at least one physical check in the past half year, and (3) were willing to take part in the investigation and give informed written consent. Demographic characteristics, Financial and disease information, and costs before and after leprosy diagnosis were collected and compared using t-test and χ2 test. A total of 254 participants completed the questionnaires, including 168 males and 86 females. Migrants and residents accounted for 33.9% and 66.1% of patients, respectively. Among migrant patients, the median cost before diagnosis was $131.6 (39.2-450.9), the median yearly cost of leprosy treatment after diagnosis was $300.6 (158.4-868.5), and the median yearly cost of leprosy complications was $69.5 (11-178.4). In comparison, among residents the median yearly costs were $152.4 (30.7-770.9) pre-diagnosis, $309.7 (103.2-1016.7) after diagnosis, and $91.9 (32.6-303.1) for leprosy complications. Base on this, we determined that the median yearly total expense after diagnosis amounted to 15% of migrant and 38% of resident patients' annual income. Leprosy places a heavy economic burden on both migrant and resident leprosy patients and governmental policies and

  1. Leprosy and Armadillos

    Centers for Disease Control (CDC) Podcasts

    2016-02-18

    Dr. Richard Truman, Chief of the National Hansen’s Disease Program Laboratory Research Branch, discusses leprosy and armadillos.  Created: 2/18/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 2/18/2016.

  2. Cost-effectiveness of a chemoprophylactic intervention with single dose rifampicin in contacts of new leprosy patients.

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    Willemijn J Idema

    Full Text Available BACKGROUND: With 249,007 new leprosy patients detected globally in 2008, it remains necessary to develop new and effective interventions to interrupt the transmission of M. leprae. We assessed the economic benefits of single dose rifampicin (SDR for contacts as chemoprophylactic intervention in the control of leprosy. METHODS: We conducted a single centre, double blind, cluster randomised, placebo controlled trial in northwest Bangladesh between 2002 and 2007, including 21,711 close contacts of 1,037 patients with newly diagnosed leprosy. We gave a single dose of rifampicin or placebo to close contacts, with follow-up for four years. The main outcome measure was the development of clinical leprosy. We assessed the cost effectiveness by calculating the incremental cost effectiveness ratio (ICER between the standard multidrug therapy (MDT program with the additional chemoprophylaxis intervention versus the standard MDT program only. The ICER was expressed in US dollars per prevented leprosy case. FINDINGS: Chemoprophylaxis with SDR for preventing leprosy among contacts of leprosy patients is cost-effective at all contact levels and thereby a cost-effective prevention strategy. In total, $6,009 incremental cost was invested and 38 incremental leprosy cases were prevented, resulting in an ICER of $158 per one additional prevented leprosy case. It was the most cost-effective in neighbours of neighbours and social contacts (ICER $214, slightly less cost-effective in next door neighbours (ICER $497 and least cost-effective among household contacts (ICER $856. CONCLUSION: Chemoprophylaxis with single dose rifampicin given to contacts of newly diagnosed leprosy patients is a cost-effective intervention strategy. Implementation studies are necessary to establish whether this intervention is acceptable and feasible in other leprosy endemic areas of the world.

  3. CHEMOPROPHYLAXIS TO CONTROL LEPROSY AND THE PERSPECTIVE OF ITS IMPLEMENTATION IN BRAZIL: A PRIMER FOR NON-EPIDEMIOLOGISTS

    OpenAIRE

    CUNHA, Sergio Souza da; BIERRENBACH, Ana Luiza; BARRETO, Vitor Hugo Lima

    2015-01-01

    The occurrence of leprosy has decreased in the world but the perspective of its elimination has been questioned. A proposed control measure is the use of post-exposure chemoprophylaxis (PEP) among contacts, but there are still questions about its operational aspects. In this text we discuss the evidence available in literature, explain some concepts in epidemiology commonly used in the research on this topic, analyze the appropriateness of implementing PEP in the context of Brazil, and answer...

  4. CHEMOPROPHYLAXIS TO CONTROL LEPROSY AND THE PERSPECTIVE OF ITS IMPLEMENTATION IN BRAZIL: A PRIMER FOR NON-EPIDEMIOLOGISTS

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    Sergio Souza da CUNHA

    2015-12-01

    Full Text Available The occurrence of leprosy has decreased in the world but the perspective of its elimination has been questioned. A proposed control measure is the use of post-exposure chemoprophylaxis (PEP among contacts, but there are still questions about its operational aspects. In this text we discuss the evidence available in literature, explain some concepts in epidemiology commonly used in the research on this topic, analyze the appropriateness of implementing PEP in the context of Brazil, and answer a set of key questions. We argue some points: (1 the number of contacts that need to receive PEP in order to prevent one additional case of disease is not easy to be generalized from the studies; (2 areas covered by the family health program are the priority settings where PEP could be implemented; (3 there is no need for a second dose; (4 risk for drug resistance seems to be very small; (5 the usefulness of a serological test to identify a higher risk group of individuals among contacts is questionable. Given that, we recommend that, if it is decided to start PEP in Brazil, it should start on a small scale and, as new evidence can be generated in terms of feasibility, sustainability and impact, it could move up a scale, or not, for a wider intervention.

  5. Corticosteroids for treating nerve damage in leprosy. A Cochrane review.

    NARCIS (Netherlands)

    N.H.J. van Veen (Natasja); P.G. Nicholls (Peter); W.C.S. Smith (Cairns); J.H. Richardus (Jan Hendrik)

    2009-01-01

    textabstractOBJECTIVE: Corticosteroids are commonly used for treating nerve damage in leprosy. We assessed the effectiveness of corticosteroids for treating nerve damage due to leprosy. METHODS: A systematic search was undertaken to identify randomised controlled trials (RCTs) comparing

  6. Cardiac Dysautonomia in Lepromatous Leprosy

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    R K Wadhwa

    1989-01-01

    Full Text Available Cardio-vascular, autonomic functions were studied in 20 patients with lepromatous leprosy and 20 healthy adult controls Autonomic dysfunction was observed in the form of abnormal response in heart rate on standing 3 (15% carotid artery pressure 7 (35%. Valsalva manoeuvre 5 (25% and mental stress 3 (15% in the leprosy patients. Response of blood pressure to standing and cold pressure test was seen in 2 (10% and 7 (359o patients respectively.

  7. Novel HLA Class I Alleles Associated with Indian Leprosy Patients

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    U. Shankarkumar

    2003-01-01

    A*0101, Cw*04011, and Cw*0602 leprosy patients was observed when compared to the controls. Further haplotype A*1102-B*4006-Cw*1502 was significantly increased among the lepromatous leprosy patients when compared to the controls. It seems that HLA class I alleles play vital roles in disease association/pathogenesis with leprosy among Indians.

  8. A Cluster-Randomized Controlled Intervention Study to Assess the Effect of a Contact Intervention in Reducing Leprosy-Related Stigma in Indonesia

    Science.gov (United States)

    Peters, Ruth M. H.; Dadun; Zweekhorst, Marjolein B. M.; Bunders, Joske F. G.; Irwanto; van Brakel, Wim H.

    2015-01-01

    Background Can deliberate interaction between the public and persons affected by leprosy reduce stigmatization? The study described in this paper hypothesises that it can and assesses the effectiveness of a ‘contact intervention’. Methods/Principal Findings This cluster-randomized controlled intervention study is part of the Stigma Assessment and Reduction of Impact (SARI) project conducted in Cirebon District, Indonesia. Testimonies, participatory videos and comics given or made by people affected by leprosy were used as methods to facilitate a dialogue during so-called ‘contact events’. A mix of seven quantitative and qualitative methods, including two scales to assess aspects of stigma named the SDS and EMIC-CSS, were used to establish a baseline regarding stigma and knowledge of leprosy, monitor the implementation and assess the impact of the contact events. The study sample were community members selected using different sampling methods. The baseline shows a lack of knowledge about leprosy, a high level of stigma and contrasting examples of support. In total, 91 contact events were organised in 62 villages, directly reaching 4,443 community members (mean 49 per event). The interview data showed that knowledge about leprosy increased and that negative attitudes reduced. The adjusted mean total score of the EMIC-CSS reduced by 4.95 points among respondents who had attended a contact event (n = 58; p stigma against other neglected tropical diseases and conditions should be evaluated. PMID:26485128

  9. DISABILITIES OF HANDS, FEET AND EYES IN NEWLY-DIAGNOSED LEPROSY PATIENTS IN EASTERN NEPAL

    NARCIS (Netherlands)

    SCHIPPER, A; LUBBERS, WJ; HOGEWEG, M; DESOLDENHOFF, R

    The objective of the study was to determine the magnitude of hand/feet/eye disabilities in newly diagnosed leprosy patients by examining all newly diagnosed leprosy patients who presented at the Eastern Leprosy Control Project (supported by The Netherlands Leprosy Relief Association), made up of a

  10. Retreatment in leprosy: a case-control study Retratamento de hanseníase: estudo de caso-controle

    Directory of Open Access Journals (Sweden)

    Ricardo Arraes Alencar Ximenes

    2007-08-01

    Full Text Available OBJECTIVE: To assess risk factors for retreatment of leprosy patients. METHODS: A case-control study with patients from two reference care units in Recife, northeastern Brazil, in 2003. The case group included retreated patients (N=155 and the control group comprised those patients who were not retreated (N=155 matched by year of diagnosis and health care unit. Univariate and multivariate analyses were conducted to test the associations and odds ratios and related 95% confidence intervals were estimated. RESULTS: The following factors were found to be significantly associated (p 1 (OR=6.43; 95% CI=1.67;24.74, therapeutic regimen consisting of sulfone monotherapy (OR=10; 95% CI=0.01;0.78 and reports of household contacts (OR=2.2; 95% CI=0.24;0.85. CONCLUSIONS: The study findings reinforce that the use of dapsone monotherapy should be discontinued, and highlight the need for epidemiological monitoring of specific groups of leprosy patients after treatment completion through periodical clinical and laboratory evaluation. Further studies to explore the association between final bacterial index and retreatment are strongly recommended.OBJETIVO: Analisar os fatores de risco para retratamento da hanseníase. MÉTODOS: Estudo de caso-controle com pacientes de duas unidades de referência para tratamento da hanseníase, em Recife, Pernambuco, no de 2003. O grupo de casos incluiu pacientes retratados (N=155 e foi comparado com o grupo controle (N=155, pacientes não retratados pareados por ano-diagnóstico e unidade de saúde. Para testar as associações foram realizadas análises uni e multivariadas, e calculados odds ratios com respectivos intervalos de confiança de 95%. RESULTADOS: Os seguintes fatores apresentaram associação estatisticamente significante (p 1 (OR=6,43; IC 95%:1,67;24,74; tratamento com a monoterapia sulfônica (OR=10; IC 95%: 0,01;0,78; relato de contato intradomiciliar com portadores de hanseníase (OR=2,2; IC 95

  11. A Cluster-Randomized Controlled Intervention Study to Assess the Effect of a Contact Intervention in Reducing Leprosy-Related Stigma in Indonesia.

    Directory of Open Access Journals (Sweden)

    Ruth M H Peters

    Full Text Available Can deliberate interaction between the public and persons affected by leprosy reduce stigmatization? The study described in this paper hypothesises that it can and assesses the effectiveness of a 'contact intervention'.This cluster-randomized controlled intervention study is part of the Stigma Assessment and Reduction of Impact (SARI project conducted in Cirebon District, Indonesia. Testimonies, participatory videos and comics given or made by people affected by leprosy were used as methods to facilitate a dialogue during so-called 'contact events'. A mix of seven quantitative and qualitative methods, including two scales to assess aspects of stigma named the SDS and EMIC-CSS, were used to establish a baseline regarding stigma and knowledge of leprosy, monitor the implementation and assess the impact of the contact events. The study sample were community members selected using different sampling methods. The baseline shows a lack of knowledge about leprosy, a high level of stigma and contrasting examples of support. In total, 91 contact events were organised in 62 villages, directly reaching 4,443 community members (mean 49 per event. The interview data showed that knowledge about leprosy increased and that negative attitudes reduced. The adjusted mean total score of the EMIC-CSS reduced by 4.95 points among respondents who had attended a contact event (n = 58; p < 0.001, effect size = 0.75 compared to the score at baseline (n = 213; for the SDS this was 3.56 (p < 0.001, effect size = 0.81. About 75% of those attending a contact event said they shared the information with others (median 10 persons.The contact intervention was effective in increasing knowledge and improving public attitudes regarding leprosy. It is relatively easy to replicate elsewhere and does not require expensive technology. More research is needed to improve scalability. The effectiveness of a contact intervention to reduce stigma against other neglected tropical diseases

  12. A Cluster-Randomized Controlled Intervention Study to Assess the Effect of a Contact Intervention in Reducing Leprosy-Related Stigma in Indonesia

    NARCIS (Netherlands)

    Peters, R.M.H.; Zweekhorst, M.B.M.; Bunders-Aelen, J.G.F.; van Brakel, W.H.

    2015-01-01

    Background: Can deliberate interaction between the public and persons affected by leprosy reduce stigmatization? The study described in this paper hypothesises that it can and assesses the effectiveness of a ‘contact intervention’. Methods/Principal Findings: This cluster-randomized controlled

  13. [Analysis of the geographical distribution of cases of leprosy. Rio de Janeiro, 2001-2012].

    Science.gov (United States)

    Gracie, Renata; Peixoto, Julia Novaes de Barros; Soares, Fabiane Bertoni Dos Reis; Hacker, Mariana de Andrea Vilas-Boas

    2017-05-01

    Studies have demonstrated that the geographical distribution of leprosy is related to different socioeconomic factors. This article aims to study the geographical distribution of leprosy in the state of Rio de Janeiro. The cases of leprosy reported in the 2001-2012 period were mapped according to municipality. Epidemiological and socioeconomic indicators were calculated. The ArcMap program was used for the construction of maps and Earth View to calculate the Bayesian rate. It was observed that leprosy is presented in hyper-endemic levels especially in the metropolitan area. However, there is also a reduction of the detection rate in the most recent study period. In municipalities in the metropolitan region and the north western region detection in children under 15 is high, indicating an active transmission situation. In municipalities in the south-central region and especially in the coastal region, there was a high proportion of cases diagnosed with level II disability, reflecting late diagnosis. There was no linear correlation between socioeconomic indicators and leprosy rate. These results contribute to the analysis of the geographical distribution of leprosy, important for the identification of areas for resource allocation, aiming to control and eliminate the disease.

  14. Genetics of leprosy reactions: an overview

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    Vinicius Fava

    2012-12-01

    Full Text Available Type-1 (T1R and Type-2 (T2R leprosy reactions (LR, which affect up to 50% of leprosy patients, are aggressive inflammatory episodes of sudden onset and highly variable incidence across populations. LR are often diagnosed concurrently with leprosy, but more frequently occur several months after treatment onset. It is not uncommon for leprosy patients to develop recurring reactional episodes; however, they rarely undergo both types of LR. Today, LR are the main cause of permanent disabilities associated with leprosy and represent a major challenge in the clinical management of leprosy patients. Although progress has been made in understanding the immunopathology of LR, the factors that cause a leprosy patient to suffer from LR are largely unknown. Given the impact that ethnic background has on the risk of developing LR, host genetic factors have long been suspected of contributing to LR. Indeed, polymorphisms in seven genes [Toll-like receptors (TLR1, TLR2, nucleotide-binding oligomerisation domain containing 2, vitamin D receptor, natural resistance-associated macrophage protein 1, C4B and interleukin-6] have been found to be associated with one or more LR outcomes. The identification of host genetic markers with predictive value for LR would have a major impact on nerve damage control in leprosy. In this review, we present the recent advances achieved through genetic studies of LR.

  15. Genetics Home Reference: leprosy

    Science.gov (United States)

    ... 2 links) Encyclopedia: Leprosy Health Topic: Mycobacterial Infections Genetic and Rare Diseases Information Center (1 link) Hansen's disease Additional NIH Resources (1 link) National Institute of Allergy and Infectious Diseases (NIAID): Leprosy (Hansen's Disease) Educational Resources (8 ...

  16. Health information system model for monitoring treatment and surveillance for leprosy patients in indonesia (case study in Pekalongan District, Central Java, Indonesia).

    Science.gov (United States)

    Rachmani, Enny; Kurniadi, Arif; Hsu, Chien Yeh

    2013-01-01

    After India and Brazil, Indonesia has the third highest incidence/prevalence of leprosy in the world. Every year thousands of new cases and case with grade-2 disability are reported and, while the recovery rate lingers only 80-90 %. Therefore, more than 10 % of leprosy patients drop out of treatment and can be a source of new infections in the community. Our research was aimed at determining apparent difficulties in the leprosy control program as well as how a health information system (HIS) could assist the Indonesian leprosy control program. We used qualitative method with deep interview and observation of document. One of the difficulties which the Indonesian leprosy control program faces is discontinuity of patient's data due to rotating staff as well as the treatment monitoring and queries patients which should be monitored after treatment has ceased. Technology implementation is feasible through short message service (sms) reminders and web base applications. The leprosy control program urgently needs to implement continuous monitoring and recording of patients because of the particular characteristics of this contagious disease.

  17. Lepromatous leprosy of histoid type

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    Annigeri S

    2007-01-01

    Full Text Available Histoid leprosy is a variant of lepromatous leprosy, which develops as a result of resistance to dapsone monotherapy. Here we report two cases of lepromatous leprosy of histoid type, one with typical and another with atypical presentations.

  18. Assessment of integration of the leprosy program into primary health care in Aracaju, state of Sergipe, Brazil.

    Science.gov (United States)

    Túlio Raposo, Marcos; Nemes, Maria Ines Battistella

    2012-01-01

    The aim of this study was to assess the epidemiological and operational characteristics of the Leprosy Program before and after its integration into the Primary healthcare Services of the municipality of Aracaju-Sergipe, Brazil. Data were drawn from the national database. The study periods were divided into preintegration (1996-2000) and postintegration (2001-2007). Annual rates of epidemiological detection were calculated. Frequency data on clinico-epidemiological variables of cases detected and treated for the two periods were compared using the Chi-squared (χ²) test adopting a 5% level of significance. Rates of detection overall, and in subjects younger than 15 years, were greater for the postintegration period and were higher than rates recorded for Brazil as a whole during the same periods. A total of 780 and 1,469 cases were registered during the preintegration and postintegration periods, respectively. Observations for the postintegration period were as follows: I) a higher proportion of cases with disability grade assessed at diagnosis, with increase of 60.9% to 78.8% (p < 0.001), and at end of treatment, from 41.4% to 44.4% (p < 0.023); II) an increase in proportion of cases detected by contact examination, from 2.1% to 4.1% (p < 0.001); and III) a lower level of treatment default with a decrease from 5.64 to 3.35 (p < 0.008). Only 34% of cases registered from 2001 to 2007 were examined. The shift observed in rates of detection overall, and in subjects younger than 15 years, during the postintegration period indicate an increased level of health care access. The fall in number of patients abandoning treatment indicates greater adherence to treatment. However, previous shortcomings in key actions, pivotal to attaining the outcomes and impact envisaged for the program, persisted in the postintegration period.

  19. Specific antigen serologic tests in leprosy: implications for epidemiological surveillance of leprosy cases and household contacts

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    Ana Paula Mendes Carvalho

    Full Text Available BACKGROUND There is a lack of straightforward tests for field application and known biomarkers for predicting leprosy progression in infected individuals. OBJECTIVE The aim was to analyse the response to infection by Mycobacterium leprae based on the reactivity of specific antigens: natural disaccharide linked to human serum albumin via an octyl (NDOHSA, a semisynthetic phenolic glycolipid-I (PGL-I; Leprosy Infectious Disease Research Institute Diagnostic-1 (LID-1 and natural disaccharide octyl - Leprosy Infectious Disease Research Institute Diagnostic-1 (NDOLID. METHODS The study population consisted of 130 leprosy cases diagnosed between 2010 and 2015 and 277 household contacts. An enzyme-linked immunosorbent assay (ELISA was used to analyse the reactivity of antibodies against NDOHSA, LID-1 and NDOLID. The samples and controls were tested in duplicate, and the antibody titer was expressed as an ELISA index. Data collection was made by home visits with application of questionnaire and dermatological evaluation of all household contacts to identify signs and symptoms of leprosy. FINDINGS Significant differences in the median ELISA results were observed among leprosy cases in treatment, leprosy cases that had completed treatment and household contacts. Higher proportions of seropositivity were observed in leprosy cases in treatment. Seropositivity was also higher in multibacillary in relation to paucibacillary, with the difference reaching statistical significance. Lower titers were observed among cases with a longer treatment time or discharge. For household contacts, the differences according to the clinical characteristics of the leprosy index case were less pronounced than expected. Other factors, such as the endemicity of leprosy, exposure outside the residence and genetic characteristics, appeared to have a greater influence on the seropositivity. MAIN CONCLUSIONS Serologic tests could be used as auxiliary tools for determining the

  20. Leprosy in the Bible.

    Science.gov (United States)

    Grzybowski, Andrzej; Nita, Małgorzata

    2016-01-01

    For many years, the biblical term tzaraat has referred to leprosy. In fact, the disease or diseases described under this name have no relationship to leprosy, as it was known in the Middle Ages or today; moreover, the term referred not only to skin disease, but also to the state of the ritual impurity and punishment for the sins. Although the real nature of tzaraat remains unknown, the differential diagnosis might include the following: Psoriasis, seborrheic dermatitis, favus, dermatophyte infections, nummular dermatitis, atopic dermatitis, pityriasis rosea, crusted scabies, syphilis, impetigo, sycosis barbae, alopecia areata, furuncles, scabies, neurodermatitis, scarlet fever, lupus erythematosus, lichen sclerosus et atrophicus, folliculitis decalvans, morphea, sarcoidosis, and lichen planopilaris. Leprosy became interchangeable with the biblical leprosy due to two inaccurate translations: The Hebrew tzaraat was first translated into Greek as leprosy in the sixth century, and later, the word leprosy was translated into Arabic as lepra in the ninth century. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Corticosteroids for treating nerve damage in leprosy

    OpenAIRE

    Veen, Natasja; Nicholls, Peter; Smith, Cairns; Richardus, Jan Hendrik

    2007-01-01

    textabstractBackground: Leprosy causes nerve damage which can result in nerve function impairment and disability. Corticosteroids are commonly used for treating nerve damage, although the long-term effect is uncertain. Objectives: To assess the effects of corticosteroids on nerve damage in leprosy. Search strategy: We searched the Cochrane Neuromuscular Disease Group Register, the Cochrane Central Register of Controlled Trials (Issue 4), MEDLINE (from 1966), EMBASE (from 1980), CINAHL (from 1...

  2. Epidemiological aspects of leprosy in Juazeiro-BA, from 2002 to 2012*

    Science.gov (United States)

    Silva, Maria Eduarda Gomes da Cruz; de Souza, Carlos Dornels Freire; Silva, Susanne Pinheiro Costa e; da Costa, Flávia Monteiro; do Carmo, Rodrigo Feliciano

    2015-01-01

    BACKGROUND Leprosy is an infectious disease caused by Mycobacterium leprae, able to infect large numbers of people. This work is relevant to Juazeiro-BA, a hyper-endemic area for leprosy, since unravel the behavior of the disease in the area, may suggest the decision making for sectors of surveillance, establishing strategies, organizing and evaluating programs and services. OBJECTIVES To analyze the epidemiology of leprosy in Juazeiro-BA, from 2002 to 2012. METHODS A descriptive, cross-sectional study was conducted based in data of the Diseases Notification System, assigned by the service of Epidemiology from Juazeiro-BA, between 2002 and 2012. RESULTS 1,916 new cases of leprosy were detected between 2002 and 2012, of which 921 (48.07%) represented male sex, 995 (51.93%) female, and there was a reduction in the incidence rate of leprosy per 100,000 inhabitants. Most carriers were brown individuals, with low levels of education, living in the urban area, being more prevalent in the economically active age group. Through statistical analysis we found that there are more chances of developing sequelae among men, and multibacillary individuals older than 45 years. CONCLUSIONS The work serves to direct efforts to control this disease, and highlights the importance of active search for new cases to achieve an early diagnosis, reducing the number of sequels and allowing breaking the chain of disease transmission. PMID:26734859

  3. Musculoskeletal manifestations and autoantibodies in children and adolescents with leprosy.

    Science.gov (United States)

    Neder, Luciana; Rondon, Daniel A; Cury, Silvana S; Silva, Clovis A da

    2014-01-01

    To evaluate musculoskeletal involvement and autoantibodies in pediatric leprosy patients. 50 leprosy patients and 47 healthy children and adolescents were assessed according to musculoskeletal manifestations (arthralgia, arthritis, and myalgia), musculoskeletal pain syndromes (juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, and tendinitis), and a panel of autoantibodies and cryoglobulins. Health assessment scores and treatment were performed in leprosy patients. At least one musculoskeletal manifestation was observed in 14% of leprosy patients and in none of the controls. Five leprosy patients had asymmetric polyarthritis of small hands joints. Nerve function impairment was observed in 22% of leprosy patients, type 1 leprosy reaction in 18%, and silent neuropathy in 16%. None of the patients and controls presented musculoskeletal pain syndromes, and the frequencies of all antibodies and cyoglobulins were similar in both groups (p > 0.05). Further analysis of leprosy patients demonstrated that the frequencies of nerve function impairment, type 1 leprosy reaction, and silent neuropathy were significantly observed in patients with versus without musculoskeletal manifestations (p = 0.0036, p = 0.0001, and p = 0.309, respectively), as well as multibacillary subtypes in leprosy (86% vs. 42%, p = 0.045). The median of physicians' visual analog scale (VAS), patients' VAS, pain VAS, and Childhood Health Assessment Questionnaire (CHAQ) were significantly higher in leprosy patients with musculoskeletal manifestations (p = 0.0001, p = 0.002, p = 0002, and p = 0.001, respectively). This was the first study to identify musculoskeletal manifestations associated with nerve dysfunction in pediatric leprosy patients. Hansen's disease should be included in the differential diagnosis of asymmetric arthritis, especially in endemic regions. Copyright © 2014 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. Musculoskeletal manifestations and autoantibodies in children and adolescents with leprosy

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    Luciana Neder

    2014-09-01

    Full Text Available Objective: To evaluate musculoskeletal involvement and autoantibodies in pediatric leprosy patients. Methods: 50 leprosy patients and 47 healthy children and adolescents were assessed according to musculoskeletal manifestations (arthralgia, arthritis, and myalgia, musculoskeletal pain syndromes (juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, and tendinitis, and a panel of autoantibodies and cryoglobulins. Health assessment scores and treatment were performed in leprosy patients. Results: At least one musculoskeletal manifestation was observed in 14% of leprosy patients and in none of the controls. Five leprosy patients had asymmetric polyarthritis of small hands joints. Nerve function impairment was observed in 22% of leprosy patients, type 1 leprosy reaction in 18%, and silent neuropathy in 16%. None of the patients and controls presented musculoskeletal pain syndromes, and the frequencies of all antibodies and cyoglobulins were similar in both groups (p > 0.05. Further analysis of leprosy patients demonstrated that the frequencies of nerve function impairment, type 1 leprosy reaction, and silent neuropathy were significantly observed in patients with versus without musculoskeletal manifestations (p = 0.0036, p = 0.0001, and p = 0.309, respectively, as well as multibacillary subtypes in leprosy (86% vs. 42%, p = 0.045. The median of physicians' visual analog scale (VAS, patients' VAS, pain VAS, and Childhood Health Assessment Questionnaire (CHAQ were significantly higher in leprosy patients with musculoskeletal manifestations (p = 0.0001, p = 0.002, p = 0002, and p = 0.001, respectively. Conclusions: This was the first study to identify musculoskeletal manifestations associated with nerve dysfunction in pediatric leprosy patients. Hansen's disease should be included in the differential diagnosis of asymmetric arthritis, especially in endemic regions.

  5. A comparative study of the quality of life, knowledge, attitude and belief about leprosy disease among leprosy patients and community members in Shantivan Leprosy Rehabilitation centre, Nere, Maharashtra, India

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    Madhavi J Mankar

    2011-01-01

    Full Text Available Background: Leprosy a chronic infectious affliction, is a communicable disease that posses a risk of permanent and progressive disability. The associated visible deformities and disabilities have contributed to the stigma and discrimination experienced by leprosy patients, even among those who have been cured. Aims and Objectives: 1 To assess the knowledge, attitude and belief about leprosy in leprosy patients compared with community members. 2 To find the perceived stigma among leprosy patients. 3. To evaluate the quality of life in leprosy patients as compared to community members using WHO Quality of Life assessment questionaire (WHOQOL- BREF. Materials and Methods: A cross sectional study was conducted at Leprosy Rehabilitation Centre, Shantivan, Nere in Panvel Taluka, district Raigad from October - December 2009. A pre-designed and pre-structured questionaire was used to evaluate knowledge, attitude and perceived stigma among leprosy patients and community members. WHO Quality of life questionaire (WHOQOL-BREF was used to assess quality of life in leprosy patients and controls. Data analysis was done with the help of SPSS package. Result: Among the cases and control, 43.13% of cases were aware that leprosy is an infectious disease compared to 20.69% of control. 68.62% of cases had knowledge of hypopigmented patches being a symptom of leprosy compared to the 25.86% in control. There was overall high level of awareness about disease, symptoms, transmission and curability in leprosy patients as compared to control. Among control group, 43.10% of population said that they would not like food to be served by leprosy patients as compared to 13.73% in study group. It was seen that the discrimination was much higher in female leprosy patients as compared to male leprosy patients. The mean quality of life scores for cases was significantly lower than those for control group in physical and psychological domain but not in the social relationship and

  6. HISTORY OF LEPROSY

    OpenAIRE

    Hanumanthayya; Manjunath; Anisha; Nida; Minakshi

    2016-01-01

    Leprosy is one of the oldest and most dreaded diseases, which has tormented humans throughout history, leaving lasting impressions on religion, literature and art. If history is traced, evidence of leprosy is found in all the four Yugas of Hindu religion, quotes of Jesus in Bible of Christianity and verses of Prophet in Muslim religion.

  7. HISTORY OF LEPROSY

    Directory of Open Access Journals (Sweden)

    Hanumanthayya

    2016-01-01

    Full Text Available Leprosy is one of the oldest and most dreaded diseases, which has tormented humans throughout history, leaving lasting impressions on religion, literature and art. If history is traced, evidence of leprosy is found in all the four Yugas of Hindu religion, quotes of Jesus in Bible of Christianity and verses of Prophet in Muslim religion.

  8. Drug therapy of leprosy

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    A. A. Kubanov

    2016-01-01

    Full Text Available Leprosy (Hansen’s disease is a chronic granulomatous bacterial infection mainly affecting the skin and peripheral nervous system yet also involving other organs and systems as a result of a pathological process. The causative agent of leprosy - Mycobacterium leprae - is an obligate intracellular microorganism. Despite the removal of a threat of a leprosy epidemic, European countries still record outbreaks of the disease mainly among migrants coming from endemic areas. A golden standard of the treatment of leprosy is a WHO-recommended combined drug therapy comprising drugs such as dapsone, clofazimine and rifampicin. The article provides current data on the mechanisms of action, efficacy and safety of these drugs and their combined scheme of treatment obtained as a result of clinical trials. Moreover, it also reviews new regimens of the drug therapy of leprosy including those with the use of drugs from the group of fluoroquinols as well as immunotherapy of the disease.

  9. Quality of life in lepromatous leprosy patients

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    Betül Demir

    2014-09-01

    Full Text Available Background and Design: Leprosy is a chronic infectious disease caused by Mycobacterium leprae bacillus affecting the skin and peripheral nervous system. Leprosy can lead to severe deformities depending on the extent of the disease. In this study, we aimed to investigate the quality of life of patients with lepromatous leprosy. Materials and Methods: Thirty-five patients with lepromatous leprosy and 35 healthy controls were included in the study. The patients were evaluated with the Turkish version of the Dermatology Life Quality Index (DLQI and the 36-Item Short Form Health Survey (SF-36. The relationship of quality of life with age, gender, marital status, and the grade of the visual impairment was studied and compared with the healthy controls. Results: Total and all the subgroup DLQI scores were higher in the leprosy group than in the control group (p<0.05. The patients with grade 2 visual impairment were more severely affected by the disease with regard to symptoms/feelings and school/work life as compared to the patients with grade 1 visual impairment (p=0.04, p=0.03, respectively. SF-36 physical functioning, physical role functioning, general health perceptions, vitality, social role functioning, and emotional role functioning scores were statistically lower in the patient group than in the control group (p<0.05. Conclusion: We observed that DLQI scores were lower in patients with lepromatous leprosy than in the control group, while increasing impairment in eyes was found to have a negative impact on quality of life. The SF-36 revealed that physical functioning, physical role functioning, general health perceptions, vitality, social role functioning, emotional role functioning, and mental health were negatively influenced in patients with lepromatous leprosy.

  10. Skin Tests for Evaluation of Cell Mediated Immunity in Leprosy

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    P S Mallya

    1989-01-01

    Full Text Available Cell-mesate,d immune (CMI response to lepromin and dinitrochloro benzene (DNCB was evaluatt-d in 60 freshly detected leprosy cases. It was observed that 70%, ( 28 of 40 of the pa across tie leprosy spectrum except LL cases revealed delayed hypersensitivity to DNCB as -against 42.5% (1-7 of 40 to lepromin. DNCB test was found superior to lepromin test to measure CMI because of its simplicity and easy interpretation of skin reactivity. It detected CMI in 40% of BL cases who were lepromin negative. Grading of skin reactivity showed a program decrease in delayed hypersensitivity across the spectrum of leprosy from TT to LL. It can be concluded that there is no gross impairment of non-specific CMI in leprosy patients other than LL cases and this non-specific CMI depression correlates well with Ridley-Jopling clinical scale of leprosy.

  11. Uniform multidrug therapy for leprosy patients in Brazil (U-MDT/CT-BR: Results of an open label, randomized and controlled clinical trial, among multibacillary patients.

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    Gerson Oliveira Penna

    2017-07-01

    Full Text Available Leprosy control is based on early diagnosis and multidrug therapy. For treatment purposes, leprosy patients can be classified as paucibacillary (PB or multibacillary (MB, according to the number of skin lesions. Studies regarding a uniform treatment regimen (U-MDT for all leprosy patients have been encouraged by the WHO, rendering disease classification unnecessary.An independent, randomized, controlled clinical trial conducted from 2007 to 2015 in Brazil, compared main outcomes (frequency of reactions, bacilloscopic index trend, disability progression and relapse rates among MB patients treated with a uniform regimen/U-MDT (dapsone+rifampicin+clofazimine for six months versus WHO regular-MDT/R-MDT (dapsone+rifampicin+clofazimine for 12 months. A total of 613 newly diagnosed, untreated MB patients with high bacterial load were included. There was no statistically significant difference in Kaplan-Meyer survival function regarding reaction or disability progression among patients in the U-MDT and R-MDT groups, with more than 25% disability progression in both groups. The full mixed effects model adjusted for the bacilloscopic index average trend in time showed no statistically significant difference for the regression coefficient in both groups and for interaction variables that included treatment group. During active follow up, four patients in U-MDT group relapsed representing a relapse rate of 2.6 per 1000 patients per year of active follow up (95% CI [0·81, 6·2] per 1000. During passive follow up three patients relapsed in U-MDT and one in R-MTD. As this period corresponds to passive follow up, sensitivity analysis estimated the relapse rate for the entire follow up period between 2·9- and 4·5 per 1000 people per year.Our results on the first randomized and controlled study on U-MDT together with the results from three previous studies performed in China, India and Bangladesh, support the hypothesis that UMDT is an acceptable option to be

  12. Nutritional status of leprosy patients in India.

    Science.gov (United States)

    Rao, P S S; John, A S

    2012-01-01

    Across-sectional epidemiological study was carried out at a Leprosy Referral Hospital in Delhi to assess the nutritional status of multibacillary leprosy patients in comparison to the general population using BMI. 150 people affected with multibacillary leprosy were included in the study, of whom 108 (72%) had WHO Grade 2 disability. 100 non leprosy patients were also included as a control group. Socio-demographic and clinical details as well as their height and weight were measured and the BMI computed. The findings clearly showed that under-nutrition (BMI disability made the incidence of under-nutrition more likely. The duration of disease, number of lesions or bacterial index had no impact on the level of nutrition. There may be multiple factors working together to lead to this under-nutrition and these are discussed briefly. If, we aim to provide high quality services with a holistic approach, a mandatory BMI should be calculated for every patient and if under nourished, a qualitative diet summary should be done and suitable nutritional advice given. Further, studies are needed for a better understanding of the occurrence and progression of under-nutrition in leprosy to find efficient ways to combat this problem.

  13. Socioeconomic benefit to individuals of achieving 2020 targets for four neglected tropical diseases controlled/eliminated by innovative and intensified disease management : Human African trypanosomiasis, leprosy, visceral leishmaniasis, Chagas disease

    NARCIS (Netherlands)

    E.J. Lenk (Edeltraud); W.K. Redekop (Ken); M. Luyendijk (Marianne); C. Fitzpatrick (Christopher); L.W. Niessen (Louis Wilhelmus); W.A. Stolk (Wilma); F. Tediosi (Fabrizio); A.J. Rijnsburger (Rian); R. Bakker (Roel); J.A.C. Hontelez (Jan); J.H. Richardus (Jan Hendrik); J. Jacobson (Julie); E.A. le Rutte (Epke); S.J. de Vlas (Sake); J.L. Severens (Hans)

    2018-01-01

    markdownabstract__Background__ The control or elimination of neglected tropical diseases (NTDs) has targets defined by the WHO for 2020, reinforced by the 2012 London Declaration. We estimated the economic impact to individuals of meeting these targets for human African trypanosomiasis, leprosy,

  14. Endocrine dysfunction in patients of leprosy

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    Rohit Kumar Singh

    2015-01-01

    Full Text Available Background: Leprosy is a chronic granulomatous disease and affects many internal organs in addition to the skin and peripheral nerves. Endocrine dysfunction is often silent and is often missed in patients of leprosy leading to significant morbidity. We studied the presence of occult endocrine disorders in leprosy patients and compared the same with disease parameters. Materials and Methods: We evaluated 40 patients of leprosy (aged 18-70 years, any duration in this cross-sectional, observational study. All subjects were assessed for pituitary, thyroid, adrenal, gonadal function, and dynamic testing was done when deemed necessary. The participants were divided into two groups: Group 1 (Leprosy, n = 40 and Group 2 (Controls, n = 20 and the data were analyzed with appropriate statistical tests. Results: The study participants (35 males, 5 females had a mean age of 36.4 ± 11.3 years, and duration of the disease was 2.5 ± 5.5 years. Eleven out of 40 patients showed results consistent with an endocrine disorder, including subclinical hypothyroidism (n = 4, sick euthyroid syndrome (n = 3, growth hormone (GH deficiency (n = 2, primary hypogonadism (n = 2 and secondary hypogonadism in one patient. One patient had partial hypopituitarism (GH deficiency and secondary hypogonadism and none of the controls showed any hormonal dysfunction. Testosterone levels showed inverse correlation with the number of skin patches (P = 0.0006. Conclusion: Occult endocrine dysfunction is seen in a quarter of patients with leprosy. Thyroid and gonadal axes abnormalities are common, and the severity is more in lepromatous forms of the disease. Further large studies are required to confirm the findings observed in our study.

  15. Borderline lepromatous leprosy with neurofibromatosis

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    Angoori Gnaneshwar

    2010-01-01

    Full Text Available The coexistence of leprosy with neurofibromatosis is rare both the diseases present with nerve thickening and skin lesions (patches and nodules. The coexistence of neurofibroma with borderline tuberculoid, lepromatous, histoid, and neuritic leprosy has been reported in the past. We report here a case of borderline lepromatous leprosy coexisting with neurofibromatosis in a 60 year-old male, who presented with neurofibromata and nerve thickening. Histopathology of skin biopsy from the leprosy and neurofibroma nodules confirmed the diagnosis of leprosy and neurofibroma.

  16. Leprosy - evolution of the path to eradication

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    Sunil Dogra

    2013-01-01

    Full Text Available Leprosy is among the world′s oldest and most dreaded diseases and it has been synonymous with stigma and discrimination due to the hideous deformities it produced, mystery around its aetiology and transmission and lack of any effective remedy till recently. Leprosy control started with the use of chaulmoogra oil and for the last three decades, multi drug therapy (MDT has been our main tool against leprosy. In the last two decades, the reported global prevalence of active leprosy infection has dropped by almost 90 per cent by the combined efforts of the World Health Organization (WHO, local governments, health professionals, and non-governmental organizations (NGOs, however, a parallel drop in the incidence or new case detection rate (NCDR has not occurred. From 1994 through 2011, more than 100,000 new cases are being detected annually, of whom maximum case load is from India. There is need for research on tools for early diagnosis, short and effective treatment, and prevention of deformities and disabilities. Evaluating the role of immunotherapy and immunoprophylaxis will also lead us to better understanding of their mode of action. Further molecular analysis of Mycobacterium leprae genome may provide the requisite basis for all this. The current reality is that there is a need to sustain and provide quality leprosy services to all persons through general health services, including good referral system. All these provisions in the integrated health care approach will go a long way in further reducing the stigma. Efforts need to be made to reduce deformity through early detection, self care, physiotherapy and reconstructive surgery and developing sound surveillance systems. With all the remarkable achievements in the fight against leprosy, the stage is now set for the final assault. It is hoped that with the efforts of all the stake holders and strong political will, the disease will be eradicated in the near future.

  17. Current strategy for leprosy control in Brazil: time to pursue alternative preventive strategies?

    OpenAIRE

    Sérgio S. Cunha; Laura C. Rodrigues; Nádia Cristina Duppre

    2004-01-01

    La estrategia actual para el control de la lepra en Brasil se basa en dos actividades principales: la detección precoz de casos y el tratamiento de casos con farmacoterapia combinada. Además de dichas medidas, se realizan esfuerzos complementarios para identificar los contactos domésticos para el diagnóstico precoz y la vacunación con el bacilo de Calmette-Guérin (BCG). Sin embargo, la eficacia de estas acciones a la hora de reducir la incidencia de la lepra es aún discutible. Esto genera dud...

  18. Current strategy for leprosy control in Brazil: time to pursue alternative preventive strategies?

    Directory of Open Access Journals (Sweden)

    Sérgio S. Cunha

    2004-11-01

    Full Text Available La estrategia actual para el control de la lepra en Brasil se basa en dos actividades principales: la detección precoz de casos y el tratamiento de casos con farmacoterapia combinada. Además de dichas medidas, se realizan esfuerzos complementarios para identificar los contactos domésticos para el diagnóstico precoz y la vacunación con el bacilo de Calmette-Guérin (BCG. Sin embargo, la eficacia de estas acciones a la hora de reducir la incidencia de la lepra es aún discutible. Esto genera dudas acerca de la factibilidad de eliminar la lepra en Brasil e indica que deberían adoptarse otras medidas de prevención. A pesar del hecho de que la vacunación de los contactos se practica desde hace varios años, falta información sobre el impacto de esta medida sobre la incidencia de la lepra en la comunidad. Además, con frecuencia no se tiene en cuenta el impacto de la vacunación neonatal con la vacuna BCG. Sostenemos que hay lugar para la investigación de métodos alternativos en el control y recomendamos que el programa brasileño de control haga un seguimiento esmerado de las tasas de cobertura para la vacunación neonatal en aquellas zonas donde la lepra es endémica, con el fin de lograr que la cobertura siga siendo elevada. Además, recomendamos la realización de estudios, orientados hacia el desarrollo de políticas, sobre la eficacia, factibilidad e impacto de estrategias alternativas más previsoras. Algunos posibles temas para estos estudios serían: 1 el impacto de la vacunación de contactos sobre la incidencia de la enfermedad en la población en general, 2 la factibilidad y el impacto de la quimioprofilaxis, y 3 el impacto de la identificación de grupos de alto riesgo (o mediante la adopción de una definición amplia de los contactos expuestos a la lepra, o mediante la creación de nuevas herramientas diagnósticas, y del diseño de programas para la detección precoz y la administración de farmacoterapia combinada espec

  19. Leprosy Specific Orofacial Aspects

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    Vathsala Naik

    2011-01-01

    Full Text Available Leprosy is a chronic infection caused by Mycobactenum leprae, GHA- Hansen first identified the organism in 1873, so called Hansen disease. Mycobacterium leprae is a bacillus that presents a peculiar tropism for the skin and peripheral nerves. The upper airway has a great importance as a route of M. Leprae infection. The clinical spectrum of leprosy ranges from the tuberculoid form (TT to the disseminative and progressive lepromatous form (LL. Cell-mediated immunity is considered to be the crucial defence against the disease and the magnitude of this immunity defines the extent of the disease- Facial lesions in leprosy can occur in all form of the disease and also in lepra reaction, oral lesions are rare but, when present, occur in the lepromatous form

  20. Controle de verrugose, melanose e leprose em laranja pera, com fungicidas e acaricida em mistura com adubo foliar Control of citrus scab, melanose and leprosis with fungicides and miticide mixed to foliar fertilizer

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    W. Bettiol

    1994-12-01

    Full Text Available Pulverizações com ziram (Rodisan SC, oxicloreto de cobre (Coprantol BR e óxido de fembutatina (Torque 500 SC em dosagens normais e subdosagens, isoladamente ou em mistura com um adubo foliar originário da fermentação glutâmica do melaço, controlaram de forma efetiva a verrugose, melanose e leprose em laranja pera. A aplicação isolada do resíduo da fermentação glutâmica do melaço, base para diversos adubos foliares, nas dosagens de 0,25% e 5% do produto comercial Ajifol, não interferiu na ocorrência de verrugose e melanose. Entretanto, ocasionou um aumento do número de frutos com leprose, do número de lesões de leprose por fruto e do número de ácaros da leprose (Brevipalpus phoenicis Geipsks nas folhas e nos frutos.Normal dosage and tinder-dosage sprays of ziram (Rodisan SC; cooper oxychloride (Coprantol BR and fenbutatin oxide (Torque 500 SC, isolately or in association with Ajifol, a foliar fertilizer from molasses glutamic fermentation, provided efficient control of scab, melanose and leprosis in 'Pera' orange. Sprays of Ajifol at 0.25 and 5% had no effect on the rate of occurrence of scab and melanose, but was correlated with increases in the rates of fruits with symptoms of leprosis, number of leprosis spots per fruit, and the number of leprosis mites (Brevipalpus phoenicis Geijskes on leaves and fruits.

  1. Leprosy and Social Environment

    NARCIS (Netherlands)

    S.G. Feenstra-Gols (Sabiena G.)

    2013-01-01

    textabstractParliament yesterday passed a private member’s bill to repeal the Lepers Act 1898 that segregated leprosy patients from society and their families. This is the first time a private bill has got through the House during the tenure of the present Awami Leagueled government. Ruling party

  2. Study of serum lipids in leprosy

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    Gupta Anju

    2002-01-01

    Full Text Available Fifty fresh and untreated patients of leprosy constituted the study group. Fifty, age and sex matched healthy individuals formed the controls. Ridly and Jopling system of classification was used in the study. Majority i.e 21 cases were of BT group, 12 of BB, 7 of BL, 9 of LL and one case was of TT leprosy. The serum triglyceride level was lower than normal in TT, showed no alteration in BT or BB and was insignificantly increased in bL and LL patients. The total cholesterol was lowerthan normal in TT, showed no alteration in BT or BB and was insignificantly increased in Bland LL patients. The total cholesterol was lower than normal in TT, whereas in BT, BB, BL and LL groups the levels were statistically decreased. The HDL cholesterol was within normal range in TT, significantly decreased in BT and LL patients, showed no significant alteration in BB and was insignificantly decreased in BL group. The LDL cholesterol in TT was low but was not so low statistically when compared with the controls, whereas in BT, BB, BL and LL groups the levels were statistically decreased. The VLDL cholesterol was within normal range in TT and BT, was raised insignificantly in 3 of 12 cases of BB, was within normal range in BL and in LL leprosy it was raised in one out of 9 cases. In the absence of any derangement of liver function tests, it can be concluded that leprosy per se leads to alterations in lipid metabolism. However, no correlation could be established between the group/type of leprosy, bacterial indices and levels of different lipid fractions in the present study.

  3. LEPROSY NEPHROPATHY: A REVIEW OF CLINICAL AND HISTOPATHOLOGICAL FEATURES

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    Geraldo Bezerra da Silva Junior

    2015-02-01

    Full Text Available Leprosy is a chronic disease caused by Mycobacterium leprae, highly incapacitating, and with systemic involvement in some cases. Renal involvement has been reported in all forms of the disease, and it is more frequent in multibacillary forms. The clinical presentation is variable and is determined by the host immunologic system reaction to the bacilli. During the course of the disease there are the so called reactional states, in which the immune system reacts against the bacilli, exacerbating the clinical manifestations. Different renal lesions have been described in leprosy, including acute and chronic glomerulonephritis, interstitial nephritis, secondary amyloidosis and pyelonephritis. The exact mechanism that leads to glomerulonephritis in leprosy is not completely understood. Leprosy treatment includes rifampicin, dapsone and clofazimine. Prednisone and non-steroidal anti-inflammatory drugs may be used to control acute immunological episodes.

  4. Disability prevention and management in leprosy: A field experience

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    Ganapati R

    2003-11-01

    Full Text Available Bombay Leprosy Project has conducted operational research into cost effective ways of using therapeutic management for prevention of disabilities (POD. The goal of achieving this are broadly divided as 1 prevention of impairments and disabilities [POID] and 2 prevention of worsening of disabilities [POWD]. About 33-56% of newly registered leprosy patients already have clinically detectable nerve function impairment [NFI], often no longer amenable to MDT. An analysis of 892 leprosy cases treated with WHO-MDT stresses the need to focus attention on leprosy patients having > 5 skin lesions and multiple nerve thickening. Assessment of 454 disabled leprosy patients after 4 years indicated that the compliance for the services offered was good and it helped to improve the disability status in more than 50% of patients. In terms of effectiveness of the services, it was found to be effective in preventing worsening of deformities in hands and healing of trophic ulcers in feet. The methodology adopted has also helped us to develop an operational research model about the necessity to systematize the assistance and support to be given if the services can be routed through a public health facility. Because of the large numbers of leprosy patients with disability living in this region and the limited resources available, the services have to be targeted towards those who are most in need. The major advantage of such community based program is an attempt to eliminate the social stigma in the patients′ families and the education of the community.

  5. Global and local contexts: the Northern Ogoja Leprosy Scheme, Nigeria, 1945-1960

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    Manton John

    2003-01-01

    Full Text Available Deriving funding from missionary sources in Ireland, Britain and the USA, and from international leprosy relief organizations such as the British Empire Leprosy Relief Association (BELRA and drawing on developing capacities in international public health under the auspices of WHO and UNICEF through the 1950s, the Roman Catholic Mission Ogoja Leprosy Scheme applied international expertise at a local level with ever-increasing success and coverage. This paper supplements the presentation of a successful leprosy control programme in missionary narratives with an appreciation of how international medical politics shaped the parameters of success and the development of therapeutic understanding in the late colonial period in Nigeria.

  6. Recent advances in leprosy and Buruli ulcer (Mycobacterium ulcerans infection).

    Science.gov (United States)

    Walsh, Douglas S; Portaels, Françoise; Meyers, Wayne M

    2010-10-01

    After tuberculosis, leprosy (Mycobacterium leprae) and Buruli ulcer (M. ulcerans infection) are the second and third most common mycobacterial infections in humankind, respectively. Recent advances in both diseases are summarized. Leprosy remains a public health problem in some countries, and new case detections indicate active transmission. Newly identified M. lepromatosis, closely related to M. leprae, may cause disseminated leprosy in some regions. In genome-wide screening in China, leprosy susceptibility associates with polymorphisms in seven genes, many involved with innate immunity. World Health Organization multiple drug therapy administered for 1 or 2 years effectively arrests disseminated leprosy but disability remains a public health concern. Relapse is infrequent, often associated with higher pretreatment M. leprae burdens. M. ulcerans, a re-emerging environmental organism, arose from M. marinum and acquired a virulence plasmid coding for mycolactone, a necrotizing, immunosuppressive toxin. Geographically, there are multiple strains of M. ulcerans, with variable pathogenicity and immunogenicity. Molecular epidemiology is describing M. ulcerans evolution and genotypic variants. First-line therapy for Buruli ulcer is rifampin + streptomycin, sometimes with surgery, but improved regimens are needed. Leprosy and Buruli ulcer are important infections with significant public health implications. Modern research is providing new insights into molecular epidemiology and pathogenesis, boding well for improved control strategies.

  7. Curing the stigma of leprosy.

    Science.gov (United States)

    Rafferty, Joy

    2005-06-01

    The stigma of leprosy is a real phenomenon in many people's lives that affects their physical, psychological, social and economical well-being. There are many causes for this damaging image of leprosy. There is no one easy answer to dispelling this image; it is something that has to be done in partnership with communities and patients. Many papers document the effects of stigma, but few discuss or trial solutions. Education and media campaigns counteract false beliefs about leprosy and raise awareness of new advances in the field. Leprosy care is increasingly provided in an integrated setting showing patients and their communities that leprosy is not a disease apart. Physical and socio-economic rehabilitation is worthwhile in restoring self worth and status in the community and helps patients to find employment. Group counselling can allow those with leprosy to talk about their feelings and experiences to empower one another. Gradually attitudes towards leprosy are changing, but there is still much to be done if the underlying menace of stigma is to be dealt with. We as health professionals must be prepared to make the first move and give that first touch. Certainly more research is needed. In the highly endemic countries the road to elimination may yet be long. Perhaps with effort we will one day be able not only to treat the disease, but also to cure the stigma of leprosy, and make that road an easier one.

  8. Stigma in leprosy: miles to go!

    Science.gov (United States)

    Sinha, A; Kushwaha, A S; Kotwal, A; Sanghi, S; Verma, A K

    2010-01-01

    No disease has been more closely associated with stigma than leprosy such that it has become a metaphor for stigma. Stigma has been difficult to measure and little research has been done on this issue. Stigma reduction has not been an important component of anti-leprosy program. The study was undertaken to measure the stigma associated with leprosy by using P scale which is used for assessing participation restriction of those affected by the disease. This comparative questionnaire based study was carried out in two sets of patients. Two groups of 30 patients each were studied. First group belonged to a Government run Leprosarium and group two from a tertiary care skin and leprosy centre. The study used the Participation (P) scale and data was collected by interviewing the patients. Participation restriction was defined as any score equal to and more than 13. Participation restriction was observed in 27 (90%) cases of group 1while participation restriction was present in only 7 (23.3%) subjects of group 2. It was observed that mean score of participation restriction in group 1 was quite high at 31.9 while it was only 8.3 for group 2. The participation restriction was directly related to the duration of disease and the grade of disability. Longer the duration of disease, greater was the likelihood of restriction. The participation restriction was found to be negatively correlated with the education. Recommendation about prevention of disability would require program about early diagnosis of nerve damage and subsequent action at the patient-family-community level and health care providers.

  9. Serum uric acid levels during leprosy reaction episodes

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    Yvelise T. Morato-Conceicao

    2016-03-01

    Full Text Available Background. Leprosy reactions are acute inflammatory episodes that occur mainly in the multibacillary forms of the disease. The reactions are classified as type 1 (reverse reaction or type 2 (erythema nodosum leprosum. Leprosy-associated oxidative stress has been widely demonstrated. Several recent studies have shown uric acid (UA to have antioxidative effects under pathologic conditions. The objective of this study was to assess serum levels of UA in patients with leprosy reactions, with the aim of monitoring their levels before and after treatment, compared with levels in leprosy patients without reactions. Methods. The study included patients aged 18–69 years assisted at a leprosy treatment reference center in the Central Region of Brazil. Patients who were pregnant; were using immunosuppressant drugs or immunobiologicals; or had an autoimmune disease, human immunodeficiency virus infection, acquired immune deficiency syndrome, or tuberculosis were excluded. Upon recruitment, all individuals were clinically assessed for skin lesions and neural or systemic impairment. Some patients had already completed treatment for leprosy, while others were still undergoing treatment or had initiated treatment after being admitted. The treatment of the reactional episode was started only after the initial evaluation. Laboratory assessments were performed upon admission (baseline and at approximately 30 and 60 days (time points 1 and 2, respectively. Results. A total of 123 leprosy patients were recruited between June 2012 and June 2015; among them, 56, 42, and 25 presented with type 1, type 2, and no reactions, respectively. Serum UA levels were significantly reduced in patients with type 2 leprosy reactions compared with patients in the control group and remained lower in the two subsequent assessments, after initiation of anti-reaction treatments, with similar values to those recorded before the treatment. Discussion. The decreased serum UA levels in

  10. Readings in program control

    Science.gov (United States)

    Hoban, Francis T. (Editor); Lawbaugh, William M. (Editor); Hoffman, Edward J. (Editor)

    1994-01-01

    Under the heading of Program Control, a number of related topics are discussed: cost estimating methods; planning and scheduling; cost overruns in the defense industry; the history of estimating; the advantages of cost plus award fee contracts; and how program control techniques led to the success of a NASA development project.

  11. Clinical variables associated with leprosy reactions and persistence of physical impairment

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    Daniela Teles de Oliveira

    2013-10-01

    Full Text Available Introduction Leprosy is a chronic disease that affects skin and peripheral nerves. Disease complications include reactional episodes and physical impairment. One World Health Organization (WHO goal of leprosy programs is to decrease the number of grade 2 impairment diagnoses by 2015. This study aims to evaluate clinical factors associated with the occurrence of leprosy reactions and physical impairment in leprosy patients. Methods We conducted a retrospective study of data from medical records of patients followed in two important centers for the treatment of leprosy in Aracaju, Sergipe, Brazil, from 2005 to 2011. We used the chi-square test to analyze associations between the following categorical variables: gender, age, operational classification, clinical forms, leprosy reactions, corticosteroid treatment, and physical impairment at the diagnosis and after cure. Clinical variables associated with multibacillary leprosy and/or reactional episodes and the presence of any grade of physical impairment after cure were evaluated using the logistic regression model. Results We found that men were more affected by multibacillary forms, reactional episodes, and grade 2 physical impairment at diagnosis. Leprosy reactions were detected in a total of 40% of patients and all were treated with corticosteroids. However, physical impairment was observed in 29.8% of the patients analyzed at the end of the treatment and our multivariate analysis associated a low dose and short period of corticosteroid treatment with persistence of physical impairments. Conclusions Physical impairment should receive an increased attention before and after treatment, and adequate treatment should be emphasized.

  12. Psychiatric morbidity and pattern of dysfunctions in patients with leprosy

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    Bhatia M

    2006-01-01

    Full Text Available BACKGROUND: Leprosy, being a chronic infectious disease with profound social stigma, remains associated with high psychological mortidity. PURPOSES: To find out the pattern of psychiatric morbidity in leprosy patients and the relationship of various factors with the morbidity. METHODS: Ninty patients attending leprosy clinic were randomly chosen for the study group alongwith 40 patients suffering from acute skin problem other than leprosy as control group. The socio-demographic data were recorded in semi-structural proforma; all patients were given Goldbery Health Questioneaire (GHQ. Patients having GHQ score> 2 was assessed by Disability Assessent Questionaire (DAQ. The psychiatric diagnoses was made according to ICD-10 by W ho0 and physical deformity by W ho 0 Disability Scale. FINDINGS: The mean GHQ score of the study grant was 3.44 and that of control group was 1.62. The mean DAQ score was 45.13. Psychiatric disorder was seen in 44.4% and 7.5% of study group and control group respectively. The psychiatric illness was generalised anoxidy disorder (GAD (27.8%. CONCLUSIONS: Leprosis highly associated with psychiatric mobidity. LIMITATIONS: The findings can not be generalised due to small sample size and clinic-based data.

  13. BCG revaccination does not protect against leprosy in the Brazilian Amazon: a cluster randomised trial.

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    Sérgio S Cunha

    2008-02-01

    Full Text Available Although BCG has been found to impart protection against leprosy in many populations, the utility of repeat or booster BCG vaccinations is still unclear. When a policy of giving a second BCG dose to school children in Brazil was introduced, a trial was conducted to assess its impact against tuberculosis, and a leprosy component was then undertaken in parallel.to estimate the protection against leprosy imparted by a second dose of BCG given to schoolchildren.This is a cluster randomised community trial, with 6 years and 8 months of follow-up.City of Manaus, Amazon region, a leprosy-endemic area in Brazil.99,770 school children with neonatal BCG (aged 7-14 years at baseline, of whom 42,662 were in the intervention arm (revaccination.BCG given by intradermal injection.Leprosy (all clinical forms.The incidence rate ratio of leprosy in the intervention over the control arm within the follow-up, in schoolchildren with neonatal BCG, controlled for potential confounders and adjusted for clustering, was 0.99 (95% confidence interval: 0.68 to 1.45.There was no evidence of protection conferred by the second dose of BCG vaccination in school children against leprosy during the trial follow-up. These results point to a need to consider the effectiveness of the current policy of BCG vaccination of contacts of leprosy cases in Brazilian Amazon region.

  14. Estimation of serum level of interleukin-17 and interleukin-4 in leprosy, towards more understanding of leprosy immunopathogenesis

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    Marwa Abdallah

    2013-01-01

    Full Text Available Background: Combating Mycobacterium leprae is known to be via T-helper1 response. However, other T-helper effector cells; T-helper17 and T-helper2; play a role, particularly in the context of disease type. Aims: We aimed to evaluate serum levels of interleukin (IL-17 (T-helper17 cytokine and IL-4 (T-helper2 cytokine in untreated patients with different types of leprosy, compared to controls. Methods: Using enzyme-linked immunosorbent assay, serum IL-17 and IL-4 levels were estimated in 43 leprotic patients and 43 controls. Patients were divided into six groups; tuberculoid, borderline cases, lepromatous, erythema nodosum leprosum (ENL, type 1 reactional leprosy, and pure neural leprosy. Patients were also categorized according to bacillary load and the presence or absence of reactions. Results: Serum IL-17 was significantly lower in cases (4-61.5 pg/mL; median 19, compared to controls (26-55 pg/mL; median 36 (P < 0.001, and was significantly lower in each type of leprosy compared to controls, with the lowest level in lepromatous leprosy (4-61.5 pg/mL; median 12.5. Significantly elevated serum IL-4 was found in patients (1.31-122.4 pg/mL; median 2.31 compared to controls (1.45-5.72 pg/mL; median 2.02 (P = 0.008, with the highest level among lepromatous leprosy patients (2-87.2 pg/mL; median 28.9, and the lowest in type 1 reactional leprosy (1.4-2.5 pg/mL; median 1.87 (P = 0.006. Conclusion: Defective secretion of IL-17 is related to disease acquisition as well as progression toward lepromatous pole in leprosy patients. The overproduction of IL-4 in patients with lepromatous leprosy may infer their liability to develop ENL. Nevertheless, the small number of the studied population is a limitation.

  15. Hemolytic anemia in patients receiving daily dapsone for the treatment of leprosy.

    Science.gov (United States)

    Deps, Patricia; Guerra, Patrícia; Nasser, Sofia; Simon, Marisa

    2012-09-01

    Multidrug therapy for leprosy is currently done with dapsone, clofazimine and rifampicin. Dapsone is known to cause hemolytic anemia (HA) and this adverse event during MDT seems to be more frequent than reported. The aim of this report is to discuss and grade HA due to dapsone during MDT treatment for leprosy. This is a retrospective study of 194 leprosy patients from a Leprosy Control Programme Unit in Vit6ria-ES, Brazil. HA was observed in 48 (24.7%) patients and occurred within the first 3 months in 51% of these. Mean hematocrit levels fell from 38.5 to 31.5 and hemoglobin from 12.8 to 10.3. Dapsone used in the MDT regime for leprosy decreases the hematocrit and hemoglobin levels due to a low grade hemolysis, which can result in significant anemia.

  16. Inheritance and heritability of resistance to citrus leprosis.

    Science.gov (United States)

    Bastianel, Marinês; de Oliveira, Antonio Carlos; Cristofani, Mariângela; Filho, Oliveiro Guerreiro; Freitas-Astúa, Juliana; Rodrigues, Vandeclei; Astúa-Monge, Gustavo; Machado, Marcos Antônio

    2006-10-01

    ABSTRACT The genetic inheritance of resistance to leprosis, the most important viral disease of citrus in Brazil, was characterized through the phenotypic assessment of 143 hybrids resulting from crosses between tangor 'Murcott' (Citrus sinensis x C. reticulata) and sweet orange 'Pêra' (C. sinensis), considered to be resistant and susceptible to the disease, respectively. All plants were grafted onto Rangpur lime (C. limonia) and inoculated with Citrus leprosis virus, cytoplasmic type through the infestation with viruliferous mites, Brevipalpus phoenicis. The experiments were arranged in a completely randomized block design with 10 replicates. Incidence and severity of the disease in leaves and stems as well as plant growth parameters (plant height and stem diameter) were recorded for 3 years after the infestation with the viruliferous mites. The average values of all variables were analyzed using principal component analysis, discriminant factorial analysis, estimation of the clonal repeatability coefficients, and frequency of the distributions of the average values for each measured variable. The principal component analysis resulted in the identification of at least two groups with resistance and susceptibility to leprosis, respectively. About 99% of all hybrids were correctly classified according to the discriminant factorial analysis. The broad-sense heritability coefficients for characteristics associated with incidence and severity of leprosis ranged from 0.88 to 0.96. The data suggest that the inheritance of resistance to leprosis may be controlled by only a few genes.

  17. Conversion Disorder Presenting As Neuritic Leprosy

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    Sayal SK

    2000-01-01

    Full Text Available Conversion disorder is not normally listed amongst the conditions in differential diagnosis of leprosy neuropathy. A case conversion reaction who was initially diagnosed as neuritic leprosy is reported. Patient responded to narcosuggestion and psychotherapy.

  18. Auditing measurement control programs

    International Nuclear Information System (INIS)

    Roberts, F.P.; Brouns, R.J.

    1979-10-01

    Requirements and a general procedure for auditing measurement control programs used in special nuclear material accounting are discussed. The areas of measurement control that need to be examined are discussed and a suggested checklist is included to assist in the preparation and performance of the audit

  19. Patterns of health-seeking behaviour amongst leprosy patients in ...

    African Journals Online (AJOL)

    This case-control study sought to determine factors influencing the early reporting of leprosy patients to modern treatment units. The Cases were 31 patients presenting with WHO disability grade 2 while controls were 48 patients presenting with grade 0. More than three- quarters (77%) of the cases waited for longer than 1 ...

  20. Histoid leprosy: a rare exuberant case*

    Science.gov (United States)

    de Andrade, Pedro Jose Secchin; Messias, Sulamita dos Santos Nascimento Dutra; Ferreira, Paola Cristina Brandão Oliveira; Sales, Anna Maria; Machado, Alice de Miranda; Nery, José Augusto da Costa

    2015-01-01

    Leprosy is a neglected disease. We point up the need of recognizing the unusual clinical presentations of the disease in order to make early diagnosis and proper treatment possible, and break the transmission chain. The authors report a rare type of multibacillary leprosy: histoid leprosy and present images of numerous well-circumscribed indurated papules and nodules distributed throughout the entire body. PMID:26560226

  1. Histoid leprosy: a rare exuberant case*

    OpenAIRE

    de Andrade, Pedro Jose Secchin; Messias, Sulamita dos Santos Nascimento Dutra; Ferreira, Paola Cristina Brand?o Oliveira; Sales, Anna Maria; Machado, Alice de Miranda; Nery, Jos? Augusto da Costa

    2015-01-01

    AbstractLeprosy is a neglected disease. We point up the need of recognizing the unusual clinical presentations of the disease in order to make early diagnosis and proper treatment possible, and break the transmission chain. The authors report a rare type of multibacillary leprosy: histoid leprosy and present images of numerous well-circumscribed indurated papules and nodules distributed throughout the entire body.

  2. Models for leprosy. An appraisal of graphic representations of the "spectrum" concept as models and a suggestion for a catastrophe theory model for leprosy.

    Science.gov (United States)

    Srinivasan, H

    1984-09-01

    Graphic representations of the spectrum concept of leprosy are examined in some detail as models for this disease. This reveals that this concept is somewhat inadequate and that the spectrum metaphor may itself be inappropriate because, by its very linearity of logic, it may not be able to depict the nonlinear behavior of leprosy properly. The assumptions underlying this concept and their logical consequences, brought out by the graphic representations, include an invariable relation between CMI and BI, identity of one type of leprosy with one specific level of CMI, a fixed sequence of types, and the consequent impossibility of skipping the sequence. However, our experience with leprosy does not bear out these assumptions. Further, development and progress of leprosy from a normal (nonleprous) state cannot be represented in these models. A search for alternative conceptual models therefore appears reasonable and even necessary. The catastrophe theory (a branch of topology in mathematics) describes a number of models for explaining how continuous causes could produce sudden or discontinuous changes. Of the various catastrophe theory models available, the relatively simple "cusp" model appears capable of application to leprosy. This model, as applied here, requires two control factors (identified tentatively as the amount of dead bacilli and the amount of living bacilli or their indicators) and one pattern of behavior, identified as progress towards limited or extensive disease. This model suggests under what conditions leprosy will change from one type to another and whether that will happen gradually or suddenly. It also suggests that for certain values of control factors the disease may manifest in one of two forms of borderline leprosy, and that lesions very similar to start with can progress to quite different states under similar conditions of change. The behavior of leprosy agrees more or less with that suggested by this model. The cusp model thus seems to: a

  3. Leprosy--evolution of the path to eradication.

    Science.gov (United States)

    Dogra, Sunil; Narang, Tarun; Kumar, Bhushan

    2013-01-01

    Leprosy is among the world's oldest and most dreaded diseases and it has been synonymous with stigma and discrimination due to the hideous deformities it produced, mystery around its aetiology and transmission and lack of any effective remedy till recently. Leprosy control started with the use of chaulmoogra oil and for the last three decades, multi drug therapy (MDT) has been our main tool against leprosy. In the last two decades, the reported global prevalence of active leprosy infection has dropped by almost 90 per cent by the combined efforts of the World Health Organization (WHO), local governments, health professionals, and non-governmental organizations (NGOs), however, a parallel drop in the incidence or new case detection rate (NCDR) has not occurred. From 1994 through 2011, more than 100,000 new cases are being detected annually, of whom maximum case load is from India. There is need for research on tools for early diagnosis, short and effective treatment, and prevention of deformities and disabilities. Evaluating the role of immunotherapy and immunoprophylaxis will also lead us to better understanding of their mode of action. Further molecular analysis of Mycobacterium leprae genome may provide the requisite basis for all this. The current reality is that there is a need to sustain and provide quality leprosy services to all persons through general health services, including good referral system. All these provisions in the integrated health care approach will go a long way in further reducing the stigma. Efforts need to be made to reduce deformity through early detection, self care, physiotherapy and reconstructive surgery and developing sound surveillance systems. With all the remarkable achievements in the fight against leprosy, the stage is now set for the final assault. It is hoped that with the efforts of all the stake holders and strong political will, the disease will be eradicated in the near future.

  4. Controlled thermonuclear research program

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    The Plasma Physics and Controlled-Fusion Research Program at the Lawrence Berkeley Laboratory is divided into five projects: Plasma Production and Heating Experiments, Plasma Theory, Atomic Physics Studies, the Tormac Project, and Neutral-Beam Development and Technology listed in order of increasing magnitude, as regards manpower and budget. Some cross sections and yields are shown in atomic physics

  5. National Hansen's Disease (Leprosy) Program

    Science.gov (United States)

    ... content Search Advanced Search Grants Loans & Scholarships Data Warehouse About HRSA  share     You are here Home > National ... United States abstract Interview with Dr. Richard Truman, Chief, Laboratory Research Branch Hansen's disease, also known as ...

  6. Haematological alteration in Leprosy patients treated with dapsone ...

    African Journals Online (AJOL)

    Objective: To evaluate the haemoglobin concentration (Hb); total white blood cell count (WBC), differential WBC count; platelet count and reticulocyte count in leprosy patients already treated with dapsone. Design: A case-control study. Setting: Specialist Hospital Ossiomo, which is a Leprosarium and Haematology ...

  7. Operational barriers to the implementation of multidrug therapy and leprosy elimination in Cameroon.

    Science.gov (United States)

    Nsagha, Dickson S; Bamgboye, Elijah A; Oyediran, Alain B O O

    2009-01-01

    The World Health Organization targeted to eliminate leprosy from the world with multidrug therapy (MDT) by 2000. But, leprosy remains a problem in Essimbiland of Menchum Division of Cameroon, with a prevalence of 1.7/10,000 and high rate of case detection in children. To assess knowledge and practices on the cure of leprosy, treatment duration, drug availability and problems faced by leprosy patients acquiring drugs in order to enhance MDT implementation and leprosy elimination in Menchum and Boyo divisions. Observational study in which a structured questionnaire was administered to leprosy patients, their contacts and a control group. 480 respondents were interviewed and 405 (84.8%) (95% confidence interval [CI]: 81.6-87.2%) knew that leprosy can be cured. These respondents comprised 166 (92.2%) of 180 contacts, 129 (93.5%) of 138 patients and 110 (67.9%) of 162 controls. Two hundred and fourteen (44.6%) (95% CI: 40.1-48.9%) respondents knew that leprosy treatment is free, comprising of 110 (51.4%) patients, 99 (46.3%) contacts and five (2.3%) controls. A statistically significant difference in the knowledge on free treatment of leprosy was found to exist between leprosy patients, contacts and controls, with leprosy patients having a better knowledge (79.71%) (95% CI: 73-86.42%), followed by contacts (55.0%) (95% CI: 47.73-62.26%) and controls (3.1%) (95% CI: 0.43-5.77%) (P = 0.00). Pertinent problems faced by patients in getting MDT included distant health facilities and poor road network (91[19.0%]), lack of confidence in treatment (56 [11.7%]), MDT shortage (45 [9.4%]), few health facilities (52 [10.8%]), gratification demands (25 [5.2%]), disturbance from other illnesses (24 [5.0]), ignorance (21 [4.4%]) and poor relationship with nurses (24 [5.0%]). Patients still face problems in getting free MDT. Better MDT implementation and leprosy elimination strategies are proposed.

  8. Operational barriers to the implementation of multidrug therapy and leprosy elimination in Cameroon

    Directory of Open Access Journals (Sweden)

    Nsagha Dickson

    2009-01-01

    Full Text Available Background: The World Health Organization targeted to eliminate leprosy from the world with multidrug therapy (MDT by 2000. But, leprosy remains a problem in Essimbiland of Menchum Division of Cameroon, with a prevalence of 1.7/10,000 and high rate of case detection in children. Aims: To assess knowledge and practices on the cure of leprosy, treatment duration, drug availability and problems faced by leprosy patients acquiring drugs in order to enhance MDT implementation and leprosy elimination in Menchum and Boyo divisions. Methods: Observational study in which a structured questionnaire was administered to leprosy patients, their contacts and a control group. Results: 480 respondents were interviewed and 405 (84.8% (95% confidence interval [CI]: 81.6-87.2% knew that leprosy can be cured. These respondents comprised 166 (92.2% of 180 contacts, 129 (93.5% of 138 patients and 110 (67.9% of 162 controls. Two hundred and fourteen (44.6% (95% CI: 40.1-48.9% respondents knew that leprosy treatment is free, comprising of 110 (51.4% patients, 99 (46.3% contacts and five (2.3% controls. A statistically significant difference in the knowledge on free treatment of leprosy was found to exist between leprosy patients, contacts and controls, with leprosy patients having a better knowledge (79.71% (95% CI: 73-86.42%, followed by contacts (55.0% (95% CI: 47.73-62.26% and controls (3.1% (95% CI: 0.43-5.77% (P = 0.00. Pertinent problems faced by patients in getting MDT included distant health facilities and poor road network (91[19.0%], lack of confidence in treatment (56 [11.7%], MDT shortage (45 [9.4%], few health facilities (52 [10.8%], gratification demands (25 [5.2%], disturbance from other illnesses (24 [5.0], ignorance (21 [4.4%] and poor relationship with nurses (24 [5.0%]. Conclusion: Patients still face problems in getting free MDT. Better MDT implementation and leprosy elimination strategies are proposed.

  9. Space-time variability of citrus leprosis as strategic planning for crop management.

    Science.gov (United States)

    Andrade, Daniel J; Lorençon, José R; Siqueira, Diego S; Novelli, Valdenice M; Bassanezi, Renato B

    2018-01-31

    Citrus leprosis is the most important viral disease of citrus. Knowledge of its spatiotemporal structure is fundamental to a representative sampling plan focused on the disease control approach. Such a well-crafted sampling design helps to reduce pesticide use in agriculture to control pests and diseases. Despite the use of acaricides to control citrus leprosis vector (Brevipalpus spp.) populations, the disease has spread rapidly through experimental areas. Citrus leprosis has an aggregate spatial distribution, with high dependence among symptomatic plants. Temporal variation in disease incidence increased among symptomatic plants by 4% per month. Use of acaricides alone to control the vector of leprosis is insufficient to avoid its incidence in healthy plants. Preliminary investigation into the time and space variation in the incidence of the disease is fundamental to select a sampling plan and determine effective strategies for disease management. © 2018 Society of Chemical Industry. © 2018 Society of Chemical Industry.

  10. Accentuation of ichthyosis vulgaris due to associated leprosy

    Science.gov (United States)

    Shah, A. P.; Shah, S. S.; Doshi, H. V.

    1973-01-01

    A case of ichthyosis vulgaris associated with tuberculoid leprosy is reported. Ichthyotic scales were markedly accentuated within the anaesthetic patches of leprosy. The probable mechanism of the accentuation of ichthyosis by leprosy is discussed. ImagesFig. 1 PMID:4760727

  11. Association of TNF -1031 C/C as a potential protection marker for leprosy development in Amazonas state patients, Brazil.

    Science.gov (United States)

    Silva, G A V; Ramasawmy, R; Boechat, A L; Morais, A C; Carvalho, B K S; Sousa, K B A; Souza, V C; Cunha, M G S; Barletta-Naveca, R H; Santos, M P; Naveca, F G

    2015-03-01

    Polymorphisms present in the TNF promoter region has shown to influence the gene transcription. Leprosy displays different clinical manifestations according to the immune responses of the individual infected with Mycobacterium leprae. In this study, we evaluated the single nucleotide polymorphisms (SNPs) -238 G/A (rs361525), -308 G/A (rs1800629), -857 C/T (rs1799724), -863 A/C (rs1800630) and -1031 T/C (rs1799964) in the promoter region of the TNF to see whether these SNPs influence host-susceptibility to leprosy and the different clinical manifestation. Nucleotide sequencing was performed with DNA samples from 108 leprosy patients and 253 control subjects. An association between -1031 C/C genotype and protection from leprosy was observed when leprosy patients were compared to controls (OR 0.11; 95% CI=0.01-0.82; p=0.012). The -857 C/T genotype may be associated with susceptibility to leprosy (OR=1.81; 95% CI=1.09-3.00; p=0.028). Similar genotype and allele frequencies for the SNPs -308 G/A and -238 G/A were observed between leprosy patients and control subjects. Altogether, TNF polymorphisms in the promoter region may be predictive of leprosy outcome. Copyright © 2015 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  12. Avaliação e controle de contatos faltosos de doentes com hanseníase Evaluación y control de contactos faltantes de enfermos con lepra Evaluation and control of missing contacts of leprosy patients

    Directory of Open Access Journals (Sweden)

    Carmen Silvia de Campos Almeida Vieira

    2008-11-01

    Full Text Available Estudo descritivo, com variáveis qualitativas, realizado no Ambulatório Regional de Especialidades de Taubaté, com objetivo de resgatar e avaliar contatos faltosos de doentes de hanseníase. Analisou-se 36 prontuários de casos novos, no período de janeiro de 2003 a julho de 2004. Identificou-se 92 contatos, sendo 64,1% faltosos, tendo 25% entre 20 a 29 anos e 58,5% do sexo feminino. Destes, 61% foram submetidos à consulta de enfermagem no domicilio. Relataram não adesão ao controle por esquecimento (66,6%, e falta de tempo (11,1%; 4 contatos tinham sintomas de hanseníase, e 1 foi confirmado (forma transmissível - Dimorfa. Sem atingir 100% da cobertura de busca ativa, sugerimos, para assegurar a meta de eliminação da doença, parcerias e descentralização das ações de controle.Estudio descriptivo, con cualitativas variable, realizado en el Ambulatorio de Especialidades Regional de Taubaté, a fin de canjear y evaluar las deficiencias de enfermos de lepra. Se analizaron los registros de 36 nuevos casos, entre enero de 2003 y julio de 2004. Se identificaron 92 contactos, sendo 64,1% deficiencias, tendo 25% de 20 a 29 años y 58,5% mujeres. De estos, 61% fueron sometidos a consulta en la casa de los enfermos . Informó de la no pertenencia al control en el olvido (66,6%, y la falta de tiempo (11,1%, 4 contactos había síntomas de la lepra, y se confirmó 1 (formulario transmisibles - Dimorfa. Sin lograr una cobertura del 100% del activo de búsqueda, le sugerimos que, para garantizar el objetivo de eliminar la enfermedad, las asociaciones y la descentralización de las actividades de control.Descriptive study, with qualitative variables, carried on in the Ambulatory of Specialties Region of Taubaté, in order to evaluate the missing contacts of leprosy patients. Thirty-six records of new cases were analyzed, from January 2003 to July 2004. Ninety-two contacts were identified, being 64.1% missing ones, having 25% from 20 to 29 years

  13. Oral coinfection can stress peripheral lymphocyte to inflammatory activity in leprosy

    Directory of Open Access Journals (Sweden)

    Ana Carolina Fragoso Motta

    2013-01-01

    Full Text Available INTRODUCTION: This study evaluated the intracellular profile of interleukin-2 (IL-2, interleukin-4 (IL-4, interleukin-10 (IL-10 and interferon-γ (IFN-γ in peripheral blood mononuclear cells (PBMCs from leprosy patients based on oral infections presence to determine whether these coinfections could be associated with pro-inflammatory activity in leprosy. METHODS: Leprosy patients regardless of clinical form and specific leprosy treatment (n=38 were divided into two groups: Group I - leprosy patients with oral infections (n=19, and Group II - leprosy patients without oral infections (n=19. Non-leprosy patients presenting oral infections were assigned to the control Group (n=10. Intracellular IL-2, IL-4, IL-10 and IFN-γ production was evaluated by flow cytometry (FACS before and 7 days after controlling the oral infection in the Group I, before and 7 days after dental prophylaxis in the Group II, and during oral infection process in control Group. RESULTS: Low percentages of CD3+ lymphocytes bearing IL-2, IL-10 and IFN-γ were observed in the Group I and Group II at baseline and 7 days after therapy or prophylaxis compared to controls. Group I showed reduced percentages of IL-4 at baseline and 7 days after therapy compared to controls, or at baseline of Group II, and the Group II showed reduced percentages of CD3+ cells bearing IL-4 compared to control. An increase of the percentages of CD3+cells bearing IL-4 was observed in the Group I after the oral infections treatment. CONCLUSIONS: The occurrence of oral infections favors the intracellular cytokines expression and, probably, the inflammatory reaction operating as a stimulatory signal triggering the leprosy reactions.

  14. Identification of Urban Leprosy Clusters

    Science.gov (United States)

    Paschoal, José Antonio Armani; Paschoal, Vania Del'Arco; Nardi, Susilene Maria Tonelli; Rosa, Patrícia Sammarco; Ismael, Manuela Gallo y Sanches; Sichieri, Eduvaldo Paulo

    2013-01-01

    Overpopulation of urban areas results from constant migrations that cause disordered urban growth, constituting clusters defined as sets of people or activities concentrated in relatively small physical spaces that often involve precarious conditions. Aim. Using residential grouping, the aim was to identify possible clusters of individuals in São José do Rio Preto, Sao Paulo, Brazil, who have or have had leprosy. Methods. A population-based, descriptive, ecological study using the MapInfo and CrimeStat techniques, geoprocessing, and space-time analysis evaluated the location of 425 people treated for leprosy between 1998 and 2010. Clusters were defined as concentrations of at least 8 people with leprosy; a distance of up to 300 meters between residences was adopted. Additionally, the year of starting treatment and the clinical forms of the disease were analyzed. Results. Ninety-eight (23.1%) of 425 geocoded cases were located within one of ten clusters identified in this study, and 129 cases (30.3%) were in the region of a second-order cluster, an area considered of high risk for the disease. Conclusion. This study identified ten clusters of leprosy cases in the city and identified an area of high risk for the appearance of new cases of the disease. PMID:24288467

  15. Identification of Urban Leprosy Clusters

    Directory of Open Access Journals (Sweden)

    José Antonio Armani Paschoal

    2013-01-01

    Full Text Available Overpopulation of urban areas results from constant migrations that cause disordered urban growth, constituting clusters defined as sets of people or activities concentrated in relatively small physical spaces that often involve precarious conditions. Aim. Using residential grouping, the aim was to identify possible clusters of individuals in São José do Rio Preto, Sao Paulo, Brazil, who have or have had leprosy. Methods. A population-based, descriptive, ecological study using the MapInfo and CrimeStat techniques, geoprocessing, and space-time analysis evaluated the location of 425 people treated for leprosy between 1998 and 2010. Clusters were defined as concentrations of at least 8 people with leprosy; a distance of up to 300 meters between residences was adopted. Additionally, the year of starting treatment and the clinical forms of the disease were analyzed. Results. Ninety-eight (23.1% of 425 geocoded cases were located within one of ten clusters identified in this study, and 129 cases (30.3% were in the region of a second-order cluster, an area considered of high risk for the disease. Conclusion. This study identified ten clusters of leprosy cases in the city and identified an area of high risk for the appearance of new cases of the disease.

  16. Factors Associated with Migration in Individuals Affected by Leprosy, Maranhão, Brazil: An Exploratory Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    C. Murto

    2013-01-01

    Full Text Available In Brazil, leprosy is endemic and concentrated in high-risk clusters. Internal migration is common in the country and may influence leprosy transmission and hamper control efforts. We performed a cross-sectional study with two separate analyses evaluating factors associated with migration in Brazil’s Northeast: one among individuals newly diagnosed with leprosy and the other among a clinically unapparent population with no symptoms of leprosy for comparison. We included 394 individuals newly diagnosed with leprosy and 391 from the clinically unapparent population. Of those with leprosy, 258 (65.5% were birth migrants, 105 (26.6% were past five-year migrants, and 43 (10.9% were circular migrants. In multivariate logistic regression, three independent factors were found to be significantly associated with migration among those with leprosy: (1 alcohol consumption, (2 separation from family/friends, and (3 difficulty reaching the healthcare facility. Separation from family/friends was also associated with migration in the clinically unapparent population. The health sector may consider adapting services to meet the needs of migrating populations. Future research is needed to explore risks associated with leprosy susceptibility from life stressors, such as separation from family and friends, access to healthcare facilities, and alcohol consumption to establish causal relationships.

  17. Lepromatous Leprosy of Prepuce- A Case Report

    Directory of Open Access Journals (Sweden)

    Kalpana R. Sulhyan

    2013-01-01

    Full Text Available Leprosy is commonly seen over cooler parts of the body and very rarely found over external genitalia because of their warm temperature.We report a case of lepromatous leprosy of prepuce in a 79 years old male who presented with phimosis. Local examination revealed anodule over prepuce and the clinical diagnosis was carcinoma of penis. This case highlights that leprosy should be kept in mind in the differential diagnosis of penile lesions.

  18. Leg ulcer in lepromatous leprosy - Case report*

    Science.gov (United States)

    Fernandes, Tania Rita Moreno de Oliveira; dos Santos, Talita Suzany Siqueira; Lopes, Ramon Rodrigues de Macedo

    2016-01-01

    In Brazil, leprosy is a widespread infectious and contagious disease. Clinicians and specialists view leprosy broadly as a systemic infection, since, in its manifestations, it mimics many conditions, such as rheumatic, vascular, ENT, neurological and dermatological diseases. There are few studies that characterize the factors associated with ulcers in leprosy. These injuries should be prevented and treated promptly to avoid serious problems like secondary infections, sepsis, carcinomatous degeneration and amputations. We describe a patient with ulcers on his legs, involving late diagnosis of lepromatous leprosy. PMID:27828650

  19. BCG and Adverse Events in the Context of Leprosy

    Directory of Open Access Journals (Sweden)

    Renate Richardus

    2018-04-01

    Full Text Available BackgroundNotwithstanding its beneficial immunoprophylactic outcomes regarding leprosy and childhood TB, BCG vaccination may cause adverse events, particularly of the skin. However, this local hyper-immune reactivity cannot be predicted before vaccination, nor is its association with protection against leprosy known. In this study we investigated the occurrence of adverse events after BCG (revaccination in contacts of leprosy patients and analyzed whether the concomitant systemic anti-mycobacterial immunity was associated with these skin manifestations.MethodsWithin a randomized controlled BCG vaccination trial in Bangladesh, 14,828 contacts of newly diagnosed leprosy patients received BCG vaccination between 2012 and 2017 and were examined for adverse events 8 to 12 weeks post-vaccination. From a selection of vaccinated contacts, venous blood was obtained at follow-up examination and stimulated with Mycobacterium leprae (M. leprae antigens in overnight whole-blood assays (WBA. M. leprae phenolic glycolipid-I-specific antibodies and 32 cytokines were determined in WBAs of 13 individuals with and 13 individuals without adverse events after vaccination.ResultsOut of the 14,828 contacts who received BCG vaccination, 50 (0.34% presented with adverse events, mainly (80% consisting of skin ulcers. Based on the presence of BCG scars, 30 of these contacts (60% had received BCG in this study as a booster vaccination. Similar to the pathological T-cell immunity observed for tuberculoid leprosy patients, contacts with adverse events at the site of BCG vaccination showed elevated IFN-γ levels in response to M. leprae-specific proteins in WBA. However, decreased levels of sCD40L in serum and GRO (CXCL1 in response to M. leprae simultaneously indicated less T-cell regulation in these individuals, potentially causing uncontrolled T-cell immunity damaging the skin.ConclusionSkin complications after BCG vaccination present surrogate markers for protective

  20. Leprosy mimicry of lupus vulgaris and misdiagnosis of leprosy--a case report.

    Science.gov (United States)

    Mandal, B C; Bandyopadhyay, G

    2012-01-01

    Leprosy and tuberculosis (TB) both are still rampant in India. Leprosy predominantly presents through skin manifestations whereas cutaneous manifestations of TB though not so frequent but are not rare. Lupus vulgaris (LV), the commonest of all cutaneous manifestations of TB, mimics leprosy very closely and may prompt the examiner to misdiagnose leprosy, especially, by health workers (HW), in a field situation, where leprosy is diagnosed and treated on clinical basis alone as per NLEP guidelines. Because of existing stigmata, such wrong diagnosis can put the patient and the party under psychological stress and creates unnecessary complications.

  1. Integrative literature review of the reported uses of serological tests in leprosy management

    Directory of Open Access Journals (Sweden)

    Angélica da Conceição Oliveira Coelho Fabri

    2016-04-01

    Full Text Available Abstract: An integrative literature review was conducted to synthesize available publications regarding the potential use of serological tests in leprosy programs. We searched the databases Literatura Latino-Americana e do Caribe em Ciências da Saúde, Índice Bibliográfico Espanhol em Ciências da Saúde, Acervo da Biblioteca da Organização Pan-Americana da Saúde, Medical Literature Analysis and Retrieval System Online, Hanseníase, National Library of Medicine, Scopus, Ovid, Cinahl, and Web of Science for articles investigating the use of serological tests for antibodies against phenolic glycolipid-I (PGL-I, ML0405, ML2331, leprosy IDRI diagnostic-1 (LID-1, and natural disaccharide octyl-leprosy IDRI diagnostic-1 (NDO-LID. From an initial pool of 3.514 articles, 40 full-length articles fulfilled our inclusion criteria. Based on these papers, we concluded that these antibodies can be used to assist in diagnosing leprosy, detecting neuritis, monitoring therapeutic efficacy, and monitoring household contacts or at-risk populations in leprosy-endemic areas. Thus, available data suggest that serological tests could contribute substantially to leprosy management.

  2. Understanding the stigma of leprosy | Luka | South Sudan Medical ...

    African Journals Online (AJOL)

    Leprosy is the oldest disease known to man. The earliest written records describing true leprosy came from India around the period 600 BC. Leprosy is caused by Mycobacterium leprae; the Norwegian, Dr Amauer Hansen, isolated the bacterium in 1873. Leprosy is also called Hansen's disease after him. Although it is the ...

  3. Dermatologic Diseases in School Going Children of Parents Having Leprosy

    Directory of Open Access Journals (Sweden)

    J S Pasricha

    1986-01-01

    Full Text Available All the 138 school children whose parent (s had leprosy were examined for leprosy or other dermatological disease. BT leprosy was detected in one child, while in 2 other cases, the diagnosis of leprosy was doubtful. Among the other dermatological diseases. the prevalence of pityriasis versicolor and pediculosis capitis was high.

  4. Coinfection of leprosy and tuberculosis.

    Science.gov (United States)

    Shetty, Seema; Umakanth, Shashikiran; Manandhar, Bhawani; Nepali, Pankaj Bahadur

    2018-03-15

    Leprosy and tuberculosis (TB) are endemic to India, however, their coinfection is not frequently encountered in clinical practice. Here, we report a 32-year-old female patient who presented with a history of high-grade intermittent fever, cough and painless skin lesions since a month, along with bilateral claw hand (on examination). The haematological profile was suggestive of anaemia of chronic disease, chest radiograph showed consolidation, sputum smears were positive for Mycobacterium tuberculosis, and skin slit smear confirmed leprosy. The patient was prescribed WHO recommended multidrug therapy for multibacillary leprosy with three drugs. Additionally, prednisolone was added to her regimen for 2 weeks to treat the type 2 lepra reaction. For treatment of TB, she was placed on the standard 6-month short course chemotherapy. She was lost to follow-up, and attempts were made to contact her. Later, it came to our notice that she had discontinued medications and passed away 3 months after diagnosis. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  5. Human Immunodeficiency Virus and Leprosy Coinfection: Challenges in Resource-Limited Setups

    Directory of Open Access Journals (Sweden)

    Charles M. Kwobah

    2012-01-01

    Full Text Available Mycobacteria leprae(leprosy and HIV coinfection are rare in Kenya. This is likely related to the low prevalence (1 per 10,000 of population of leprosy. Because leprosy is no longer a public health challenge there is generally a low index of suspicion amongst clinicians for its diagnosis. Management of a HIV-1-leprosy-coinfected individual in a resource-constrained setting is challenging. Some of these challenges include difficulties in establishing a diagnosis of leprosy; the high pill burden of cotreatment with both antileprosy and antiretroviral drugs (ARVs; medications’ side effects; drug interactions; scarcity of drug choices for both diseases. This challenge is more profound when managing a patient who requires second-line antiretroviral therapy (ART. We present an adult male patient coinfected with HIV and leprosy, who failed first-line antiretroviral therapy (ART and required second-line treatment. Due to limited choices in antileprosy drugs available, the patient received monthly rifampicin and daily lopinavir-/ritonavir-based antileprosy and ART regimens, respectively. Six months into his cotreatment, he seemed to have adequate virological control. This case report highlights the challenges of managing such a patient.

  6. Corticosteroids for treating nerve damage in leprosy

    NARCIS (Netherlands)

    N.H.J. van Veen (Natasja); P.G. Nicholls (Peter); W.C.S. Smith (Cairns); J.H. Richardus (Jan Hendrik)

    2007-01-01

    textabstractBackground: Leprosy causes nerve damage which can result in nerve function impairment and disability. Corticosteroids are commonly used for treating nerve damage, although the long-term effect is uncertain. Objectives: To assess the effects of corticosteroids on nerve damage in leprosy.

  7. Pure neuritic leprosy: Current status and relevance

    Directory of Open Access Journals (Sweden)

    P Narasimha Rao

    2016-01-01

    Full Text Available Pure neuritic leprosy has always been an enigma due to its clinical and management ambiguities. Although only the Indian Association of Leprologist's classification recognizes 'pure neuritic leprosy' as a distinct sub group of leprosy, cases nonetheless are reported from various countries of Asia, Africa, South America and Europe, indicating its global relevance. It is important to maintain pure neuritic leprosy as a subgroup as it constitutes a good percentage of leprosy cases reported from India, which contributes to more than half of global leprosy numbers. Unfortunately, a high proportion of these patients present with Grade 2 disability at the time of initial reporting itself due to the early nerve involvement. Although skin lesions are absent by definition, when skin biopsies were performed from the skin along the distribution of the affected nerve, a proportion of patients demonstrated leprosy pathology, revealing sub-clinical skin involvement. In addition on follow-up, skin lesions are noted to develop in up to 20% of pure neuritic leprosy cases, indicating its progression to manifest cutaneous disease. Over the decades, the confirmation of diagnosis of pure neuritic leprosy has been subjective, however, with the arrival and use of high-resolution ultrasonography (HRUS for nerve imaging, we have a tool not only to objectively measure and record the nerve thickening but also to assess the morphological alterations in the nerve including echo texture, fascicular pattern and vascularity. Management of pure neuritic leprosy requires multidrug therapy along with appropriate dose of systemic corticosteroids, for both acute and silent neuritis. Measures for pain relief, self-care of limbs and physiotherapy are important to prevent as well as manage disabilities in this group of patients.

  8. Scabies Among Elderly Korean Patients with Histories of Leprosy.

    Science.gov (United States)

    Park, Hyungcheol; Lee, Chaeyoung; Park, Seungkyu; Kwon, Hyeon; Kweon, Sun-Seog

    2016-07-06

    A scabies epidemic, traced by the hospital-based surveillance system, was reported in a Korean leprosarium. A total of 200 symptomatic cases were found during 2012-2014 among 570 elderly former leprosy patients. Most of cases were classic type scabies (87%) and aged 75 years and older (72%). Surveillance system for early diagnosis and prompt intervention was applied and the scabies epidemic was controlled effectively in this long-term care facility. © The American Society of Tropical Medicine and Hygiene.

  9. Household costs of leprosy reactions (ENL in rural India.

    Directory of Open Access Journals (Sweden)

    David J Chandler

    2015-01-01

    Full Text Available Erythema nodosum leprosum (ENL is a common immune-mediated complication of lepromatous (LL and borderline lepromatous (BL leprosy. Most patients experience chronic or multiple acute ENL over many years during an economically active period of their lives. Understanding the economic burden of ENL is essential to provide effective patient support, yet this area has not been investigated.Ninety-one patients with LL or BL leprosy attending a leprosy hospital in Purulia district of West Bengal, India, were interviewed using a structured questionnaire. Cases (n = 53 were identified as those who had one or more episodes of ENL within the last 3 years. Controls (n = 38 had LL or BL leprosy but no history of ENL. Data were collected on household income, direct and indirect costs, and coping strategies.The total household cost was Rs 1543 per month or 27.9% (IQR 13.2-52.6 of monthly household income for cases, and Rs 237 per month or 4.9% (IQR 1.7-13.4 of monthly household income for controls. Indirect costs accounted for 65% of total household costs for cases. Direct costs accounted for the remaining 35% of household costs, and resulted almost entirely from treatment-seeking in the private sector. Total household costs exceeded 40% of household income for 37.7% of cases (n = 20 and 2.6% of controls (n = 1 [1 USD = 59 INR].Households affected by ENL face significant economic burden and are at risk of being pushed further into poverty. Health policy should acknowledge the importance of private sector provision and the significant contribution to total household costs of lost productivity (indirect cost. Further work is needed to explore this area and identify solutions.

  10. A relação entre soroprevalência de anticorpos contra o glicolipídeo fenólico-I entre crianças em idade escolar e endemicidade da hanseníase no Brasil The relation between seroprevalence of antibodies against phenolic glycolipid-I among school children and leprosy endemicity in Brazil

    Directory of Open Access Journals (Sweden)

    Samira Bührer-Sékula

    2008-01-01

    Full Text Available Os programas de controle da hanseníase se beneficiariam de um método fácil para estimar prevalência e avaliar o impacto das ações de controle na prevalência da doença. A determinação da soroprevalência de anticorpos contra PGL-I através de estudos com crianças em idade escolar foi sugerida como indicador útil da taxa de prevalência da hanseníase a nível municipal.Para investigar se a soropositividade estaria associada aos coeficientes de detecção da hanseníase e se poderia ser usada como indicador da prevalência em outras áreas, 7.073 crianças em três estados endêmicos de hanseníase no Brasil foram testadas. Resultados mostram uma considerável variação da distribuição de soropositividade nas comunidades, independente do número de casos de hanseníase detectados. A soroprevalência foi significativamente menor nos colégios. Nenhuma diferença na distribuição da soropositividade determinada por ELISA ou dipstick foi observada. Nenhuma correlação entre o coeficiente de detecção da hanseníase e soropositividade pôde ser estabelecida.Leprosy control programs would benefit expressively from an easy method to estimate disease prevalence and to assess the effect of leprosy control measures on disease prevalence. Determination of the seroprevalence of antibodies to PGL-I through school children surveys might be a useful indicator of leprosy prevalence at the district level. To investigate whether seropositivity rates could be related to leprosy detection rates and whether seropositivity could be used as a proximal indicator to predict the leprosy incidence in other areas, 7,073 school children in three different leprosy-endemic states in Brazil were tested. The results show a widely varying distribution of seropositivity in the communities independent of the number of leprosy cases detected. Seroprevalence was significantly lower at private schools. No differences in the patterns of seropositivity between ELISA

  11. Leprosy: International Public Health Policies and Public Health Eras

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    Niyi Awofeso

    2011-09-01

    Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

  12. Leprosy in Southern Brazil: a twenty-year epidemiological profile

    Directory of Open Access Journals (Sweden)

    Ana Paula Nazario

    Full Text Available Abstract INTRODUCTION: This study evaluated leprosy rates in Rio Grande do Sul, an area with a historically low prevalence. However, recent studies are lacking. METHODS: Data extracted from a National Database were analyzed for clinical features and compared to 1980s data. Tendency was assessed via stationarity analysis. RESULTS: Between 1990 and 2011, 4,770 cases were reported (0.21/10,000 inhabitants; 95% CI = 0.19-0.24. Detection was slightly higher among males, 1.9% cases were among children and most multibacillary (74.7% at diagnosis. CONCLUSIONS: Leprosy is controlled in RS, but most cases are multibacillary. Early identification is important to avoid disabilities due to late diagnosis.

  13. CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME IN LEPROSY

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    Dr. Vaibhav Chewoolkar

    2010-01-01

    Full Text Available Catastrophic antiphospholipid syndrome is an acute and life threatening variant of antiphospholipid syndrome with a high mortality rate. Many infections are known to be accompanied by the thrombotic manifestations of this syndrome. We came across a patient of leprosy who developed bowel ischaemia secondary to mesenteric venous thrombosis as a part of catastrophic antiphospholipid syndrome and later on succumbed. We thereby wish to highlight the need for early diagnosis and aggressive treatment of this potentially fatal condition in patients with infections.

  14. Perspective on BVDV control programs.

    Science.gov (United States)

    Givens, M Daniel; Newcomer, Benjamin W

    2015-06-01

    Programs for control and eradication of bovine viral diarrhea virus (BVDV) are often considered prudent when the expense of a control program within a specified time frame effectively prevents loss due to disease and the expense of control does not exceed the costs associated with infection. In some geographic areas, concerns about animal welfare or desires to reduce antibiotic usage may motivate BVDV control even when control programs are associated with a lack of financial return on investment. In other geographic areas, concerns about financial return on investment may be the key motivating factor in considering implementation of BVDV control programs. Past experiences indicate that systematic, well-coordinated control programs have a clear potential for success, while voluntary control programs in cultures of distributed decision-making often result in notable initial progress that ultimately ends in dissolution of efforts. Segmentation of the cattle industry into cow-calf producers, stocker/backgrounders, and feedlot operators amplifies the distribution of decision-making regarding control programs and may result in control measures for one industry segment that are associated with significant costs and limited rewards. Though the host range of BVDV extends well beyond cattle, multiple eradication programs that focus only on testing and removal of persistently infected (PI) cattle have proven to be effective in various countries. While some individuals consider education of producers to be sufficient to stimulate eradication of BVDV, research surrounding the adoption of innovative health care procedures suggests that the process of adopting BVDV control programs has a social element. Collegial interactions and discussions may be crucial in facilitating the systematic implementation necessary to optimize the long-term success of control programs. Compulsory control programs may be considered efficient and effective in some regions; however, in a nation where

  15. Dental caries and risk indicators for patients with leprosy in China.

    Science.gov (United States)

    Guo, Yue; Tian, Li-Li; Zhang, Feng-Yi; Bu, Yan-Hong; Feng, Yun-Zhi; Zhou, Hou-De

    2017-02-01

    In leprosy, oral health is often neglected and poorly understood. This study aimed to evaluate the prevalence and risk indicators of dental caries in patients with leprosy in China. This cross-sectional, multicentre study included 613 patients with leprosy and 602 control subjects. Based on the established standards of the World Health Organization, we investigated dental caries in cluster samplings from six so-called 'leprosy villages' in three Chinese provinces. Clinical oral examinations were performed and data were reported as decayed (D), missing (M) and filled (F) teeth (DMFT scores). The average DMFT scores were 10.39 in patients with leprosy (D = 4.43; M = 5.94; and F = 0.02) and 4.39 in control individuals (D = 2.29; M = 2.02; F = 0.08). The DMFT scores were statistically significantly different in patients with different ages, educational backgrounds and daily brushing frequency (P caries. Effective therapy and oral health education should be enhanced for this group of patients. © 2016 The Authors. International Dental Journal published by John Wiley & Sons Ltd on behalf of World Dental Federation.

  16. Hypopigmented macules: leprosy, atopy or pityriasis versicolor?

    Science.gov (United States)

    Massone, C; Cavalchini, A; Clapasson, A; Nunzi, E

    2010-12-01

    Lepromatous leprosy (LL) represents the highest infective and multibacillary form of leprosy. Clinical manifestations are consequent to the haematogenous spread of bacilli and include macules, plaques and nodules in a symmetric distribution or a diffuse infiltration of the skin. LL may mimic many different inflammatory and neoplastic skin diseases and in a small percentage of patients, skin manifestation may be atypical. This article reports the case of a South American child with LL presenting with symmetrically distributed hypopigmented macules previously misdiagnosed as pytiriasis alba, atopic dermatitis and pityriasis versicolor. Atopy and pityriasis versicolor are common skin conditions that can be also observed in leprosy patients and that can masquerade the diagnosis of LL, especially if occurring in dark skin. Dermatologists in Europe should be aware of this unusual form of presentation of leprosy and must take in mind Hansen disease in the differential diagnosis in patients coming from endemic areas.

  17. Socioeconomic benefit to individuals of achieving 2020 targets for four neglected tropical diseases controlled/eliminated by innovative and intensified disease management: Human African trypanosomiasis, leprosy, visceral leishmaniasis, Chagas disease.

    Science.gov (United States)

    Lenk, Edeltraud J; Redekop, William K; Luyendijk, Marianne; Fitzpatrick, Christopher; Niessen, Louis; Stolk, Wilma A; Tediosi, Fabrizio; Rijnsburger, Adriana J; Bakker, Roel; Hontelez, Jan A C; Richardus, Jan H; Jacobson, Julie; Le Rutte, Epke A; de Vlas, Sake J; Severens, Johan L

    2018-03-01

    The control or elimination of neglected tropical diseases (NTDs) has targets defined by the WHO for 2020, reinforced by the 2012 London Declaration. We estimated the economic impact to individuals of meeting these targets for human African trypanosomiasis, leprosy, visceral leishmaniasis and Chagas disease, NTDs controlled or eliminated by innovative and intensified disease management (IDM). A systematic literature review identified information on productivity loss and out-of-pocket payments (OPPs) related to these NTDs, which were combined with projections of the number of people suffering from each NTD, country and year for 2011-2020 and 2021-2030. The ideal scenario in which the WHO's 2020 targets are met was compared with a counterfactual scenario that assumed the situation of 1990 stayed unaltered. Economic benefit equaled the difference between the two scenarios. Values are reported in 2005 US$, purchasing power parity-adjusted, discounted at 3% per annum from 2010. Probabilistic sensitivity analyses were used to quantify the degree of uncertainty around the base-case impact estimate. The total global productivity gained for the four IDM-NTDs was I$ 23.1 (I$ 15.9 -I$ 34.0) billion in 2011-2020 and I$ 35.9 (I$ 25.0 -I$ 51.9) billion in 2021-2030 (2.5th and 97.5th percentiles in brackets), corresponding to US$ 10.7 billion (US$ 7.4 -US$ 15.7) and US$ 16.6 billion (US$ 11.6 -US$ 24.0). Reduction in OPPs was I$ 14 billion (US$ 6.7 billion) and I$ 18 billion (US$ 10.4 billion) for the same periods. We faced important limitations to our work, such as finding no OPPs for leprosy. We had to combine limited data from various sources, heterogeneous background, and of variable quality. Nevertheless, based on conservative assumptions and subsequent uncertainty analyses, we estimate that the benefits of achieving the targets are considerable. Under plausible scenarios, the economic benefits far exceed the necessary investments by endemic country governments and their

  18. PROTEIN OXIDATION AND ANTIOXIDANT VITAMINS IN LEPROSY

    OpenAIRE

    Sunita Girish

    2011-01-01

    Methods: Total 30 leprosy cases were studied. Patients were subjected to various tests like, serum protein carbonyl as an index of protein oxidation, while serum Vitamin C and Vitamin E levels as endogenous antioxidants.Aims The presence of carbonyl groups in proteins has been used as a marker of ROS-mediated protein oxidation. The present work was undertaken to study the importance of endogenous antioxidants like Vitamin C and vitamin E in different types of leprosy patients.Results: An i...

  19. Walking Machine Control Programming

    Science.gov (United States)

    1983-08-31

    ANECDOTE #1: Students at Carnegie-Mellon University have named the machine "The Trojan Cockroach ." BACKGROUND This paper is about the operational...motion in a pair of smaall plastic tubes. The fluid connection transmits the commands to the pumps, returns the control loading forces to the driver...takes a full minute might better be described otherwise, and offered the following eight lines: The Trojan Cockroach fliggledy Piggledy Ivan E

  20. Current status of the Citrus leprosis virus (CiLV -C and its vector Brevipalpus phoenicis (Geijskes

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    Guillermo León M

    2012-08-01

    Full Text Available The Citrus leprosis virus CiLV-C is a quarantine disease of economic importance. Over the past 15 years, this disease has spread to several countries of Central and South America. Colombia has about 45,000 hectares of citrus planted with an annual production of 750,000 tonnes. The CiLV-C has only been detected in the departments of Meta, Casanare and recently Tolima. Meta has 4,300 hectares representing 10% of the national cultivated area, and Casanare, where CiLV-C appeared in 2004, has no more than 500 ha planted with citrus. The presence of the Citrus leprosis virus in Colombia could affect the international market for citrus, other crops and ornamental plants with the United States and other countries without the disease. The false spider mite Brevipalpus phoenicis (Geijskes (Acari: Tenuipalpidae is the main vector of the CiLV-C. Disease management is based on control programs of the vector and diminishing host plants. Chemical mite control is expensive, wasteful and generates resistance to different acaricides. This paper provides basic information on CiLV-C and its vector, advances in diagnosis and methods to control the disease and prevention of its spread

  1. Leprosy in Buriticupu, state of Maranhão: active search in the general population

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    Antonio Rafael da Silva

    2012-04-01

    Full Text Available INTRODUCTION: This study was developed to evaluate the situation of leprosy in the general population of the municipality of Buriticupu, State of Maranhão, Brazil. METHODS: We used the method of active search to identify new cases from 2008 to 2010. Bacilloscopy of intradermal scrapings was performed in all patients with skin lesions compatible with leprosy, and histopathological examination in those who had doubts on the definition of the clinical form. RESULTS: The study included 19,104 individuals, with 42 patients diagnosed with leprosy after clinical examination, representing a detection rate of 219.84 per 100,000 inhabitants. The predominant clinical presentation was tuberculoid with 24 (57.1% cases, followed by borderline with 11, indeterminate with four, and lepromatous with three cases. The study also allowed the identification of 81 patients with a history of leprosy and other skin diseases, such as pityriasis versicolor, dermatophytosis, scabies, vitiligo, and skin carcinoma. The binomial test showed that the proportion of cases in the headquarters was significantly higher than that in the villages (p = 0.04, and the generalized exact test showed that there was no association between age and clinical form (p = 0.438 and between age and gender (p = 0.083. CONCLUSIONS: The elevated detection rate defines the city as hyperendemic for leprosy; the active search for cases, as well as the organization of health services, is an important method for disease control.

  2. national jalma institute for leprosy & other mycobacterial diseases

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. NATIONAL JALMA INSTITUTE FOR LEPROSY & OTHER MYCOBACTERIAL DISEASES : MAJOR THRUST AREAS. LEPROSY : Understanding the disease better using electrophysiological, immunological, molecular and electron-microscopic tools. Developing better ...

  3. AEC controlled area safety program

    International Nuclear Information System (INIS)

    Hendricks, D.W.

    1969-01-01

    The detonation of underground nuclear explosives and the subsequent data recovery efforts require a comprehensive pre- and post-detonation safety program for workers within the controlled area. The general personnel monitoring and environmental surveillance program at the Nevada Test Site are presented. Some of the more unusual health-physics aspects involved in the operation of this program are also discussed. The application of experience gained at the Nevada Test Site is illustrated by description of the on-site operational and safety programs established for Project Gasbuggy. (author)

  4. Primary neural leprosy: systematic review

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    Jose Antonio Garbino

    2013-06-01

    Full Text Available The authors proposed a systematic review on the current concepts of primary neural leprosy by consulting the following online databases: MEDLINE, Lilacs/SciELO, and Embase. Selected studies were classified based on the degree of recommendation and levels of scientific evidence according to the “Oxford Centre for Evidence-based Medicine”. The following aspects were reviewed: cutaneous clinical and laboratorial investigations, i.e. skin clinical exam, smears, and biopsy, and Mitsuda's reaction; neurological investigation (anamnesis, electromyography and nerve biopsy; serological investigation and molecular testing, i.e. serological testing for the detection of the phenolic glycolipid 1 (PGL-I and the polymerase chain reaction (PCR; and treatment (classification criteria for the definition of specific treatment, steroid treatment, and cure criteria.

  5. Differential Expression of MicroRNAs in Leprosy Skin Lesions

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    Cleverson T. Soares

    2017-08-01

    Full Text Available Leprosy, a chronic infectious disease caused by Mycobacterium leprae, is a major public health problem in poor and developing countries of the Americas, Africa, and Asia. MicroRNAs (miRNAs, which are small non-coding RNAs (18–24 nucleotides, play an important role in regulating cell and tissue homeostasis through translational downregulation of messenger RNAs (mRNAs. Deregulation of miRNA expression is important for the pathogenesis of various neoplastic and non-neoplastic diseases and has been the focus of many publications; however, studies on the expression of miRNAs in leprosy are rare. Herein, an extensive evaluation of differentially expressed miRNAs was performed on leprosy skin lesions using microarrays. Leprosy patients, classified according to Ridley and Jopling’s classification or reactional states (R1 and R2, and healthy controls (HCs were included. Punch biopsies were collected from the borders of leprosy lesions (10 tuberculoid, 10 borderline tuberculoid, 10 borderline borderline, 10 borderline lepromatous, 4 lepromatous, 14 R1, and 9 R2 and from 9 HCs. miRNA expression profiles were obtained using the Agilent Microarray platform with miRBase, which consists of 1,368 Homo sapiens (hsa-miRNA candidates. TaqMan quantitative real-time reverse transcription polymerase chain reaction (RT-PCR was used to validate differentially expressed miRNAs. Sixty-four differentially expressed miRNAs, including 50 upregulated and 14 downregulated (fold change ≥2.0, p-value ≤ 0.05 were identified after comparing samples from patients to those of controls. Twenty differentially expressed miRNAs were identified exclusively in the reactional samples (14 type 1 and 6 type 2. Eight miRNAs were validated by RT-PCR, including seven upregulated (hsa-miR-142-3p, hsa-miR-142-5p, hsa-miR-146b-5p, hsa-miR-342-3p, hsa-miR-361-3p, hsa-miR-3653, and hsa-miR-484 and one downregulated (hsa-miR-1290. These miRNAs were differentially expressed in leprosy and

  6. Leprosy Sufferers' Perception Of Social Stigma As A Determinant Of ...

    African Journals Online (AJOL)

    This study aimed at relating leprosy sufferers perception of social stigma to their lifestyles. Eighty leprosy affected persons comprising males and females drawn from Delta State Government Tuberculosis and Leprosy Referral Center participated in this study. A focus group discussion schedule containing information about ...

  7. Leprosy and the eye a review of epidemiology, pathogenesis, ocular ...

    African Journals Online (AJOL)

    Objectives: 1. To update knowledge on the current trends in the epidemiology, pathogenesis, and treatment of leprosy 2. To highlight the ocular complications associated with leprosy. Methodology:Current literature on various aspects of leprosy research obtained from the Internet and supplemented by available journals ...

  8. QUALITY OF LIFE, PERCEIVED STIGMA, ACTIVITY AND PARTICIPATION OF PEOPLE WITH LEPROSY-RELATED DISABILITIES IN SOUTH-EAST NEPAL

    Directory of Open Access Journals (Sweden)

    Huib Cornielje

    2011-05-01

    Full Text Available In Nepal, many people live with leprosy-related disabilities. The objective of this study was to evaluate differences in socio-economic characteristics, quality of life (QOL, perceived stigma, activity and participation among people affected by leprosy as a group and between this group and the general population, and to identify prime determinants of QOL among the leprosy-affected people. People with leprosy-related disabilities (N=100; 54DGI/46DGII and community controls (N=100 were selected from Morang district, South-East Nepal, using quota sampling. QOL, perceived stigma and participation and activity limitations were measured using the Nepali abbreviated version of the World Health Organisation Quality of Life (WHOQOL assessment and the Nepali versions of the Jacoby Scale, Participation Scale and Green Pastures Activity Scale (GPAS, respectively. Total QOL, participation and activity levels of people affected by leprosy were worse than those of the general population. Regression analysis showed that the ability to maintain a family, satisfaction with health, vocational training, sex, activity and participation limitations (the latter for QOL only, perceived stigma and living situation (i.e. joint family, type of house were significantly associated with a deterioration in QOL and higher participation restriction in one or both of the grading groups. There is an urgent need for interventions focused on quick referral of people with leprosy, to minimize the development of visible impairments, and social rehabilitation. The latter can be achieved by creating more public awareness, providing (financial support for income generating projects and /or vocational training to leprosy- affected people, and by encouraging them to be involved in all community development activities. The current results indicate that such measures would help improve the quality of life of people with leprosy-related disabilities.DOI 10.5463/DCID.v22i1.15

  9. Impact of PGL-I seropositivity on the protective effect of BCG vaccination among leprosy contacts: a cohort study.

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    Nádia C Düppre

    Full Text Available BACKGROUND: Contacts of leprosy patients are at increased risk of developing leprosy and need to be targeted for early diagnosis. Seropositivity to the phenolic glycolipid I (PGL-I antigen of Mycobacterium leprae has been used to identify contacts who have an increased risk of developing leprosy. In the present study, we studied the effect of seropositivity in patient contacts, on the risk of developing leprosy, stratified by Bacille Calmette Guerin (BCG vaccination after index case diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: Leprosy contacts were examined as part of the surveillance programme of the Oswaldo Cruz Institute Leprosy Outpatient Clinic in Rio de Janeiro. Demographic, social, epidemiological and clinical data were collected. The presence of IgM antibodies to PGL-I in sera and BCG vaccination status at the time of index case diagnosis were evaluated in 2,135 contacts. During follow-up, 60 (2.8%; 60/2,135 leprosy cases were diagnosed: 41 among the 1,793 PGL-I-negative contacts and 19 among the 342 PGL-I-positive contacts. Among PGL-I-positive contacts, BCG vaccination after index case diagnosis increased the adjusted rate of developing clinical manifestations of leprosy (Adjusted Rate Ratio (aRR = 4.1; 95% CI: 1.8-8.2 compared with the PGL-I-positive unvaccinated contacts (aRR = 3.2; 95% CI: 1.2-8.1. The incidence density was highest during the first year of follow-up for the PGL-I-positive vaccinated contacts. However, all of those contacts developed PB leprosy, whereas most MB cases (4/6 occurred in PGL-I-positive unvaccinated contacts. CONCLUSION: Contact examination combined with PGL-I testing and BCG vaccination remain important strategies for leprosy control. The finding that rates of leprosy cases were highest among seropositive contacts justifies targeting this specific group for close monitoring. Furthermore, it is recommended that PGL-I-positive contacts and contacts with a high familial bacteriological index

  10. Health-related quality of life, depression, and self-esteem in adolescents with leprosy-affected parents: results of a cross-sectional study in Nepal

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    Yamaguchi Nobuko

    2013-01-01

    parents were unaffected by leprosy. Thus, mental health support programs might be necessary for adolescents with leprosy-affected parents, particularly for adolescents where both parents are leprosy-affected. Further studies with larger sample sizes are necessary to draw decisive conclusions.

  11. Health-related quality of life, depression, and self-esteem in adolescents with leprosy-affected parents: results of a cross-sectional study in Nepal.

    Science.gov (United States)

    Yamaguchi, Nobuko; Poudel, Krishna C; Jimba, Masamine

    2013-01-10

    programs might be necessary for adolescents with leprosy-affected parents, particularly for adolescents where both parents are leprosy-affected. Further studies with larger sample sizes are necessary to draw decisive conclusions.

  12. Leprosy of the Larynx: A Case Report

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    Mansoureh Momen Heravi

    2009-12-01

    Full Text Available Leprosy is an ancient deforming disease caused by Mycobacterium leprae, which is still poorly understood and often feared by the general public and even by some in the health care professions Fortunately, the outlook for patients has dramatically improved over the last three decades with the introduction of multi-drug treatment and management strategies that have somewhat diminished the stigma of this diagnosis. We report a rare case of leprosy of larynx. A 45 year old man presented with complaints cough, dyspnea and hoarseness since many years ago. Because of demonstration of acid fast bacilli in smear of his sputum, the diagnosis of tuberculosis was made and anti tuberculosis treatment was initiated. But he developed fever and his symptoms exacerbated. In examination there was a tender erythematous nodule on right supraclavicular region, loss of eyebrows and lashes and disseminated hyper and hypo pigmented cutaneous lesions on abdomen, thorax, back with normal chest x ray. Laryngoscopy to rule out laryngeal tuberculosis was done and granulomatous lesion was seen. Laryngeal and skin biopsy was performed which numerous acid fast bacilli, macrophages and foamy cells suggestive of lepromatous leprosy were demonstrated in both specimens. Treatment was started on multi bacillary regime of WHO multidrug therapy. In conclusion, this report highlights the importance of systemic involvement in lepromatous leprosy especially when the initial presentation is laryngitis or respiratory symptoms. Laryngeal leprosy may mistaken with tuberculosis laryngitis due to respiratory problems and existence of acid fast bacilli in respiratory secretions.

  13. Stigma in leprosy: concepts, causes and determinants.

    Science.gov (United States)

    Sermrittirong, Silatham; Van Brakel, Wim H

    2014-03-01

    Leprosy is a chronic infectious disease that has stigmatised people affected since ancient times until now. This has resulted in difficulties in the lives of those affected. This literature review was conducted to understand the concept, causes, and determinants of stigma in leprosy. Electronic searches were undertaken using PubMed (Medline), CINAHL and PsycInfo databases. The internet was searched through Google Scholar for papers not found in these databases. The main inclusion criteria were papers related to stigma or leprosy written in Thai or English. After searching the databases, 84 papers were identified, 3 were removed because of duplication and parallel publication, and 20 were removed on abstract screening. After reading 61 full papers, 7 were excluded. Finally, 54 were included in this review. It was found that the concept of stigma involves not only characteristics considered undesirable, but also the social context of the individual or group. Reported causes and determinants of stigma related to leprosy are the external manifestations of the disease, cultural and religious beliefs, fear of transmission, association with people considered inferior and public health-related interventions. Stigma is a complex phenomenon that has multiple causes, often linked to the cultural context in which it occurs. Despite this, many similarities were found in leprosy-related stigma across countries and cultures, which would facilitate the development of interventions.

  14. National sample survey to assess the new case disease burden of leprosy in India

    Directory of Open Access Journals (Sweden)

    Kiran Katoch

    2017-01-01

    Full Text Available A national sample survey of leprosy was undertaken in partnership with Indian Council of Medical Research (ICMR institutions, National Leprosy Eradication Programme (NLEP, Panchayati Raj members, and treated leprosy patients to detect new cases of leprosy in India. The objectives of the survey were to estimate the new leprosy case load; record both Grade 1 and Grade 2 disabilities in the new cases; and to assess the magnitude of stigma and discrimination prevalent in the society. A cluster based, cross-sectional survey involving all States was used for the door-to-door survey using inverse sampling methodology. Rural and urban clusters were sampled separately. The population screened for detecting 28 new cases in rural and 30 in urban clusters was enumerated, recorded and analyzed. Data capture and analysis in different schedules were the main tools used. For quality control three tiers of experts were utilized for the confirmation of cases and disabilities. Self-stigma was assessed in more than half of the total new patients detected with disabilities by the approved questionnaire. A different questionnaire was used to assess the stigma in the community. A population of 14,725,525 (10,302,443 rural; 4,423,082 urban was screened and 2161 new cases - 1300 paucibacillary (PB and 861 multibacillary (MB were detected. New case estimates for leprosy was 330,346 (95% Confidence limits, 287,445-380,851. Disabilities observed in these cases were 2.05/100,000 population and 13.9 per cent (302/2161 in new cases. Self-stigma in patients with disabilities was reduced, and the patients were well accepted by the spouse, neighbour, at workplace and in social functions.

  15. Genetic variants of the MAVS, MITA and MFN2 genes are not associated with leprosy in Han Chinese from Southwest China.

    Science.gov (United States)

    Wang, Dong; Li, Guo-Dong; Zhang, Deng-Feng; Xu, Ling; Li, Xiao-An; Yu, Xiu-Feng; Long, Heng; Li, Yu-Ye; Yao, Yong-Gang

    2016-11-01

    Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae), which has massive genomic decay and dependence on host metabolism. Accumulating evidence showed a crucial role of mitochondria in metabolism and innate immunity. We hypothesized that the mitochondrial-related antimicrobial/antiviral immune genes MAVS (mitochondrial antiviral signaling protein), MITA (mediator of IRF3 activation) and MFN2 (mitofusin 2) would confer a risk to leprosy. In this study, we performed a case-control study to analyze 11 tag and/or non-synonymous SNPs of the MAVS, MITA and MFN2 genes in 527 leprosy patients and 583 healthy individuals, and directly sequenced the three genes in 80 leprosy patients with a family history from Yunnan, Southwest China. We found no association between these SNPs and leprosy (including its subtypes) based on the frequencies of alleles, genotypes and haplotypes between the cases and controls. There was also no enrichment of potential pathogenic variants of the three genes in leprosy patients. Our results suggested that genetic variants of the MAVS, MITA and MFN2 genes might not affect the susceptibility to leprosy. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Schleswig: medieval leprosy on the boundary between Germany and Denmark.

    Science.gov (United States)

    Boldsen, Jesper L; Rasmussen, Kaare Lund; Riis, Thomas; Dittmar, Manuela; Weise, Svenja

    2013-01-01

    Leprosy was a well-recognized and dreaded disease in medieval Europe. The disease is reported to have reached Germany with the Roman invasion and it was present in Scandinavia in the first centuries AD. This paper estimates and analyzes the frequency of leprosy among adult people buried in one of five medieval cemeteries in the city of Schleswig. Seven different dichotomous osteological lesions indicative of leprosy were analyzed, and it was possible to score at least one of these conditions on 350 adult skeletons (aged 15 or older). The scores were transformed to a statistic indicating the likelihood that the person to whom the skeleton belonged suffered from leprosy. It was found that the frequency of leprosy in the five cemeteries varied between 9 and 44%. Four of the five cemeteries showed frequencies ranging from 35 and 44% and with no statistically significant differences among them. The fifth cemetery showed a significantly lower frequency of leprosy (9%). The distribution of female age at death does not appear to be affected by leprosy status. This means that females experienced a considerably elevated risk of dying once they had contracted leprosy as the disease usually has a mid-adulthood age of onset. In four of the five cemeteries males with leprosy died in higher ages than men without leprosy--in two of the cemeteries the difference was statistically significant. This indicates that leprosy usually added less to the risk of dying among men than among women in medieval Schleswig.

  17. Salmonella Control Programs in Denmark

    DEFF Research Database (Denmark)

    Wegener, Henrik Caspar; Hald, Tine; Wong, Danilo Lo Fo

    2003-01-01

    We describe Salmonella control programs of broiler chickens, layer hens, and pigs in Denmark. Major reductions in the incidence of foodborne human salmonellosis have occurred by integrated control of farms and food processing plants. Disease control has been achieved by monitoring the herds...... and flocks, eliminating infected animals, and diversifying animals (animals and products are processed differently depending on Salmonella status) and animal food products according to the determined risk. In 2001, the Danish society saved U.S.$25.5 million by controlling Salmonella. The total annual...... Salmonella control costs in year 2001 were U.S.$14.1 million (U.S.$0.075/kg of pork and U.S.$0.02/kg of broiler or egg). These costs are paid almost exclusively by the industry. The control principles described are applicable to most industrialized countries with modern intensive farming systems....

  18. Interventions for skin changes caused by nerve damage in leprosy.

    Science.gov (United States)

    Reinar, Liv Merete; Forsetlund, Louise; Bjørndal, Arild; Lockwood, Diana

    2008-07-16

    More than three million persons are disabled by leprosy worldwide. The main complication of sensory nerve damage is neuropathic ulceration, particularly of the feet. In this review we explored interventions that can prevent and treat secondary damage to skin and limbs. To assess the effects of self-care, dressings and footwear in preventing and healing secondary damage to the skin in persons affected by leprosy. We searched the Cochrane Skin Group Specialised Register (April 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2008), MEDLINE (from 2003 to April 2008), EMBASE (from 2005 to April 2008), CINAHL (1982-2006) and LILACS (1982- April 2008 ) as well as online registers of ongoing trials (April 2008). Randomised controlled trials involving anyone with leprosy and damage to peripheral nerves treated with any measures designed to prevent damage with the aim of healing existing ulcers and preventing development of new ulcers. Two authors assessed trial quality and extracted data. Eight trials with a total of 557 participants were included. The quality of the trials was generally poor. The interventions and outcome measures were diverse. Although three studies that compared zinc tape to more traditional dressings found some benefit, none of these showed a statistically significant effect. One trial indicated that topical ketanserin had a better effect on wound healing than clioquinol cream or zinc paste, RR was 6.00 (95% CI 1.45 to 24.75). We did not combine the results of the two studies that compared topical phenytoin to saline dressing, but both studies found statistically significant effects in favour of phenytoin for healing of ulcer (SMD -2.34; 95% CI -3.30 to -1.39; and SMD -0.79; 95% CI -1.20 to 0.39). Canvas shoes were not much better than PVC-boots, and double rocker shoes did not promote healing much more than below-knee plasters. One study suggested that topical ketanserin is more effective than clioquinol cream

  19. EFFICIENCY OF NEEM OIL ON CITRUS LEPROSIS MITE Brevipalpus phoenicis (GEIJSKES, 1939 CONTROL EFICIÊNCIA DO ÓLEO DE NEEM NO CONTROLE DO ÁCARO DA LEPROSE DOS CITROS Brevipalpus phoenicis (GEIJSKES, 1939

    Directory of Open Access Journals (Sweden)

    Cleber Daniel de Goes Maciel

    2009-01-01

    -bidi-language:#0400;}

    In order to determine the efficiency of neem oil on citrus leprosis mite, Brevipalpus phoenicis (Geijskes, control, a laboratory test was conducted in Jaboticabal, São Paulo State, Brazil, using a completely randomized design, with six treatments and six repetitions. Each plot was formed by one orange fruit (Pêra Rio variety. An area with 4 cm of diameter was delimited in each fruit, using Tanglefoot® adhesive. The methodology consisted in submerging each fruit of each treatment in the solution prepared with neem oil (Nim-I-Go®, with 0.5%, 1.0%, 1.5%, and 2.0% v/v; cyhexatin, with 0.025% v/v; and a check submerged in water. After 30 minutes of submersion, eight mites were placed in each fruit and evaluations were made after 24, 48, and 72 hours, determining the mite survival, mortality rate, and mites adhered to the glue. It was found that neem oil, at 1.5% v/v, showed high efficiency to control B. phoenicis on orange fruits, also obtaining the largest number of mites adhered to the glue. It may be concluded that, at this concentration, the product showed repellence action. Under laboratory conditions, the neem oil was effective for citrus leprosis mite control.

     

    KEY-WORDS: Citrus leprosis mite; Azadirachta indica.

  1. Effect of nigella sativa on IL-10 in MB leprosy that received MDT-WHO therapy

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    Febrina Primasanti

    2016-07-01

    Full Text Available Background: Leprosy, a chronic infectious disease presents a broad clinical spectrum that is correlated with the immunological response of the patient, mainly related to Th1/Th2 cells. IL-10 is a major cytokine produced by Th2 cells inhibits imunostimulatory cytokine produced by Th1 cells. Suppressive effects of IL-10 in monocytes and cytokine synthesis by Th1 cells presumably because IL-10 has a general suppressive effect on immune function. Nigella sativa has a potent potentiating effect on cellular immunity through suppression of Th2 cells and IL-10, resulting in potentiation of Th1 cells. Method: The study design is a randomized pretest and posttest controlled design involving 40 subjects of MB leprosy patients. Serum levels of IL-10 were measured by ELISA. Result: The mean decrease in serum levels of IL-10 (IL-10 delta in the treatment group (average fell 3.12 pg/ml is greater than the control group (average rose 0.21 pg/ml, where the difference is statistically significant (p = 0.029. Nigella sativa giving significant correlation with a decrease in IL-10 compared to the control group (p=0.044, OR: 10.23. Conclusion: supplementation of Nigella sativa 3 x 1000 mg for 2 months in patients with MB leprosy can reduce levels of IL-10, thus increasing the cellular immune response in patients with MB leprosy.

  2. Leprosy and the adaptation of human toll-like receptor 1.

    Directory of Open Access Journals (Sweden)

    Sunny H Wong

    2010-07-01

    Full Text Available Leprosy is an infectious disease caused by the obligate intracellular pathogen Mycobacterium leprae and remains endemic in many parts of the world. Despite several major studies on susceptibility to leprosy, few genomic loci have been replicated independently. We have conducted an association analysis of more than 1,500 individuals from different case-control and family studies, and observed consistent associations between genetic variants in both TLR1 and the HLA-DRB1/DQA1 regions with susceptibility to leprosy (TLR1 I602S, case-control P = 5.7 x 10(-8, OR = 0.31, 95% CI = 0.20-0.48, and HLA-DQA1 rs1071630, case-control P = 4.9 x 10(-14, OR = 0.43, 95% CI = 0.35-0.54. The effect sizes of these associations suggest that TLR1 and HLA-DRB1/DQA1 are major susceptibility genes in susceptibility to leprosy. Further population differentiation analysis shows that the TLR1 locus is extremely differentiated. The protective dysfunctional 602S allele is rare in Africa but expands to become the dominant allele among individuals of European descent. This supports the hypothesis that this locus may be under selection from mycobacteria or other pathogens that are recognized by TLR1 and its co-receptors. These observations provide insight into the long standing host-pathogen relationship between human and mycobacteria and highlight the key role of the TLR pathway in infectious diseases.

  3. IADC's well control accreditation program

    International Nuclear Information System (INIS)

    Kropla, S.M.

    1997-01-01

    WellCAP is a well control accreditation program devised and implemented by the International Association of Drilling Contractors (IADC). It is a worldwide comprehensive system that defines a well control training curriculum, establishes minimum standards and recommends guidelines for course structure. The program began in mid-1993 and is viewed as a means for training institutions to demonstrate industry recognition to customers, contractors and local governments. Schools can apply to have their courses accredited. The accreditation system is administered by a review panel. The application process requires that the school perform a detailed review of its curriculum and operations and bring them in line with the WellCAP curriculum and accreditation criteria. Currently, more than 75 schools around the world have requested application materials for WellCAP. To date fifteen schools have been fully accredited

  4. Program Baseline Change Control Procedure

    International Nuclear Information System (INIS)

    1993-02-01

    This procedure establishes the responsibilities and process for approving initial issues of and changes to the technical, cost, and schedule baselines, and selected management documents developed by the Office of Civilian Radioactive Waste Management (OCRWM) for the Civilian Radioactive Waste Management System. This procedure implements the OCRWM Baseline Management Plan and DOE Order 4700.1, Chg 1. It streamlines the change control process to enhance integration, accountability, and traceability of Level 0 and Level I decisions through standardized Baseline Change Proposal (BCP) forms to be used by the Level 0, 1, 2, and 3 Baseline Change Control Boards (BCCBs) and to be tracked in the OCRWM-wide Configuration Information System (CIS) Database.This procedure applies to all technical, cost, and schedule baselines controlled by the Energy System Acquisition Advisory Board (ESAAB) BCCB (Level 0) and, OCRWM Program Baseline Control Board (PBCCB) (Level 1). All baseline BCPs initiated by Level 2 or lower BCCBs, which require approval from ESAAB or PBCCB, shall be processed in accordance with this procedure. This procedure also applies to all Program-level management documents controlled by the OCRWM PBCCB

  5. Hepatitis B and C Seroprevalence in Leprosy Patients

    Directory of Open Access Journals (Sweden)

    Türkkan Öztürk Kaygusuz

    2015-09-01

    Full Text Available Objective: Leprosy is a contagious chronic granulomatous disease and commonly affects the eyes and the internal organs. Leprosy can be classified according to the level of immune response. Leprosy is a disease that is associated with defects in cellular immunity. This is why we have investigated the leprosy patients that were referred to our hospital for chronic hepatitis B and C co-infections. Methods: Fifty patients who were treated in the leprosy unit of Elazığ Research and Training hospital between the dates of June-December 2011 were enrolled to this descriptive study. Macro ELISA assay was performed for Hepatitis B,C and HIV. Results: Fifty patients who were treated in the leprosy unit of our hospital participated in the study. A total of 8% HBsAg presence was noted. A total of 16 Anti HCV presence was noted in the patient group. Anti HCV positivity was determined at seven of 14 patients with tuberculoid form leprosy (50% and nine of 33 lepromatous leprosy form (27,2%. Conclusion: In conclusion, leprosy patients, especially lepromatous leprosy group, are immunologically vulnerable to HBV and HCV co-infections. Thus, physicians should be aware of HBV coinfections in these patients and education should be given to patients to increase their knowledge regarding risky situations for transmission of the disease. J Microbiol Infect Dis 2015;5(3: 114-118

  6. Catastrophic antiphospholipid syndrome in leprosy | Chewoolkar ...

    African Journals Online (AJOL)

    Catastrophic antiphospholipid syndrome is an acute and life threatening variant of antiphospholipid syndrome with a high mortality rate. Many infections are known to be accompanied by the thrombotic manifestations of this syndrome. We came across a patient of leprosy who developed bowel ischaemia secondary to ...

  7. Job of the Bible: leprosy or scabies?

    Science.gov (United States)

    Appelboom, Thierry; Cogan, Elie; Klastersky, Jean

    2007-04-01

    Proposing a medical diagnosis a posteriori of a person who died a long time ago is not as impossible as it sounds if sufficient medical history is available.A whole book of the Bible is devoted to Job and his trials. The diagnosis of leprosy has been generally accepted by medieval commentators because the verses of the Book speak of ulcers disseminated over the skin, and also because leprosy is an exemplary sanction imposed by way of example by God to punish those who have committed a sin. In this paper, we have taken the different verses with a medical content from the Book of Job, and reconstructed the clinical picture as if the patient had turned up in the 21st century in order to see if the diagnosis of leprosy may be called into question, and to discuss the limits of the medico-historic approach. The clinical picture of the disease consists of deterioration in the general condition, with widespread pain, confusion, skin eruptions, bilious vomiting, and so on. Under these conditions, if Job did exist, and if the retrospective medical history is reliable, the most likely diagnosis is that of scabies rather than leprosy. Copyright (c) 2007 Mount Sinai School of Medicine.

  8. [Coping with leprosy in the Dutch West Indies in the 19th century; opposing but meaningful views from Suriname].

    Science.gov (United States)

    Menke, Henk; Snelders, Stephen; Pieters, Toine

    2009-01-01

    Leprosy was highly prevalent among African slaves in the Dutch West Indian colony of Suriname. Largely based on observations in Suriname, Dutch physicians described the aetiology of leprosy in terms of'a substrate' to which all sorts of mixtures of infection, heredity and hygiene contributed ('seed and soil'). This explanatory model with multiple options for prevention and treatment left room for different developmental trajectories to control the spread of the disease in the various tropical colonies of the Dutch empire. In Suriname there was a growing worry in the 19th century regarding the spread of leprosy, threatening the health of slaves, settlers and colonial administrators. And this could be harmful to an already weakening plantation economy. This concern prompted the local administration to develop a rigorous policy of strict isolation of leprosy sufferers. This, in turn, intersected with a changing insight in Europe - including the Netherlands - that leprosy was non-contagious. However,'in splendid isolation' in the economically and politically marginal colony Suriname, Dutch physicians like Charles Landre and his son, Charles Louis Drognat Landré, could afford to ignore the European non-contagious approach and continue to support the strict isolation policies. Moreover, they developed a dissident radical explanation of leprosy as a disease caused only by contagion. In the absence of a receptive Dutch audience Drognat Landré published his contagion theory in French and so succeeded in inspiring the Norwegian Hansen, who subsequently discovered the culpable micro-organism. At the same time colonial administrators and physicians in the economically and politically important Dutch colonies in the East Indies adhered to the prevailing European concept and changed policies: the system of isolation was abolished. Given the rather different trajectories of leprosy health policies in the Dutch East and West Indies we point out the importance of a comparative

  9. Begotten of Corruption? Bioarchaeology and "othering" of leprosy in South Asia.

    Science.gov (United States)

    Robbins Schug, Gwen

    2016-12-01

    Leprosy is strongly stigmatized in South Asia, being regarded as a manifestation of extreme levels of spiritual pollution going back through one or more incarnations of the self. Stigma has significant social consequences, including surveillance, exclusion, discipline, control, and punishment; biologically speaking, internalized stigma also compounds the disfigurement and disability resulting from this disease. Stigma results from an othering process whereby difference is recognized, meaning is constituted, and eventually, sufferers may be negatively signified and marked for exclusion. This paper traces the history of leprosy's stigmatization in South Asia, using archaeology and an exegesis of Vedic texts to examine the meaning of this disease from its apparent zero-point-when it first appears but before it was differentiated and signified-in the mature Indus Age. Results suggest that early in the second millennium BCE, leprosy was perceived as treatable and efforts were apparently made to mitigate its impact on the journey to the afterworld. Ignominy to the point of exclusion does not emerge until the first millennium BCE. This paper uses archaeology to create an effective history of stigma for leprosy, destabilizing what is true about this disease and its sufferers in South Asia today. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Association of Taq I, Fok I and Apa I polymorphisms in Vitamin D Receptor (VDR) gene with leprosy.

    Science.gov (United States)

    Neela, Venkata Sanjeev Kumar; Suryadevara, Naveen Chandra; Shinde, Vidya Gouri; Pydi, Satya Sudheer; Jain, Suman; Jonnalagada, Subbanna; Singh, Surya Satyanarayana; Valluri, Vijaya Lakshmi; Anandaraj, M P J S

    2015-06-01

    Vitamin D Receptor (VDR) is a transacting transcription factor which mediates immunomodulatory function and plays a key role in innate and adaptive immune responses through its ligand and polymorphisms in VDR gene may affect its regulatory function. To investigate the association of three VDR gene polymorphisms (TaqI rs731236, FokI rs2228570 and ApaI rs7975232) with leprosy. The study group includes 404 participants of which 222 were leprosy patients (paucibacillary=87, multibacillary=135) and 182 healthy controls. Genotyping was done using PCR-RFLP technique. Statistical analysis was performed using SNP Stats and PLINK software. The VDR FokI (rs2228570) ff genotype, ApaI (rs7975232) AA, Aa genotype and haplotype T-f-a, T-F-A were positively associated with leprosy when compared to healthy controls. The two variants at Fok and Apa positions in VDR gene are significantly associated with leprosy. Genotypes at FokI (ff), ApaI (aa) and haplotype (T-F-a, T-f-a) may contribute to the risk of developing leprosy by altering VDR phenotype/levels subsequently modulation of immune response. Copyright © 2015 American Society for Histocompatibility and Immunogenetics. Published by Elsevier Inc. All rights reserved.

  11. Social acceptance and quality of life of leprosy patient

    Science.gov (United States)

    Eyanoer, P. C.

    2018-03-01

    Some of the leprosy patients facing problems in many aspects such as social, economic, cultural and national security. Both the debilitating effects and disfigurements of leprosy, the society tends to stigmatize negatively those suffering from leprosy. The impact of negative stigma on society causes depression and problems in workplace cause difficulty in patient’s daily life. Neuropathic pain disturbs the quality of life of leprosy patients which could become so severe and significant. The neuropathic pain will lower their productivity which later caused difficulties in finding a job. This study was an analytical observational study to identify the correlation between neuropathic pain and quality of life in Leprosy Hospital of Scanning in Medan Belawan. The result showed that there is a correlation between neuropathic pain and disruption of quality of life (p=0.017). In conclusion, the milder the neuropathic pain experienced by persons with leprosy, the less the quality of life will be disturbed.

  12. Epidemiologic and clinicopathologic aspects of Leprosy in Dakar; evaluation of 73 new cases

    Directory of Open Access Journals (Sweden)

    Suzanne Oumou Niang

    2011-10-01

    Full Text Available Hundreds of new leprosy cases are still diagnosed in Dakar despite all the efforts in the struggle by the national program for elimination of leprosy by the Institute of Applied Leprosy in Dakar. The aim of our study was to evaluate the epidemiological, clinicopathological and outcome of new cases of leprosy. A prospective study was conducted over a period of one year listing all new cases of leprosy based on clinical diagnosis, bacteriology and histology. 73 new cases were recorded. The sex ratio was 1.5 and the mean age of 39.5 years. Children aged from 0 to 15 years old represented 12%. The clinical forms were rated in order of decreasing frequency Borderline 47.94%, 30.13% lepromatous lepromatous, indeterminate 8.21, borderline lepromatous 6.84, TT: 5.47%, 1.36 and neurological bb%. Neurological signs were enlarged nerve in 50 cases, a neurological deficit in 16 cases and a sensitive deficit in 16 cases. The complications were burns and ulcerations in 10 cases, a claw in 7 cases, a reversal reaction in 7 cases, erythema nodosum in 4 cases and neuritis in 8 cases. The number of new cases mutilated was 24.65%. The smear was positive in 42% and histology contribution in 91.37% of cases. Our study highlights the significant number of patients with multibacillary contagious, affected children, the high proportion of disability grade 2/OMS reflecting the delay in diagnosis. This delay is due to ignorance, to traditional treatments and low socio-economic status and lack of trained diagnostic teams in different areas apart from referral centres.

  13. Measuring leprosy-related stigma - a pilot study to validate a toolkit of instruments.

    Science.gov (United States)

    Rensen, Carin; Bandyopadhyay, Sudhakar; Gopal, Pala K; Van Brakel, Wim H

    2011-01-01

    Stigma negatively affects the quality of life of leprosy-affected people. Instruments are needed to assess levels of stigma and to monitor and evaluate stigma reduction interventions. We conducted a validation study of such instruments in Tamil Nadu and West Bengal, India. Four instruments were tested in a 'Community Based Rehabilitation' (CBR) setting, the Participation Scale, Internalised Scale of Mental Illness (ISMI) adapted for leprosy-affected persons, Explanatory Model Interview Catalogue (EMIC) for leprosy-affected and non-affected persons and the General Self-Efficacy (GSE) Scale. We evaluated the following components of validity, construct validity, internal consistency, test-retest reproducibility and reliability to distinguish between groups. Construct validity was tested by correlating instrument scores and by triangulating quantitative and qualitative findings. Reliability was evaluated by comparing levels of stigma among people affected by leprosy and community controls, and among affected people living in CBR project areas and those in non-CBR areas. For the Participation, ISMI and EMIC scores significant differences were observed between those affected by leprosy and those not affected (p = 0.0001), and between affected persons in the CBR and Control group (p < 0.05). The internal consistency of the instruments measured with Cronbach's α ranged from 0.83 to 0.96 and was very good for all instruments. Test-retest reproducibility coefficients were 0.80 for the Participation score, 0.70 for the EMIC score, 0.62 for the ISMI score and 0.50 for the GSE score. The construct validity of all instruments was confirmed. The Participation and EMIC Scales met all validity criteria, but test-retest reproducibility of the ISMI and GSE Scales needs further evaluation with a shorter test-retest interval and longer training and additional adaptations for the latter.

  14. Advanced Emissions Control Development Program

    Energy Technology Data Exchange (ETDEWEB)

    A.P.Evans; K.E. Redinger; M.J. Holmes

    1998-04-01

    The objective of the Advanced Emissions Control Development Program (AECDP) is to develop practical, cost-effective strategies for reducing the emissions of air toxics from coal-fired boilers. Ideally, the project aim is to effectively control air toxic emissions through the use of conventional flue gas cleanup equipment such as electrostatic precipitators (ESPS), fabric filters (baghouse), and wet flue gas desulfurization. Development work to date has concentrated on the capture of mercury, other trace metals, fine particulate and hydrogen chloride. Following the construction and evaluation of a representative air toxics test facility in Phase I, Phase II focused on the evaluation of mercury and several other air toxics emissions. The AECDP is jointly funded by the United States Department of Energy's Federal Energy Technology Center (DOE), the Ohio Coal Development Office within the Ohio Department of Development (oCDO), and Babcock& Wilcox-a McDermott company (B&W).

  15. Health-related quality of life evaluated by Pediatric Quality of Life Inventory 4.0 in pediatric leprosy patients with musculoskeletal manifestations.

    Science.gov (United States)

    Neder, Luciana; van Weelden, Marlon; Viola, Gabriela Ribeiro; Lourenço, Daniela Mencaroni; Len, Claudio A; Silva, Clovis A

    2015-01-01

    To evaluate the health-related quality of life (HRQL) in pediatric leprosy patients. A cross-sectional study included 47 leprosy patients and 45 healthy subjects. The HRQL was measured by Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), and evaluated physical, emotional, social and school domains. The leprosy patients were classified by Ridley and Jopling classification criteria and assessed according to clinical musculoskeletal manifestations, laboratory and radiographic examinations. The median of current age was similar in leprosy patients and controls [12(6-18) vs. 15(5-18)years, p = 0.384], likewise the frequencies of female gender (p = 0.835) and middle/lower Brazilian socio-economic classes (p = 1.0). The domain school activities according the child-self report was significantly lower in leprosy patients compared to controls in the age group of 13-18 years [75(45-100) vs. 90(45-100), p = 0.021]. The other domains were alike in both groups (p > 0.05). At least one musculoskeletal manifestation (arthralgia, arthritis and/or myalgia) was observed in 15% of leprosy patients and none in controls (p = 0.012). Further comparison between all leprosy patients showed that the median of the physical capacity domain [81.25(50-100) vs. 98.44(50-100), p = 0.036] and school activities domain by child-self report [60(50-85) vs. 80(45-100), p = 0.042] were significantly lower in patients with musculoskeletal manifestations compared to patients without these manifestations. No differences were evidenced between the other HRQL parameters in both groups, reported by patients and parents (p > 0.05). Reduced physical capacity and school activities domains were observed in pediatric leprosy patients with musculoskeletal manifestations. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  16. Serial measurement of the circulating levels of tumour necrosis factor and its soluble receptors 1 and 2 for monitoring leprosy patients during multidrug treatment

    Directory of Open Access Journals (Sweden)

    Rosane Dias Costa

    2013-12-01

    Full Text Available Leprosy is an infectious and contagious spectral disease accompanied by a series of immunological events triggered by the host response to the aetiologic agent, Mycobacterium leprae . The induction and maintenance of the immune/inflammatory response in leprosy are linked to multiple cell interactions and soluble factors, primarily through the action of cytokines. The purpose of the present study was to evaluate the serum levels of tumour necrosis factor (TNF-α and its soluble receptors (sTNF-R1 and sTNF-R2 in leprosy patients at different stages of multidrug treatment (MDT in comparison with non-infected individuals and to determine their role as putative biomarkers of the severity of leprosy or the treatment response. ELISA was used to measure the levels of these molecules in 30 healthy controls and 37 leprosy patients at the time of diagnosis and during and after MDT. Our results showed increases in the serum levels of TNF-α and sTNF-R2 in infected individuals in comparison with controls. The levels of TNF-α, but not sTNF-R2, decreased with treatment. The current results corroborate previous reports of elevated serum levels of TNF-α in leprosy and suggest a role for sTNF-R2 in the control of this cytokine during MDT.

  17. Social stigma as an epidemiological determinant for leprosy elimination in Cameroon.

    Science.gov (United States)

    Nsagha, Dickson S; Bissek, Anne-Cécile Z K; Nsagha, Sarah M; Njunda, Anna L; Assob, Jules C N; Tabah, Earnest N; Bamgboye, Elijah A; Oyediran, Alain Bankole O O; Nde, Peter F; Njamnshi, Alfred K

    2011-03-01

    Leprosy has been eliminated as a public health problem in most countries of the world according to the WHO, but the social stigma to the disease is still very high. The present study was performed to investigate the role of social stigma as a determinant for leprosy elimination in a leprosy endemic region of Cameroon. Focus group discussions, in-depth interviews and structured questionnaires were used to investigate leprosy social stigma among lepers, their contacts and a control group consisting of patients attending a health facility for reasons other than leprosy. Informed consent was sought and gained prior to starting the study. Focus group discussions and in-depth interviews identified three types of stigma: lack of self-esteem, tribal stigma and complete rejection by society. From the 480 structured questionnaires administered, there were overall positive attitudes to lepers among the study population and within the divisions (P=0.0). The proportion of participants that felt sympathetic with deformed lepers was 78.1% [95% confidence interval (CI): 74.4-81.8%] from a total of 480. Three hundred and ninety nine (83.1%) respondents indicated that they could share a meal or drink at the same table with a deformed leper (95% CI: 79.7-86.5%). Four hundred and three (83.9%) participants indicated that they could have a handshake and embrace a deformed leper (95% CI: 80.7-87.3%). A total of 85.2% (95.0% CI: 81.9-88.4%) participants affirmed that they could move with a deformed leper to the market or church. A high proportion of 71.5% (95.0% CI: 67.5%-75.5%) participants stated that they could offer a job to a deformed leper. The results indicate that Menchum division had the lowest mean score of 3.3 on positive attitudes to leprosy compared with Mezam (4.1) and Boyo (4.8) divisions. The high proportion of positive attitudes among the participants and in different divisions is a positive indicator that the elimination of leprosy social stigma is progressing in the

  18. Social stigma as an epidemiological determinant for leprosy elimination in Cameroon

    Directory of Open Access Journals (Sweden)

    Dickson S. Nsagha

    2011-03-01

    Full Text Available Leprosy has been eliminated as a public health problem in most countries of the world according to the WHO, but the social stigma to the disease is still very high. The present study was performed to investigate the role of social stigma as a determinant for leprosy elimination in a leprosy endemic region of Cameroon. Focus group discussions, in-depth interviews and structured questionnaires were used to investigate leprosy social stigma among lepers, their contacts and a control group consisting of patients attending a health facility for reasons other than leprosy. Informed consent was sought and gained prior to starting the study. Focus group discussions and in-depth interviews identified three types of stigma: lack of self-esteem, tribal stigma and complete rejection by society. From the 480 structured questionnaires administered, there were overall positive attitudes to lepers among the study population and within the divisions (P=0.0. The proportion of participants that felt sympathetic with deformed lepers was 78.1% [95% confidence interval (CI: 74.4-81.8%] from a total of 480. Three hundred and ninety nine (83.1% respondents indicated that they could share a meal or drink at the same table with a deformed leper (95% CI: 79.7-86.5%. Four hundred and three (83.9% participants indicated that they could have a handshake and embrace a deformed leper (95% CI: 80.7-87.3%. A total of 85.2% (95.0% CI: 81.9-88.4% participants affirmed that they could move with a deformed leper to the market or church. A high proportion of 71.5% (95.0% CI: 67.5%-75.5% participants stated that they could offer a job to a deformed leper. The results indicate that Menchum division had the lowest mean score of 3.3 on positive attitudes to leprosy compared with Mezam (4.1 and Boyo (4.8 divisions. The high proportion of positive attitudes among the participants and in different divisions is a positive indicator that the elimination of leprosy social stigma is progressing

  19. Radiological control technician: Training program management manual

    International Nuclear Information System (INIS)

    1992-10-01

    This manual defines and describes the DOE Radiological Control Technician Core Training Program qualification and training process, material development requirements, standards and policies, and administration. The manual applies to Radiological Control Technician Training Programs at all DOE contractor sites

  20. Sorologia da hanseníase utilizando PGL-I: revisão sistemática Leprosy serology using PGL-I: a systematic review

    Directory of Open Access Journals (Sweden)

    Rodrigo Scaliante de Moura

    2008-01-01

    methodologies used in the past have yet to show a favorable cost-benefit ratio, although studies indicate that the use of the test might positively influence leprosy control programs. With simple and robust techniques, the use of PGL-I serology is viable.

  1. Vitamin D receptor expression levels determine the severity and complexity of disease progression among leprosy reaction patients

    Directory of Open Access Journals (Sweden)

    D. Mandal

    2015-07-01

    Full Text Available We studied the roles of vitamin D and its receptor, VDR, in the progression of leprosy. The majority of individuals with leprosy from Kolkata, India, with a type 1 or type 2 reaction have low levels of vitamin D3 in serum samples. Interestingly, individuals with a type 2 reaction associated with neuritis/erythema nodosum leprosum had very low VDR mRNA expression levels, ranging from 5% to 10%, compared to that of healthy control subjects; these patients also had a high bacilli index, ranging from 3+ to 5+. This is the first report to indicate that VDR expression levels may determine the complexity and severity of the progression of leprosy.

  2. Waardenburg′s Syndrome with Leprosy

    Directory of Open Access Journals (Sweden)

    B.S.N Reddy

    1978-01-01

    Full Text Available A rare association of Waardenburg′s syndrome and tuberculoid leprosy in a 13-year-old patient is described. This is an unrecorded feature in the literature. These two disorders are quite unrelated entities and their occurrence in the same patient is a casual one. All the classical features of Waardenburg′s syndrome except deafness were present and the disease manifested as an isolated case in the family. The pertinent literature is briefly reviewed.

  3. Elimination of Leprosy as a public health problem by 2000 AD: an ...

    African Journals Online (AJOL)

    To identify potential publications, we included papers on leprosy elimination monitoring, special action projects for the elimination of leprosy, modified leprosy elimination campaigns, and the Global Alliance to eliminate leprosy from the following principal data bases: Cochrane data base of systematic reviews, PubMed, ...

  4. availability of childhood social services in leprosy settlements

    African Journals Online (AJOL)

    Emmanuel Ameh

    career goals in life. The response to this question was used to assess the extent to which the children of leprosy patients intend to improve their means of livelihood ... (16.7%) of others in Oyo and 1(6.7%) in Abia were nursing babies. Table 1. Free education for children of leprosy patients by State. Enjoyed free education.

  5. Psychiatric morbidity among leprosy patients in Teso and Busia ...

    African Journals Online (AJOL)

    The PM was positively correlated with physical disability and marital status but not with age, sex, education, type of leprosy, or duration of the illness. The prevalence of psychiatric morbidity was lower among Kenyan leprosy patients compared to studies carried out in India (56% to 78%). It was high compared to the rate of ...

  6. Increased plantar foot pressure in persons affected by leprosy

    NARCIS (Netherlands)

    Slim, Frederik J.; van Schie, Carine H.; Keukenkamp, Renske; Faber, William R.; Nollet, Frans

    2012-01-01

    Although foot pressure has been reported to be increased in people affected by leprosy, studies on foot pressure and its determinants are limited. Therefore, the aim was to assess barefoot plantar foot pressure and to identify clinical determinants of increased plantar foot pressure in leprosy

  7. First report of citrus leprosis virus nuclear type in Colombia

    Science.gov (United States)

    Citrus leprosis is a difficult viral disease causing significant damage to citrus fruit in South America and Central America. The disease is marked by dramatic lesions on fruit, leaves and stems resulting in unmarketable product. Citrus leprosis virus cytoplasmic types (CiLV-C and CiLV-C2) wer edete...

  8. House Arrest: Florida's Community Control Program.

    Science.gov (United States)

    Chi, Keon S.

    This report highlights Florida's house arrest program, a new alternative to prison incarceration viewed as a significant criminal justice experiment. The implementation and operation of the community control program is decribed, specific goals and objectives of the community control program are listed, and a preliminary assessment is offered.…

  9. Determinants and Associated Disability of Leprosy Patients Attending GMLF, Sevagram

    Directory of Open Access Journals (Sweden)

    Meenakshi Khapre

    2013-11-01

    Full Text Available Background: Leprosy, as an oldest disease known to a man and already eliminated from India in 2005, still poses a public health problem with steady new case detection rate. Method: The present study was carried out in Gandhi memorial leprosy foundation, Wardha, with the aim to find out proportion of multibacillary leprosy cases and various grading of disability and factors associated with it in this part of country. All the successive new OPD patients were included in study and examined for type of leprosy and grade of disability if present. Analysis done by Descriptive statistics. Result: 66 % had multibacillary type of leprosy and 44 % the disability. Higher age group, females, illiterate and less educated, unskilled and low income group were mostly affected. Conclusion: high proportion of multibacillary cases and disabilities reflects the need for active thrust to identify new cases.

  10. Human Genetic Ancestral Composition Correlates with the Origin of Mycobacterium leprae Strains in a Leprosy Endemic Population.

    Directory of Open Access Journals (Sweden)

    Nora Cardona-Castro

    Full Text Available Recent reports have suggested that leprosy originated in Africa, extended to Asia and Europe, and arrived in the Americas during European colonization and the African slave trade. Due to colonization, the contemporary Colombian population is an admixture of Native-American, European and African ancestries. Because microorganisms are known to accompany humans during migrations, patterns of human migration can be traced by examining genomic changes in associated microbes. The current study analyzed 118 leprosy cases and 116 unrelated controls from two Colombian regions endemic for leprosy (Atlantic and Andean in order to determine possible associations of leprosy with patient ancestral background (determined using 36 ancestry informative markers, Mycobacterium leprae genotype and/or patient geographical origin. We found significant differences between ancestral genetic composition. European components were predominant in Andean populations. In contrast, African components were higher in the Atlantic region. M. leprae genotypes were then analyzed for cluster associations and compared with the ancestral composition of leprosy patients. Two M. leprae principal clusters were found: haplotypes C54 and T45. Haplotype C54 associated with African origin and was more frequent in patients from the Atlantic region with a high African component. In contrast, haplotype T45 associated with European origin and was more frequent in Andean patients with a higher European component. These results suggest that the human and M. leprae genomes have co-existed since the African and European origins of the disease, with leprosy ultimately arriving in Colombia during colonization. Distinct M. leprae strains followed European and African settlement in the country and can be detected in contemporary Colombian populations.

  11. Social implications of leprosy in the Netherlands - stigma among ex-leprosy patients in a non-endemic setting

    NARCIS (Netherlands)

    de Groot, R.; van Brakel, W.H.; de Vries, H.J.C.

    2011-01-01

    Background: In the Netherlands, leprosy is a rare and non-endemic disease, still occurring as an 'import disease'. Moreover a considerable group of people affected by leprosy, originating mainly from the former Dutch colonies, suffer from neuropathic complications. This study investigates the social

  12. Social implications of leprosy in the Netherlands--stigma among ex-leprosy patients in a non-endemic setting

    NARCIS (Netherlands)

    de Groot, Roos; van Brakel, Wim H.; de Vries, Henry J. C.

    2011-01-01

    In the Netherlands, leprosy is a rare and non-endemic disease, still occurring as an 'import disease'. Moreover a considerable group of people affected by leprosy, originating mainly from the former Dutch colonies, suffer from neuropathic complications. This study investigates the social

  13. Social implications of leprosy in the Netherlands--stigma among ex-leprosy patients in a non-endemic setting

    NARCIS (Netherlands)

    Groot, R. de; Brakel, W.H. Van; Vries, H.J. de

    2011-01-01

    BACKGROUND: In the Netherlands, leprosy is a rare and non-endemic disease, still occurring as an 'import disease'. Moreover a considerable group of people affected by leprosy, originating mainly from the former Dutch colonies, suffer from neuropathic complications. This study investigates the social

  14. Social inequality, urban growth and leprosy in Manaus: a spatial approach.

    Science.gov (United States)

    Imbiriba, Elsia Nascimento Belo; Silva Neto, Antônio Levino da; Souza, Wayner Vieira de; Pedrosa, Valderiza; Cunha, Maria da Graça; Garnelo, Luiza

    2009-08-01

    To analyze the epidemiology of leprosy according to spatial distribution and living conditions of the population. Ecological study based on the spatial distribution of leprosy in the municipality of Manaus, Northern Brazil, from 1998 to 2004. The 4,104 cases identified in the Sistema de Informações de Agravos de Notificação (Sinan -National Notification System) were georeferenced according to the addresses in the 1,536 urban census tracts through four different sources: postal service (73.7% of addresses found), Property Registration Program (7.3%), Family Health Program (2.1%), and Instituto Brasileiro de Geografia e Estatística (Brazilian Institute of Geography and Statistics) data sheet (1.5%). Calculation of detection coefficient was performed based on the 2001 population. Local empirical Bayesian method was used for the spatial distribution analysis, in order to estimate leprosy risk, making rate variation shorter when they were calculated for small areas. Logistic regression was employed to analyze the association between geographical distribution and risk factors. The incidence of cases in children under 15 (severity indicator) and Social Need Index built from variables of the 2000 census were adopted as explicative variables. The mean coefficient of detection was hyperendemic in 34.0% of the census tracts, and very high in 26.7%. Odds ratio was obtained for explicative variables and proved to be significant. Low-income and incidence in children under 15 were combined to identify priority areas for intervention. Spatial analysis of leprosy showed that the distribution of the disease is heterogeneous and is more strongly present in regions inhabited by more vulnerable groups.

  15. Primary Motor Cortex Representation of Handgrip Muscles in Patients with Leprosy.

    Directory of Open Access Journals (Sweden)

    Vagner Wilian Batista E Sá

    Full Text Available Leprosy is an endemic infectious disease caused by Mycobacterium leprae that predominantly attacks the skin and peripheral nerves, leading to progressive impairment of motor, sensory and autonomic function. Little is known about how this peripheral neuropathy affects corticospinal excitability of handgrip muscles. Our purpose was to explore the motor cortex organization after progressive peripheral nerve injury and upper-limb dysfunction induced by leprosy using noninvasive transcranial magnetic stimulation (TMS.In a cross-sectional study design, we mapped bilaterally in the primary motor cortex (M1 the representations of the hand flexor digitorum superficialis (FDS, as well as of the intrinsic hand muscles abductor pollicis brevis (APB, first dorsal interosseous (FDI and abductor digiti minimi (ADM. All participants underwent clinical assessment, handgrip dynamometry and motor and sensory nerve conduction exams 30 days before mapping. Wilcoxon signed rank and Mann-Whitney tests were performed with an alpha-value of p<0.05.Dynamometry performance of the patients' most affected hand (MAH, was worse than that of the less affected hand (LAH and of healthy controls participants (p = 0.031, confirming handgrip impairment. Motor threshold (MT of the FDS muscle was higher in both hemispheres in patients as compared to controls, and lower in the hemisphere contralateral to the MAH when compared to that of the LAH. Moreover, motor evoked potential (MEP amplitudes collected in the FDS of the MAH were higher in comparison to those of controls. Strikingly, MEPs in the intrinsic hand muscle FDI had lower amplitudes in the hemisphere contralateral to MAH as compared to those of the LAH and the control group. Taken together, these results are suggestive of a more robust representation of an extrinsic hand flexor and impaired intrinsic hand muscle function in the hemisphere contralateral to the MAH due to leprosy.Decreased sensory-motor function induced by

  16. Primary Motor Cortex Representation of Handgrip Muscles in Patients with Leprosy

    Science.gov (United States)

    Rangel, Maria Luíza Sales; Sanchez, Tiago Arruda; Moreira, Filipe Azaline; Hoefle, Sebastian; Souto, Inaiacy Bittencourt; da Cunha, Antônio José Ledo Alves

    2015-01-01

    Background Leprosy is an endemic infectious disease caused by Mycobacterium leprae that predominantly attacks the skin and peripheral nerves, leading to progressive impairment of motor, sensory and autonomic function. Little is known about how this peripheral neuropathy affects corticospinal excitability of handgrip muscles. Our purpose was to explore the motor cortex organization after progressive peripheral nerve injury and upper-limb dysfunction induced by leprosy using noninvasive transcranial magnetic stimulation (TMS). Methods In a cross-sectional study design, we mapped bilaterally in the primary motor cortex (M1) the representations of the hand flexor digitorum superficialis (FDS), as well as of the intrinsic hand muscles abductor pollicis brevis (APB), first dorsal interosseous (FDI) and abductor digiti minimi (ADM). All participants underwent clinical assessment, handgrip dynamometry and motor and sensory nerve conduction exams 30 days before mapping. Wilcoxon signed rank and Mann-Whitney tests were performed with an alpha-value of pDynamometry performance of the patients’ most affected hand (MAH), was worse than that of the less affected hand (LAH) and of healthy controls participants (p = 0.031), confirming handgrip impairment. Motor threshold (MT) of the FDS muscle was higher in both hemispheres in patients as compared to controls, and lower in the hemisphere contralateral to the MAH when compared to that of the LAH. Moreover, motor evoked potential (MEP) amplitudes collected in the FDS of the MAH were higher in comparison to those of controls. Strikingly, MEPs in the intrinsic hand muscle FDI had lower amplitudes in the hemisphere contralateral to MAH as compared to those of the LAH and the control group. Taken together, these results are suggestive of a more robust representation of an extrinsic hand flexor and impaired intrinsic hand muscle function in the hemisphere contralateral to the MAH due to leprosy. Conclusion Decreased sensory

  17. Transmission of Citrus leprosis virus C by Brevipalpus phoenicis (Geijskes) to Alternative Host Plants Found in Citrus Orchards

    Science.gov (United States)

    The equivalent of US$ 75 million is spent each year in Brazil to control Brevipalpus phoenicis, a mite vector of Citrus leprosis virus C (CiLV-C). In this study we investigated the possibility that hedgerows, windbreaks, and weeds normally found in citrus orchards could host CiLV-C. Mites reared on ...

  18. Inequality of leprosy disability in iran, clinical or socio-economic inequality: An extended concentration index decomposition approach

    Directory of Open Access Journals (Sweden)

    Rasool Entezarmahdi

    2014-01-01

    Conclusions: This study provided new perspective for the health system to leprosy control considering the significant gap between rich and poor (inequality regarding G2D disability, and its effective elements in socio-economic strata. Some effective actions can be considered to reduce the scale of existing inequality.

  19. Angra nuclear plant - environmental control program

    International Nuclear Information System (INIS)

    Kircher, E.; Cruz, E.S. da

    1989-01-01

    The pre-operational studies, that were elaborated before the beginning of Angra I Power Plant operation, are described in particular the environmental radiological safety area till the fuel loading in the core reactor. Several aspects are included, as socio-economic survey, seismological analysis, Meteorological Program, marine biology, water cooling system, exposure measures of natural radiation, marine sediments characterization in the effluent dispersion area and Environmental Radiological Monitoring Program. The main environmental programs developed for the operational phase of the Angra I Plant are also presented, citing some considerations about the Meteorological Program, Marine Biology Control Program, Temperature and Chlorine Control in Piraquara de Fora Bay, Radiological Environmental Monitoring Program, Sanitary Effluent Control Program and Radiological Emergency Program. (C.G.C.). 2 refs

  20. Environmental Restoration Program Control Management System

    International Nuclear Information System (INIS)

    Duke, R.T.

    1992-01-01

    Environmental Restoration managers need to demonstrate that their programs are under control. Unlike most industrial programs, the public is heavily involved in Environmental Restoration activities. The public is demanding that the country prove that real progress is being made towards cleaning up the environment. A Program Control Management System can fill this need. It provides a structure for planning, work authorization, data accumulation, data analysis and change control. But it takes time to implement a control system and the public is losing its patience. This paper describes critical items essential to the quick development and implementation of a successful control system

  1. Maryland controlled fusion research program

    International Nuclear Information System (INIS)

    Griem, H.R.; Liu, C.S.

    1989-07-01

    In recent years, members of the Maryland Plasma Theory Group have made significant contributions to the national fusion theory programs, and, in many cases, these theoretical developments helped to interpret experimental results and to design new experimental programs. In the following, we summarize the technical progress in four major areas: density limit disruptions and sawteeth in tokamaks; anomalous transport in tokamaks; L/H Transition in tokamaks; and magnetic reconnection in compact torus and REP. 9 refs

  2. ASSESSMENT OF PATIENTS’ PERCEPTIONS TOWARDS THE DIAGNOSIS OF LEPROSY

    Directory of Open Access Journals (Sweden)

    S. V. Jezus

    2018-02-01

    Full Text Available Leprosy is a contagious, long-term infection, which manifests dermatological and neurological symptoms and signs, being considered an endemic, widespread disease, regarded as a serious health problem in Brazil. Early diagnosis of leprosy and its proper treatment prevents disease from progressing, avoiding physical disabilities, which are frequent as the infection evolves, and constitute a major cause of stigma, leading the patient to social isolation. This study aimed to verify the patient's perceptions regarding Hansen's disease diagnosis, seeking to contribute to the prevention of physical disabilities. It was carried out in Sinop in the State of Mato Grosso, being classified as a qualitative research approach. Patients diagnosed with leprosy, enrolled for annual treatment in Nações Basic Health Unity (Unidade de Saúde Básica Nações, took part in the research. Data was collected using semi-structured interviews, and the results were analyzed in categories, these being, the implications on the patients’ self-esteem after diagnosis of leprosy; patients’ perceptions of treatment and changes in socioeconomic status after leprosy. It is worth noting that leprosy as a public health issue does not restrict to the immense amount of cases and its potential to cause physical disability, which interferes in the psychosocial context, should be taken into consideration. It is valid to point out that leprosy affects several aspects of the pacient’s life, including their physical, mental and social well-being, requiring a holistic and humane nursing care.

  3. The leprosy asylum in India: 1886-1947.

    Science.gov (United States)

    Robertson, Jo

    2009-10-01

    Writing against a historical practice that situates the leprosy asylum exclusively within prison-like institutions, this article seeks to show the variation in leprosy asylums, the contingencies of their evolution, and the complexity of their designs, by devoting attention to the characteristics of the leprosy asylum in India from 1886 to 1947, in particular to the model agricultural colony. Drawing upon the travel narratives of Wellesley Bailey, the founder of the Mission to Lepers in India, for three separate periods in 1886, 1890-91, and 1895-96, it argues that leprosy asylums were formed in response to a complex conjunction of impulses: missionary, medical, and political. At the center of these endeavors was the provision of shelter for persons with leprosy that accorded with principles of good stewardship and took the form of judicious use of donations provided by benefactors. As the Mission to Lepers began to bring about improvements and restructuring to asylums, pleasant surroundings, shady trees, sound accommodation, and good ventilation became desirable conditions that would confer physical and psychological benefits on those living there. At the same time, the architecture of the asylum responded to economic imperatives, in addition to religious and medical aspirations, and asylums moved towards the regeneration of a labor force. Leprosy-affected people were increasingly employed in occupations that contributed to their sustenance and self-sufficiency, symbolically reincorporating the body damaged by leprosy into the economic world of productive relations.

  4. Pride and prejudice--identity and stigma in leprosy work.

    Science.gov (United States)

    Harris, Kristine

    2011-06-01

    This article sets out to expand the way stigma, and those affected by it, are understood within leprosy discourse and to apply these insights to the analysis of the experiences of leprosy workers. The term stigma is often used simply as shorthand for 'negative social experience'. However, to reduce the negative aspects of complex everyday life experiences to a single word is often overly simplistic and can serve to objectify, rather than illuminate, the experiences of those affected. This article argues that in order to understand the lived experience of stigma we must come to understand stigma as an ongoing, dialectical social process and develop an approach to stigma that analytically separates stigma from its negative social consequences. The article applies these insights to data collected during 14 months of fieldwork with front-line leprosy workers in India, which suggests that falling leprosy prevalence rates and a rapidly changing policy landscape have led to leprosy workers feeling marginalised and stigmatised within their own organisation. The article argues that, rather than seeing stigma merely as a negative process in which leprosy workers are passive victims, we must recognise that stigma also plays a key role in the creation and maintenance of leprosy workers' identity and is utilised as a strategic tool in the struggle for influence between different groups within the organisation. Finally, the article argues for the benefit of expanding our understanding of stigma across public health and of applying these insights to designing future interventions.

  5. Can social marketing approaches change community attitudes towards leprosy?

    Science.gov (United States)

    Brown, Wendy

    2006-06-01

    This essay explores how the concept of social marketing can be employed to change attitudes towards leprosy. Firstly, the concept of social marketing is discussed, then the attitudes that people have about leprosy, the stigma that people with leprosy and their families may face, and the detrimental effects that this can have on their lives. The effect of knowledge and education on attitudes towards leprosy is discussed, as this can be a key component of social marketing campaigns. Various methods of social marketing used to change attitudes and reduce stigma are examined, such as mass media campaigns, school based education, methods which involve community leaders, and the integration and improvement of leprosy services. Principles of social marketing which can lead to the success of campaigns such as incorporating local beliefs are emphasized. The success of the social marketing campaign in Sri Lanka is described, which aimed to remove the fear of leprosy, and to encourage patients to seek and comply with treatment. Finally, it is argued that social marketing, used correctly, can be highly effective at changing community attitudes towards leprosy, reducing stigma and improving the lives of patients, who become able to seek treatment sooner as they lose their fear of stigmatization.

  6. Leprosy - one of the many forgotten tropical diseases.

    Science.gov (United States)

    Zwolska, Zofia; Augustynowicz-Kopeć, Ewa

    2017-02-14

    Leprosy or Hansen disease is caused by an infection of Mycobacterium leprae. The large number of undetected cases (2000-2012 years 4 mln people) remains a threat to the elimination of leprosy. Leprosy is an unheard in Poland and generally is considered a condition so "exotic" that it is not worth to spend more attention to it. Forgotten disease in developed countries still thrives in an environment of poor and uneducated. Regardless of the conclusion that in the 21st century none infectious disease should not be treated as a disease on the designated regions of the world, other than our own, it should be recalled that the M. leprae was discovered in Europe, where for many years there were leprosaria and still infectious hospitals in Great Brittan, France or Spain get patients suspected of leprosy. The mobility of the inhabitants of the globe caused by wars, ethnic conflicts or a simple tourism causes that any infectious disease can not be treated as solely limited to distant us regions. The best proof of this were the viral diseases, formerly found in only in Asia or Africa, and currently transmitted to Europe [1]. At any moment, we can stand up against the problem of diagnostics of humans toward leprosy. Many medical reports indicate that leprosy as a disease with many symptoms encountered difficulties in its diagnosis. Only the experience of medical professionals and good microbiological diagnosis may speed up the diagnosis of leprosy.

  7. Leprosy – one of the many forgotten tropical diseases

    Directory of Open Access Journals (Sweden)

    Zofia Zwolska

    2017-02-01

    Full Text Available Leprosy or Hansen disease is caused by an infection of Mycobacterium leprae. The large number of undetected cases (2000-2012 years 4 mln people remains a threat to the elimination of leprosy. Leprosy is an unheard in Poland and generally is considered a condition so “exotic” that it is not worth to spend more attention to it. Forgotten disease in developed countries still thrives in an environment of poor and uneducated. Regardless of the conclusion that in the 21st century none infectious disease should not be treated as a disease on the designated regions of the world, other than our own, it should be recalled that the M. leprae was discovered in Europe, where for many years there were leprosaria and still infectious hospitals in Great Brittan, France or Spain get patients suspected of leprosy. The mobility of the inhabitants of the globe caused by wars, ethnic conflicts or a simple tourism causes that any infectious disease can not be treated as solely limited to distant us regions. The best proof of this were the viral diseases, formerly found in only in Asia or Africa, and currently transmitted to Europe [1]. At any moment, we can stand up against the problem of diagnostics of humans toward leprosy. Many medical reports indicate that leprosy as a disease with many symptoms encountered difficulties in its diagnosis. Only the experience of medical professionals and good microbiological diagnosis may speed up the diagnosis of leprosy.

  8. Correlation between occurrence of leprosy and fossil fuels: role of fossil fuel bacteria in the origin and global epidemiology of leprosy.

    Science.gov (United States)

    Chakrabarty, A N; Dastidar, S G

    1989-06-01

    On the basis of correlative data on the global distribution of leprosy, its bacteria metabolizing fossil fuels (FF), and the FF themselves, the origin of leprosy in the world as a whole, and in the leprosy-free countries, in particular, as indigenous cases, appeared to be primarily due to a soil-to-man, and secondarily due to a man-to-man infection. These findings helped to elucidate similar problems of animal leprosies and nocardial diseases.

  9. Electrophysiological study of nerves in type-II reaction in leprosy

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Singh

    2017-01-01

    Full Text Available Background: Leprosy is a chronic granulomatous infection primarily affecting the peripheral nervous system, skin and reticuloendothelial system. Cutaneous nerves are severely affected in lepra reaction and this leads to morbidity. Objective: To study electrophysiological pattern of different nerves involved in Type-II reactions in leprosy. Method: The present study was undertaken in 21 leprosy patients with Type-II reactions attending in and out-patient department of Dermatology & Venereology, B.R.D. Medical College, Gorakhpur from July 2005 to October 2006. This was a prospective case control study in which 20 healthy, age and sex matched people with no evidence of any disease (particularly nerve involvement were included. Limitation: Lesser number of cases were studied. Result: The proximal motor conduction latency was significantly prolonged in both ulnar and common peroneal nerve and proximal motor conduction velocity was also significantly reduced. On examining the values beyond 2S.D. of the control value, distal latency was not affected and only proximal conduction was affected in ulnar nerve. Conclusion: In Type II lepra reaction the motor conduction abnormalities are not prominent. Abnormalities are relatively more marked in the proximal segment.

  10. Leprosy in Denmark 1980-2010

    DEFF Research Database (Denmark)

    Aftab, Huma; Nielsen, Susanne D.; Bygbjerg, Ib C.

    2016-01-01

    BACKGROUND: Leprosy, caused by Mycobacterium leprae, is a chronic and progressive granulomatous disease affecting mainly the skin and the peripheral nervous system. If left unrecognized, the infection can lead to permanent nerve damage and disability. The clinical presentation depends on the immune...... or with history of travel or work in the tropics. Due to the long incubation period with symptoms presenting long after immigration or return, clinicians often do not have the diagnosis in mind. The wide spectrum of symptoms and immunological reactions further complicates the diagnostic process. Treatment...

  11. Crime Control Programs in College Undergraduate Curricula.

    Science.gov (United States)

    Snell, Joel C.; Wakefield, William O.

    1981-01-01

    Attempts to analyze crime control program development and relate it to several independent variables which might be associated. Results show that often crime control programs were developed at the Associate degree level and appear to duplicate or approximate the police training academies. (Author)

  12. Guided Synthesis of Control Programs Using UPPAAL

    DEFF Research Database (Denmark)

    Hune, T.; Larsen, Kim Guldstrand; Pettersson, P.

    2000-01-01

    the transitions with extra guards. Applying this technique have made synthesis of control programs feasible for a plant producing as many as 60 batches. In comparison, we could only handle plants producing two batches without using guides. The synthesized control programs have been executed in a physical plant...

  13. Environmental Restoration Program Management Control Plan

    International Nuclear Information System (INIS)

    1991-09-01

    This Management Control Plan has been prepared to define the Energy Systems approach to managing its participation in the US DOE's Environmental Restoration (ER) Program in a manner consistent with DOE/ORO 931: Management Plan for the DOE Field Office, Oak Ridge, Decontamination and Decommissioning Program; and the Energy Systems Environmental Restoration Contract Management Plan (CMP). This plan discusses the systems, procedures, methodology, and controls to be used by the program management team to attain these objectives

  14. Measurement control program at model facility

    International Nuclear Information System (INIS)

    Schneider, R.A.

    1984-01-01

    A measurement control program for the model plant is described. The discussion includes the technical basis for such a program, the application of measurement control principles to each measurement, and the use of special experiments to estimate measurement error parameters for difficult-to-measure materials. The discussion also describes the statistical aspects of the program, and the documentation procedures used to record, maintain, and process the basic data

  15. IFN-γ +875 microsatellite polymorphism as a potential protection marker for leprosy patients from Amazonas state, Brazil.

    Science.gov (United States)

    Silva, G A V; Santos, M P; Mota-Passos, I; Boechat, A L; Malheiro, A; Naveca, F G; de Paula, L

    2012-11-01

    Polymorphisms present in the first intron of IFN-γ may have an important role in the regulation of the immune response, which could have functional consequences for gene transcription. Leprosy patients are characterized by different immune responses in different clinical forms. We investigated a possible association of the +874 polymorphism and CA repeats present in the first intron of IFN-γ with susceptibility to leprosy and with the manifestation of the different clinical forms. Nucleotide sequencing was performed with samples from 108 leprosy patients and 113 controls subjects, as well as immunophenotyping of CD(4)(+), CD(8)(+) and CD(69)(+) T cells by flow cytometry. The data showed that there were no significant differences between patients and control subjects, as well as according classification of Ridley-Jopling. However, the A/A genotype was significantly increased in paucibacillary patients (p=0.028) and the microsatellite encoding 16 CA repeats were significantly associated with paucibacillary compared to multibacillary patients (p=0.019). Individuals homozygous for the +874 A allele, the mean level of CD(4)(+) and CD(69)(+) T cells was higher. Our data suggest that polymorphisms present in the first intron of IFN-γ are not associated with susceptibility to leprosy, nevertheless, the +874 polymorphism and the CA repeats number encoded in IFN-γ gene may be related to a higher cellular immune response in patients and are consistently more frequently detected in PB patients. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Leprosy among patient contacts: a multilevel study of risk factors.

    Directory of Open Access Journals (Sweden)

    Anna M Sales

    Full Text Available BACKGROUND: This study aimed to evaluate the risk factors associated with developing leprosy among the contacts of newly-diagnosed leprosy patients. METHODOLOGY/PRINCIPAL FINDINGS: A total of 6,158 contacts and 1,201 leprosy patients of the cohort who were diagnosed and treated at the Leprosy Laboratory of Fiocruz from 1987 to 2007 were included. The contact variables analyzed were sex; age; educational and income levels; blood relationship, if any, to the index case; household or non-household relationship; length of time of close association with the index case; receipt of bacillus Calmette-Guérin (BGG vaccine and presence of BCG scar. Index cases variables included sex, age, educational level, family size, bacillary load, and disability grade. Multilevel logistic regression with random intercept was applied. Among the co-prevalent cases, the leprosy-related variables that remained associated with leprosy included type of household contact, [odds ratio (OR = 1.33, 95% confidence interval (CI: 1.02, 1.73] and consanguinity with the index case, (OR = 1.89, 95% CI: 1.42-2.51. With respect to the index case variables, the factors associated with leprosy among contacts included up to 4 years of schooling and 4 to 10 years of schooling (OR = 2.72, 95% CI: 1.54-4.79 and 2.40, 95% CI: 1.30-4.42, respectively and bacillary load, which increased the chance of leprosy among multibacillary contacts for those with a bacillary index of one to three and greater than three (OR = 1.79, 95% CI: 1.19-2.17 and OR: 4.07-95% CI: 2.73, 6.09, respectively. Among incident cases, household exposure was associated with leprosy (OR = 1.96, 95% CI: 1.29-2.98, compared with non-household exposure. Among the index case risk factors, an elevated bacillary load was the only variable associated with leprosy in the contacts. CONCLUSIONS/SIGNIFICANCE: Biological and social factors appear to be associated with leprosy among co-prevalent cases, whereas the factors related to the

  17. Development of Hodgkin's disease in a patient with leprosy.

    Science.gov (United States)

    Weshler, Z; Leviatan, A; Gordon, R; Kopolovic, J

    1978-01-01

    We present a patient with leprosy who developed Hodgkin's disease of the nodular sclerosing type. There are two previous reports describing the combination of leprosy and Hodgkin's disease in a single patient [3, 9]. Hodgkin's disease was diagnosed 14 months after the complete disappearance of mycobacterium leprae from the skin lesions, under treatment with DDS (diamino-diphenyl-sulfone). Hodgkin's disease was treated by irradiation and chemotherapy. Obstructive jaundice developed which resolved under treatment by irradiation of the hilar area of the liver, chemotherapy and hormones. During two years of immuno-suppressive therapy, without DDS, no exacerbation of the leprosy occurred.

  18. CD4+ Th17 cells discriminate clinical types and constitute a third subset of non Th1, Non Th2 T cells in human leprosy.

    Directory of Open Access Journals (Sweden)

    Chaman Saini

    Full Text Available BACKGROUND: Patients with localized tuberculoid and generalized lepromatous leprosy show respectively Th1 and Th2 cytokine profile. Additionally, other patients in both types of leprosy also show a non discriminating Th0 cytokine profile with both interferon-γ and IL-4. The present study investigated the role of Th17 cells which appear to be a distinct subtype of Th subtypes in 19 tuberculoid and 18 lepromatous leprosy patients. Five healthy subjects with long term exposure to infection and 4 skin biopsies from healthy subjects undergoing cosmetic surgery were used as controls. METHODOLOGY/PRINCIPLE FINDINGS: An array of Th17 related primers for cytokines, chemokines and transcription factors was used in real time reverse transcribed PCR to evaluate gene expression, ELISA for cytokine secretion in the supernatants of antigen stimulated PBMC cultures and flow cytometry for establishing the phenotype of the IL-17, IL-21 producing cells. CONCLUSIONS/SIGNIFICANCE: IL-17 isoforms showed significantly higher expression and release in supernatants of antigen stimulated PBMC cultures and dermal lesions of healthy contacts and tuberculoid leprosy as compared to lepromatous leprosy (p<0.003. This was further confirmed by Th17 associated transcription factor RORC, cytokines IL-21, IL-22, and IL-23, chemokines MMP13, CCL20, CCL22. Of interest was the association of IL-23R and not IL-6R with IL-17(+ cells. The Th17 cells were CD4(+ CCR6(+ confirming their effector cell lineage. Polarized Th1 cytokines were seen in 3/7 tuberculoid and Th2 cytokines in 5/10 lepromatous leprosy patients. Of importance was the higher association of Th17 pathway factors with the non-polarized Th0 types as compared to the polarized Th1 and Th2 (p<0.01. Our study draws attention to a third type of effector Th cell that may play a role in leprosy.

  19. Symbol generators with program control

    International Nuclear Information System (INIS)

    Gryaznov, V.M.; Tomik, J.

    1974-01-01

    Methods of constructing symbol generators are described which ensure a program variation of symbol shape and setup. The symbols are formed on the basis of a point microraster. A symbol description code contains information on a symbol shape, with one digit corresponding to each microraster element. For a microraster discrete by-pass the description code is transformed into succession of illuminating pulses by means of a shift register

  20. Oropharyngeal leprosy in art, history, and medicine.

    Science.gov (United States)

    Scollard, D M; Skinsnes, O K

    1999-04-01

    Advanced lesions of the face, nasopharynx, and oropharynx have played an important role in the medical and social history of Hansen's disease. Renaissance artists included detailed portrayals of these lesions in some of their paintings, a testimony not only to their artistic skill and powers of observation but also to the common presence of these patients in European cities and towns of the period. The disease is now understood as a broad immunologic spectrum of host responses to Mycobacterium leprae, with a variety of clinical and pathologic manifestations in nerve, soft tissues, and bone. This review incorporates the findings of 2 extraordinary studies (one from Europe and the other from Japan) of pharyngeal and facial lesions. In the 1950s, studies of skeletal remains from the churchyard of a Danish leprosarium revealed a triad of maxillofacial lesions unique to leprosy and designated facies leprosa. In pre-World War II Japan, before effective treatment had been discovered, a prominent otorhinolaryngologist studying oropharyngeal and nasopharyngeal lesions prepared watercolor illustrations of the natural progression of untreated Hansen's disease. As a result of effective antimicrobial therapy, such advanced lesions are now rarely seen, but the presenting signs and symptoms of leprosy still occasionally arise in the nasal and oral mucosa. The nasopharynx and oropharynx may be important early sites of inoculation and infection by M leprae, and they require additional emphasis in worldwide efforts toward early diagnosis and treatment of Hansen's disease.

  1. Measurement control program for nuclear material accounting

    International Nuclear Information System (INIS)

    Brouns, R.J.; Roberts, F.P.; Merrill, J.A.; Brown, W.B.

    1980-06-01

    A measurement control program for nuclear material accounting monitors and controls the quality of the measurments of special nuclear material that are involved in material balances. The quality is monitored by collecting data from which the current precision and accuracy of measurements can be evaluated. The quality is controlled by evaluations, reviews, and other administrative measures for control of selection or design of facilities, equipment and measurement methods and the training and qualification of personnel who perform SNM measurements. This report describes the most important elements of a program by which management can monitor and control measurement quality

  2. Lack of Association of the Polymorphisms IL-17A (−197G/A) and IL-17F (+7488A/G) with Multibacillary Leprosy in Mexican Patients

    Science.gov (United States)

    Escamilla-Tilch, Mónica; Estrada-García, Iris; Granados, Julio; Arenas-Guzmán, Roberto; Ramos-Payan, Rosalio; Pérez-Suárez, Thalía Gabriela; Salazar, Ma. Isabel; Pérez-Lucas, Riky Luis; Estrada-Parra, Sergio; Torres-Carrillo, Nora Magdalena

    2014-01-01

    Background. Leprosy is a chronic infectious disease caused by the intracellular acid-fast bacilli Mycobacterium leprae; it has been determined that genetic factors of the host play an important role in the disease susceptibility. Thus, in this case-control study, we evaluated the possible association between the IL-17A G-197A (rs227593) and IL-17F A7488G (His161Arg, rs763780) gene SNPs and susceptibility to leprosy disease in Mexican population. Methods. Seventy-five leprosy patients and sixty-nine control subjects were included. Both SNPs were genotyped with the polymerase chain reaction-restriction fragment length polymorphism technique. Results. We found nonsignificant differences in genotype and allele frequencies related to IL-17A G-197A (rs227593) and IL-17F A7488G (His161Arg, rs763780) gene SNPs in MB as well as subclinical forms of leprosy disease versus healthy individuals. Conclusions. Since the sample size is not large enough, it is difficult to sustain an association of susceptibility to leprosy with genotypes or allele frequencies of IL-17A G-197A (rs227593) and IL-17F A7488G (His161Arg, rs763780), suggesting that IL-17 polymorphisms have no significant role in the genetic susceptibility to development of this disease in the Mexican Mestizo population. PMID:25431761

  3. Leprosy in Pregnancy: Obstetric Diligence is the Key

    Directory of Open Access Journals (Sweden)

    Rupali Bhatia

    2017-10-01

    Full Text Available Leprosy in pregnancy is a rarely encountered event. Out of the 2000 patients detected of leprosy annually, two to three are pregnant women and majority of them are diagnosed in the third trimester. We, hereby, report a case of borderline tuberculoid leprosy with Type I lepromatous reaction in a 26-year-old pregnant woman in early second trimester with a large raised red coloured lesion over the forehead and six other small lesions involving the trunk and limbs with reduced sensory perception over involved skin. Occurrence of leprosy in an obstetric patient belonging to low prevalence area of India is infrequent especially in the post elimination era. However, we do need to have a high index of suspicion in lesions suggestive of the disease.

  4. Methemoglobinemia and dapsone levels in patients with leprosy

    Directory of Open Access Journals (Sweden)

    Jose Luiz Fernandes Vieira

    Full Text Available The objective of this work was to determine the methemoglobinemia and correlate with dapsone levels in multibacillary leprosy patients under leprosy multi-drug therapy. Thirty patients with laboratory and clinical diagnosis of multibacillary leprosy were enrolled. Dapsone was analyzed by high performance liquid chromatography and methemoglobinemia by spectrophotometry. The mean dapsone concentrations in male was 1.42 g/mL and in female was 2.42 g/mL. The mean methemoglobin levels in male was 3.09 µg/mL; 191%, and in female was 2.84 ± 1.67%. No correlations were seen between dapsone levels and methemoglobin in male and female patients. Our results demonstrated that the dosage of dapsone in leprosy treatment does not promote a significant methemoglobinemia.

  5. analysis, diagnosis and prognosis of leprosy utilizing fuzzy classifier ...

    African Journals Online (AJOL)

    TRIPPLEJO2K2

    leprae to humans: chimpanzees, mangabey monkeys, and nine-banded armadillos. The early signs and symptoms of leprosy are very subtle and occur slowly (usually over years), which includes; numbness (loss of temperature sensation), skin ...

  6. Serum neopterin as a marker for reactional states in leprosy

    NARCIS (Netherlands)

    Hamerlinck, F. F.; Klatser, P. R.; Walsh, D. S.; Bos, J. D.; Walsh, G. P.; Faber, W. R.

    1999-01-01

    Reactions, a relatively common phenomenon among leprosy patients in treatment, require early detection and proper management to prevent serious sequelae. It is generally accepted that reactional states are immunologically mediated and, as such, usually improve with immunomodulatory treatments such

  7. The Leprosy Agents Mycobacterium lepromatosis and Mycobacterium leprae in Mexico

    Science.gov (United States)

    Han, Xiang Y.; Sizer, Kurt Clement; Velarde-Félix, Jesús S.; Frias-Castro, Luis O.; Vargas-Ocampo, Francisco

    2011-01-01

    Summary Background Mycobacterium leprae was the only known cause of leprosy until 2008, when a new species, named Mycobacterium lepromatosis, was found to cause diffuse lepromatous leprosy (DLL), a unique form of leprosy endemic in Mexico. Methods We sought to differentiate the leprosy agents among 120 Mexican patients with various clinical forms of leprosy and to compare their relative prevalence and disease features. Archived skin biopsy specimens from these patients were tested for both M. leprae and M. lepromatosis using polymerase chain reaction-based species-specific assays. Results Eighty-seven (72.5%) patients were confirmed for etiologic species, including 55 with M. lepromatosis, 18 with M. leprae, and 14 with both organisms. The endemic regions of each agent differed but overlapped. Patients with M. lepromatosis were younger and from more states, and their clinical diagnoses included 13 DLL, 34 lepromatous leprosy (LL), and eight other forms of leprosy. By contrast, the diagnoses of patients with M. leprae included none DLL, 15 LL and three other forms. Thus, M. lepromatosis caused DLL specifically (p=0.023). Patients with M. lepromatosis also showed more variable skin lesions and the extremities were the commonest biopsy sites. Finally, patients with dual infections manifested all clinical forms and accounted for 16.1% of all species-confirmed cases. Conclusions M. lepromatosis is another cause of leprosy and is probably more prevalent than M. leprae in Mexico. It mainly causes LL and also specifically DLL. Dual infections caused by both species may occur in endemic area. PMID:22788812

  8. HLA-DR and HLA-DQ alleles in patients from the south of Brazil: markers for leprosy susceptibility and resistance

    Directory of Open Access Journals (Sweden)

    Peixoto Paulo R

    2009-08-01

    Full Text Available Abstract Background Many epidemiological studies have shown that the genetic factors of the host play a role in the variability of clinical response to infection caused by M. leprae. With the purpose of identifying genes of susceptibility, the present study investigated the possible role of HLA-DRB1 and DQA1/DQB1 alleles in susceptibility to leprosy, and whether they account for the heterogeneity in immune responses observed following infection in a Southern Brazilian population. Methods One hundred and sixty-nine leprosy patients and 217 healthy controls were analyzed by polymerase chain reaction amplification and reverse hybridization with sequence-specific oligonucleotide probes and sequence-specific primers(One Lambda®, CA, USA. Results There was a positive association of HLA-DRB1*16 (*1601 and *1602 with leprosy per se (7.3% vs. 3.2%, P = 0.01, OR = 2.52, CI = 1.26–5.01, in accord with previous serological studies, which showed DR2 as a marker of leprosy. Although, HLA-DQA1*05 frequency (29.8% vs. 20.9%, P = 0.0424, OR = 1.61, CI = 1.09–2.39 was higher in patients, and HLA-DQA1*02 (3.0% vs. 7.5%, P = 0.0392, OR = 0.39, CI = 0.16 – 0.95 and HLA-DQA1*04 (4.0% vs. 9.1%, P = 0.0314, OR = 0.42, CI = 0.19 – 0.93 frequencies lower, P-values were not significant after the Bonferroni's correction. Furthermore, HLA-DRB1*1601 (9.0% vs. 1.8%; P = 0.0016; OR = 5.81; CI = 2.05–16.46 was associated with susceptibility to borderline leprosy compared to control group, and while HLA-DRB1*08 (11.2% vs. 1.2%; P = 0.0037; OR = 12.00; CI = 1.51 – 95.12 was associated with susceptibility to lepromatous leprosy, when compared to tuberculoid leprosy, DRB1*04 was associated to protection. Conclusion These data confirm the positive association of HLA-DR2 (DRB1*16 with leprosy per se, and the protector effect of DRB1*04 against lepromatous leprosy in Brazilian patients.

  9. Controls Over Project Management Oversight Program

    Science.gov (United States)

    1997-12-08

    This is the final report on Federal Transit Administration's (FTA) controls over its Project Management Oversight (PMO) Program. This report reflects Office of Inspector General's (OIG) consideration of information provided in FTA's May 29, 1997, rep...

  10. Traffic control device evaluation program : FY 2016.

    Science.gov (United States)

    2017-03-01

    This report presents findings on three different activities conducted in the Traffic Control Device Evaluation Program during the 2016 fiscal year. The first two activities are evaluations of full-matrix color light-emitting diode changeable message ...

  11. Research for International Tobacco Control (RITC) : Program ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Department for International Development (DFID), United Kingdom, is making a grant of up to £1 100 000 to IDRC to cover three years of Research for International Tobacco Control (RITC) programming between April 2005 and March 2008. The funding is intended to support activities outlined in RITC's program ...

  12. Leprosy Associated with Atypical Cutaneous Leishmaniasis in Nicaragua and Honduras.

    Science.gov (United States)

    Soto, Lucrecia Acosta; Caballero, Nelson; Fuentes, Lesny Ruth; Muñoz, Pedro Torres; Gómez Echevarría, Jose Ramón; López, Montserrat Pérez; Bornay Llinares, Fernando Jorge; Stanford, John L; Stanford, Cynthia A; Donoghue, Helen D

    2017-10-01

    In Central America, few cases of leprosy have been reported, but the disease may be unrecognized. Diagnosis is based on clinical criteria and histology. Preliminary field work in Nicaragua and Honduras found patients, including many children, with skin lesions clinically suggestive of atypical cutaneous leishmaniasis or indeterminate leprosy. Histology could not distinguish these diseases although acid-fast organisms were visible in a few biopsies. Lesions healed after standard antimicrobial therapy for leprosy. In the present study, patients, family members, and other community members were skin-tested and provided nasal swabs and blood samples. Biopsies were taken from a subgroup of patients with clinical signs of infection. Two laboratories analyzed samples, using local in-house techniques. Mycobacterium leprae , Leishmania spp. and Leishmania infantum were detected using polymerase chain reactions. Mycobacterium leprae DNA was detected in blood samples and nasal swabs, including some cases where leprosy was not clinically suspected. Leishmania spp. were also detected in blood and nasal swabs. Most biopsies contained Leishmania DNA and coinfection of Leishmania spp. with M. leprae occurred in 33% of cases. Mycobacterium leprae DNA was also detected and sequenced from Nicaraguan and Honduran environmental samples. In conclusion, leprosy and leishmaniasis are present in both regions, and leprosy appears to be widespread. The nature of any relationship between these two pathogens and the epidemiology of these infections need to be elucidated.

  13. Automatic control of commercial computer programs

    International Nuclear Information System (INIS)

    Rezvov, B.A.; Artem'ev, A.N.; Maevskij, A.G.; Demkiv, A.A.; Kirillov, B.F.; Belyaev, A.D.; Artem'ev, N.A.

    2010-01-01

    The way of automatic control of commercial computer programs is presented. The developed connection of the EXAFS spectrometer automatic system (which is managed by PC for DOS) is taken with the commercial program for the CCD detector control (which is managed by PC for Windows). The described complex system is used for the automation of intermediate amplitude spectra processing in EXAFS spectrum measurements at Kurchatov SR source

  14. Measurement control program for new special recovery

    International Nuclear Information System (INIS)

    Hsue, S.T.; Campbell, K.; Barlich, G.

    1987-04-01

    This report summarizes the design of the measurement control (MC) program for the New Special Recovery facility. The MC program is divided into two levels. Level 1 MC checks are performed at the individual instrument computer and will always be functional even when the instrument-control computer is down. The level 1 MCs are divided into statistical checks for both bias and precision, and diagnostic checks. All the instruments are connected on line to an instrument-control computer to which the measurement results can be communicated. Level 2 MC analyses are performed at this computer. The analyses consist of control charts for bias and precision and statistical tests used as analytic supplements to the control charts. They provide the desired detection sensitivity and yet can be interpreted quickly and easily. Recommendations are also made in terms of the frequency of the tests, the standard used, and other operational aspects of the MC program. 16 refs., 11 figs., 10 tabs

  15. Prevalence and Correlates of Leprosy in a High-Risk Community Setting in Sri Lanka.

    Science.gov (United States)

    Dabrera, Thushani Marie Elizabeth; Tillekeratne, L Gayani; Fernando, M S Nilanthi; Kasturiaratchi, S T Kaushlya; Østbye, Truls

    2016-10-01

    Leprosy is caused by the Mycobacterium leprae bacillus. Pockets of high endemicity remain in a number of countries including Sri Lanka, in spite of the fact that elimination has been achieved at the national level. In 2012, in a village in the Puttlam district, dermatologists reported an increase in individuals with leprosy. This village had been established in the 1990s for people displaced from Northern Sri Lanka during a civil war. A comprehensive household survey was conducted by district health officials from June to July 2012, and all household members present during the survey period were examined for leprosy lesions. Patients with suspected leprosy were referred to a dermatology clinic for clinical or pathological confirmation. The prevalence of leprosy was high (511 per 10 000 population). Household contact with another patient with leprosy increased the risk of leprosy (odds ratio = 6.69; P < .001). Continued vigilance is needed to keep leprosy at bay in high-risk communities.

  16. Learning from a leprosy project in Indonesia: making mindsets explicit for stigma reduction

    NARCIS (Netherlands)

    Peters, R.M.H.; Lusli, M.M.; Zweekhorst, M.B.M.; Miranda Galarza, H.B.; van Brakel, W.H.; Bunders-Aelen, J.G.F.

    2015-01-01

    International attention for disability recognises that it plays an important role in persistent poverty. Leprosy can cause preventable disability. Stigma associated with leprosy often has greater implications for people affected than physical impairments. The Stigma Assessment and Reduction of

  17. Measurement of Change in the Knowledge and Attitude about Leprosy in Physiotherapy Students Undergoing Intensive One Week Training in Leprosy.

    Science.gov (United States)

    Prakashkumar, M D; Ebenezer, M; Richard, J

    2014-01-01

    Leprosy is a disease that causes not only physical problems, but also mental and social problems. In the post integration era, every health care professional needs to understand about leprosy, to be able to diagnose and treat them. Physiotherapy students, in their usual syllabus, have minimal exposure to leprosy, in spite of the fact that they have a major role in preventing impairments and disabilities caused by leprosy, as well as treating such impairments. In order to educate physiotherapy students on leprosy, a one-week intensive training course was organised. This study was done to assess if the intensive training to physiotherapy students resulted in increase in their knowledge on leprosy and change their attitude positively. A batch consisting of 42 physiotherapy students went through the one-week training programme. The improvement in knowledge and attitude were assessed through a pre-test and a post-test design. Results showed that there was significant improvement in knowledge (53.05%) and brought positive change in attitude (75.0%). Such training programmes are recommended for all physiotherapy students.

  18. ZINC SERUM LEVEL AND PERIPHERAL BLOOD MONOCYTE COUNT OF MULTIBACILAR LEPROSY PATIENT LOWER THAN PAUCIBACILAR LEPROSY IN RSUP SANGLAH

    Directory of Open Access Journals (Sweden)

    Putu Kurniawan Dhana

    2013-04-01

    Full Text Available Zinc has been known to have important role in the immune system. Zinc deficiency can inhibit activation and production cytokine of Th1 and  may cause cellular immunity dysfunction. This conditon also may cause changes of lymphopoiesis and hematopoiesis also peripheral blood of mononuclear cell as mononuclear fagocyte. The Aim of this study is to know zinc serum status and peripheral blood monocyte count of leprosy patient in Dermato Venerologi policlinic Sanglah hospital Denpasar. This study use cross sectional design. Sample of study take by consecutive sampling with sample size contains 75 patient.  Mean of zinc serum status on multibacillary leprosy patient is 5.66  (SB 11.74 found lower compare to paucibacillary leprosy patient 19.38 (SB 18.21 and statistically significant with P < 0.05. Mean of peripheral blood monocyte count in multibacillary patient is 7.12 (SB 2.53 lower compare to paucibacillary leprosy patient with 7.88 (SB 3.08, but statistically not significant with P > 0.05. Binary logistic analysis show the influence of zinc serum status to probability to have leprosy. This study suggest correction of serum zinc level in leprosy patient through nutritional approach or the granting of a supplement of zinc

  19. Divison of Environmental Control Technology program, 1978

    International Nuclear Information System (INIS)

    1979-06-01

    This report covers Division of Environmental Control Technology projects in progress during FY 1978, within the Office of the Assistant Secretary for Environment, Department of Energy. It is the second in a planned series of annual reports. The Division of Environmental Control Technology (ECT) continues to support the Assistant Secretary for Environment (EV) in discharging two primary responsibilities: (1) under the Environmental Engineering (EE) Program, the independent overview and assessment of environmental control aspects of both the U.S. Department of Energy's (DOE) research, development, and demonstration (RD and D) programs and the Nation's energy policies, and (2) under the Decontamination and Decommissioning Program, the reduction of potential environmental hazards at the radioactively contaminated sites that are presently owned or were formerly used by the Government. This report presents a short summary of objectives, approach, progress and results, future plans, and a reference bibliography for each research, development, or assessment project within the program areas described above

  20. Leprosy and the testis La lepra y el testículo

    Directory of Open Access Journals (Sweden)

    Fernando López

    2011-09-01

    Full Text Available Introduction. Damage of testicles is frequent in lepromatous leprosy worsen by the presence of erythema nodosum leprosum.
    Objective. One patient is presented who developed lepromatous leprosy and erythema nodosum leprosum with important testicular compromise.
    Material and methods. A 28 year old man patient who had lepromatous leprosy since his 22 was studied. During a polychemotherapy treatment for the lepromatous leprosy, he presented chronic erythema nodosum leprosum that affected both testicles and did not respond to the conventional treatment. A left orchidectomy was practiced to treat the persistent pain.
    Results. The extracted testis evidenced the following findings: tubular atrophy, remarkable fibrosis, cumulus of foamy macrophages without rods, focal Leydig cell hyperplasia, linfocitary and granulomatous arteritis and endarteritis of small and medium size vessels. These changes were also observed in the epididymis. Two years after the polychemoterapy and the orchidectomy, the patient revealed azoospermy, normal total testosterone, discretely diminished free testosterone and elevated luteinizing hormone and follicle-stimulating hormone. No loss of libido or sexual activity. We reviewed general concepts about erythema nodosum leprosum and the pathologic changes produced by leprosy in the testis.
    Conclusion. Lepromatous leprosy may lead to hypogonadism. This should be considered by the leprosy programs in order to avoid and treat the consequences of the possible hypogonadism.
    Introducción. La afección testicular es frecuente en la lepra lepromatosa, daño que se incrementa cuando cursa con eritema nodoso leproso.
    Objetivo. Presentar un paciente con lepra lepromatosa y eritema nodoso leproso con severo compromiso testicular.
    Materiales y métodos. Estudiamos un hombre de 28 años con lepra lepromatosa desde los 22, que durante el tratamiento con poliquimioterapia para la lepra presentó eritema nodoso

  1. Material control system simulator program reference manual

    International Nuclear Information System (INIS)

    Hollstien, R.B.

    1978-01-01

    A description is presented of a Material Control System Simulator (MCSS) program for determination of material accounting uncertainty and system response to particular adversary action sequences that constitute plausible material diversion attempts. The program is intended for use in situations where randomness, uncertainty, or interaction of adversary actions and material control system components make it difficult to assess safeguards effectiveness against particular material diversion attempts. Although MCSS may be used independently in the design or analysis of material handling and processing systems, it has been tailored toward the determination of material accountability and the response of material control systems to adversary action sequences

  2. Material control system simulator program reference manual

    Energy Technology Data Exchange (ETDEWEB)

    Hollstien, R.B.

    1978-01-24

    A description is presented of a Material Control System Simulator (MCSS) program for determination of material accounting uncertainty and system response to particular adversary action sequences that constitute plausible material diversion attempts. The program is intended for use in situations where randomness, uncertainty, or interaction of adversary actions and material control system components make it difficult to assess safeguards effectiveness against particular material diversion attempts. Although MCSS may be used independently in the design or analysis of material handling and processing systems, it has been tailored toward the determination of material accountability and the response of material control systems to adversary action sequences.

  3. Advanced Digital Controller Development Program, Task I.

    Science.gov (United States)

    1982-07-01

    digital controller through an electra-hydraulic servo valve ( EHSV ) and a position transducer. A pair of hydraulic cylinders will actuate a bell crank...AD-A129 269 ADVANCED DIGITAL CONTROLLER DEVELOPMENT PROGRAM TASK 1 1/1 ()GENERAL MOTORS CORP INDIANAPOLIS IN DETROIT DIESEL ALLISON D0. d H HUNTER JL...BUREAU OF S IANDARDS I-63 A I-16 2 I "-I [ I1 I ? I I I I II I I AFWAL-TR-82-2047 ’ Advanced Digital Controller < Development Program, Task I Detroit

  4. Controlled thermonuclear reactions and Tora Supra program

    International Nuclear Information System (INIS)

    1988-01-01

    The research programs for the nuclear energy production by means of thermonuclear fusion are shown. TORA SUPRA, Joint European Torus, Next European Torus and those developed at the Atomic Energy Center are described. The controlled fusion necessary conditions, the energy and confinement balance, and the research of a better tokamak configuration are discussed. A description of TORA SUPRA, the ways of achieving the project and the expected delays are shown. The Controlled Fusion Research Department functions, concerning these programs, are described. The importance of international cooperation and the perspectives about the use of controlled fusion are underlined [fr

  5. Efeito da adição de óleos mineral e vegetal a acaricidas no controle do ácaro-da-leprose dos citros Brevipalpus phoenicis (Geijskes (Acari: Tenuipalpide Effect of mineral and vegetal oils on the efficacy of miticides in control of the citrus leprosis mites Brevipalpus phoenicis (Geijskes (Acari:Tenuipalpidae

    Directory of Open Access Journals (Sweden)

    Carolina Pirajá de Oliveira

    2003-08-01

    affect negatively the efficiency of acaricides in the control of the citrus leprosis mite, as occured with pyridaben 200 EC and 750 WP and cyhexatin 500 WP. Triona and Assist did not affect the efficiency of the acaricides tested. The insaturation level of the acaricide mistures with Natur'l Óleo was measured using the iodine index method indicating that there was incorporation of the acaricide molecules by the insaturated links of the oil; however, this doesn't explain the different behavior of the products in the control of the citrus leprosis mite.

  6. Polyneuritic leprosy presenting with bone changes prior to the onset of florid skin manifestation

    Directory of Open Access Journals (Sweden)

    Kuravi Anandam

    2001-01-01

    Full Text Available A case of polyneuritic leprosy is reported. There were minimal changes on skin, but changes in the bones were predominant. It is emphasized that polyneuritic leprosy is an entity. It is also stressed that neuritic leprosy can produce changes in deeper structures like bones, with minimal changes on skin.

  7. Polyneuritic leprosy presenting with bone changes prior to the onset of florid skin manifestation

    OpenAIRE

    Kuravi Anandam; Girish K; Ghatti Suvarna; Stephen T; Kumar V

    2001-01-01

    A case of polyneuritic leprosy is reported. There were minimal changes on skin, but changes in the bones were predominant. It is emphasized that polyneuritic leprosy is an entity. It is also stressed that neuritic leprosy can produce changes in deeper structures like bones, with minimal changes on skin.

  8. Household expenditure on leprosy outpatient services in the Indian health system: A comparative study

    NARCIS (Netherlands)

    Tiwari, A. (Anuj); Suryawanshi, P. (Pramilesh); Raikwar, A. (Akash); Arif, M. (Mohammad); J.H. Richardus (Jan Hendrik)

    2018-01-01

    textabstractBackground: Leprosy is a major public health problem in many low and middle income countries, especially in India, and contributes considerably to the global burden of the disease. Leprosy and poverty are closely associated, and therefore the economic burden of leprosy is a concern.

  9. The Meaning of Leprosy and Everyday Experiences: An Exploration in Cirebon, Indonesia.

    NARCIS (Netherlands)

    Peters, R.M.H.; Lusli, M.M.; Miranda Galarza, H.B.; van Brakel, W.H.; Zweekhorst, M.B.M.; Damayanti, R.; Seda, F.S.S.E.; Bunders-Aelen, J.G.F.

    2013-01-01

    It is imperative to consider the meaning of leprosy and everyday experiences of people affected by leprosy and key persons in the community if one aims to make leprosy services more effective, which appears necessary in Indonesia given the large numbers of new cases detected annually. However,

  10. Clinical manifestations of leprosy after BCG vaccination: An observational study in Bangladesh

    NARCIS (Netherlands)

    R. Richardus (Renate); C.R. Butlin (C. Ruth); K. Alam (Khorshed); K. Kundu (Kallyan); A. Geluk (Annemieke); J.H. Richardus (Jan Hendrik)

    2015-01-01

    textabstractBackground: Although BCG is used as a vaccine against tuberculosis, it also protects against leprosy. Previous evaluation over 18 years of an intervention of two doses BCG for 3536 household contacts of leprosy patients showed that 28 (23%) out of 122 contacts diagnosed with leprosy,

  11. Disappearance of leprosy from Norway: an exploration of critical factors using an epidemiological modelling approach

    NARCIS (Netherlands)

    A. Meima; L.M. Irgens; G.J. van Oortmarssen (Gerrit); J.H. Richardus (Jan Hendrik); J.D.F. Habbema (Dik)

    2002-01-01

    textabstractBACKGROUND: By the middle of the 19th century, leprosy was a serious public health problem in Norway. By 1920, new cases only rarely occurred. This study aims to explain the disappearance of leprosy from Norway. METHODS: Data from the National Leprosy Registry of

  12. Leprosy in Puerto Rico: insight into the new millennia.

    Science.gov (United States)

    Valentín, Diana C; Candelario, Nicole; Carrasquillo, Osward Y; Figueroa, Luz; Sánchez, Jorge L

    2017-04-01

    Leprosy, or Hansen's disease, is a chronic infectious disease caused by the bacillus Mycobacterium leprae. In 2000, the World Health Organization (WHO) defined the elimination of the disease as a global prevalence of less than one case per 10,000 population. However, disease transmission is an ongoing worldwide public health concern, as evidenced by the more than 220,000 new cases diagnosed each year. This study is an update of the incidence and prevalence of leprosy in Puerto Rico for the period of 2000-2014. A retrospective analysis of data was obtained from the Tropical Disease Clinic (TDC) of the University of Puerto Rico School of Medicine. Sixty-three new cases of leprosy are detailed in this study. Disease incidence and prevalence were 1.65 and 5.26 per 100,000 inhabitants (of the island of Puerto Rico), respectively, and an average of 4.2 new cases per year. Most of the male patients in the study suffered from lepromatous leprosy (P = 0.026). In all, 47 (74.6%) patients had been born in Puerto Rico, and 29 (46%) had an affected family member or were in close contact with someone with leprosy. Compared to those of previous studies, these results demonstrate a decrease in both the incidence and prevalence of leprosy in Puerto Rico over the past 15 years. The relatively high prevalence of leprosy in Puerto Rico means that it remains endemic on the island. Concerted efforts must be undertaken to achieve the goal of the elimination of this old and stigmatized disease. © 2017 The International Society of Dermatology.

  13. Employers should disband employee weight control programs.

    Science.gov (United States)

    Lewis, Alfred; Khanna, Vikram; Montrose, Shana

    2015-02-01

    American corporations continue to expand wellness programs, which now reach an estimated 90% of workers in large organizations, yet no study has demonstrated that the main focus of these programs-weight control-has any positive effect. There is no published evidence that large-scale corporate attempts to control employee body weight through financial incentives and penalties have generated savings from long-term weight loss, or a reduction in inpatient admissions associated with obesity or even long-term weight loss itself. Other evidence contradicts the hypothesis that population obesity rates meaningfully retard economic growth or manufacturing productivity. Quite the contrary, overscreening and crash dieting can impact employee morale and even harm employee health. Therefore, the authors believe that corporations should disband or significantly reconfigure weight-oriented wellness programs, and that the Affordable Care Act should be amended to require such programs to conform to accepted guidelines for harm avoidance.

  14. Lucio Leprosy with Lucio's phenomenon, digital gangrene and anticardiolipin antibodies.

    Science.gov (United States)

    Nunzie, Enrico; Ortega Cabrera, L V; Macanchi Moncayo, F M; Ortega Espinosa, P F; Clapasson, A; Massone, C

    2014-09-01

    Lucio's phenomenon (LPh) is considered a necrotizing panvasculitis and a variant of leprosy Type 2 reaction, clinically characterised by necrotic-haemorrhagic lesions on the extremities and trunk. LPh is observed in diffuse lepromatous leprosy (DLL or Lucio-Latapí leprosy). This is a distinct form of lepromatous leprosy (LL) reported mainly in Mexico. Anti-phospholipid antibody syndrome (APS) has been rarely described in LPh. We report a case of Lucio-Latapí leprosy with LPh observed in a patient from the province of El Oro in Ecuador, who presented clinical manifestations of long standing DLL (non-nodular infiltration of the skin, collapse of the nasal pyramid, madarosis, atrophy of the earlobes), of LPh (necrotic-haemorrhagic macules with irregular shapes) and of APS (necrosis of the right big and second toe). Histopathology showed perineural and periadnexal foamy macrophages with numerous bacilli (diagnostic of LL) in the subcutis, a mild lobular panniculitis with a large subcutaneous vessel infiltrated by macrophages in the wall (typical of LPh) and vessels of the superficial and mid dermis occluded by thrombi but without signs of vasculitis (typical of occlusive vasculopathy as in APS). Our observations suggest that some cases of LPh may be associated with APS. Anti-cardiolipin antibodies (aCL) and lupus anticoagulant (LA) should be tested in patients with LPh because this may have therapeutic implications.

  15. Spatial distribution of leprosy in Brazil: a literature review

    Directory of Open Access Journals (Sweden)

    Cláuffer Luiz Machado Silva

    Full Text Available Abstract Leprosy remains a public health problem in developing countries. Among communicable diseases, it is one of the leading causes of permanent disability. Brazil had not reached the goal of reducing cases to less than 1 per 10,000 population. This study aimed to analyze the spatial distribution of leprosy cases in Brazil, using a literature review. The search strategy included the LILACS and MEDLINE databases with no language or period restriction. Ecological studies with spatial data analysis were considered as a criterion for the inclusion. We found 38 studies for review after the selection criteria. Among the epidemiological indicators of the disease, the most common was the new case detection rate. Several articles have explored the association between spatial distribution of leprosy and socioeconomic, demographic, and environmental factors. The most common unit of analysis was the municipality. The spatial distribution methods mostly used were: empirical Bayesian method, autocorrelation (Moran’s I index and Kernel estimates. The distribution of leprosy was very heterogeneous, independent of the unit of analysis. There was a decrease in the rate of detection and among under-15-year-olds, but some regions maintained high endemicity during the study period. The distribution and risk of illness were directly related to living conditions of the population. Improved access to health services was associated with increased detection rate in some regions. Spatial analysis seems to be a very useful tool to study leprosy and to guide interventions and surveillance.

  16. Spatial distribution of leprosy in Brazil: a literature review.

    Science.gov (United States)

    Silva, Cláuffer Luiz Machado; Fonseca, Sandra Costa; Kawa, Helia; Palmer, Dayanna de Oliveira Quintanilha

    2017-01-01

    Leprosy remains a public health problem in developing countries. Among communicable diseases, it is one of the leading causes of permanent disability. Brazil had not reached the goal of reducing cases to less than 1 per 10,000 population. This study aimed to analyze the spatial distribution of leprosy cases in Brazil, using a literature review. The search strategy included the LILACS and MEDLINE databases with no language or period restriction. Ecological studies with spatial data analysis were considered as a criterion for the inclusion. We found 38 studies for review after the selection criteria. Among the epidemiological indicators of the disease, the most common was the new case detection rate. Several articles have explored the association between spatial distribution of leprosy and socioeconomic, demographic, and environmental factors. The most common unit of analysis was the municipality. The spatial distribution methods mostly used were: empirical Bayesian method, autocorrelation (Moran's I index) and Kernel estimates. The distribution of leprosy was very heterogeneous, independent of the unit of analysis. There was a decrease in the rate of detection and among under-15-year-olds, but some regions maintained high endemicity during the study period. The distribution and risk of illness were directly related to living conditions of the population. Improved access to health services was associated with increased detection rate in some regions. Spatial analysis seems to be a very useful tool to study leprosy and to guide interventions and surveillance.

  17. Study Of Socio- Economic Factors In Relation To Leprosy

    Directory of Open Access Journals (Sweden)

    Alam Mahjabeen

    1998-01-01

    Full Text Available Research question: what are the socio-economic factors in relation to leprosy and their implications? Objectives: (i To study the socio-economic factors in relation to leprosy.(ii To assess the impact of disease on patients’ job/income. Study design: Cross-sectional. Setting and Participants: Patients attending the dermatology OPD, J.N. Medical college hospital, A.M.U., Aligarh. Sample size: 200 leprosy patients. Study variables: education, occupation, social class, incapacitation, change in job, reduction in income. Statically analysis: Chi-square test Results: 46% of the leprosy patients were illiterate. A large majority of patients (78% were involved in heavy manual work as farmers and labourers. 68.5% patients belonged to low social classes (IV and V. More males (26.3% suffered from incapacitation than females (8.5%. 2.5% patients lost their job or were unable to work and 11.5% had to change their jobs due to the disease or disability caused by it. 17.5% patients had a history of reduction in their income after occurrence of leprosy.

  18. Some aspects of the pathogenesis and pathomorphology of leprosy*

    Science.gov (United States)

    Ivanova, N. A.

    1972-01-01

    The results of bacteriological and histological examinations of the organs of mice infected in the footpad with human leprosy bacilli by the Shepard method are summarized. The periods of observation ranged from a few days to 2 years. The disease developed in mice as a chronic infection with a lengthy “incubation” period of 3-4 months or more without symptoms. Usually about 2 years after inoculation, or in some cases after a shorter interval, the disease became generalized. Different types of tissue reaction occurred: simple inflammatory infiltration, tuberculoid granuloma, and leproma-like granuloma, similar to the clinical types of leprosy in man. When the infection became general, cells resembling lepra cells formed in the internal organs and at the site of infection. These cells contained massive intracellular aggregations of mycobacteria and compact globi with lipids and a vacuolized protoplasm, similar in origin and morphology to the lepra cells in human lesions. Changes were found in the neuroreceptor apparatus of the skin of the mice, with groups of leprosy bacilli in the endoneurium, the Schwann cells, and the perineural spaces. The length of the experiments and the histological examination of material from the sacrificed mice at different stages of the infective process revealed biological parallels with human leprosy and threw light on a number of aspects of the pathogenesis of leprosy. ImagesFig. 2Fig. 3Fig. 4Fig. 5Fig. 1 A-DFig. 10Fig. 11Fig. 12Fig. 13Fig. 6Fig. 7Fig. 8Fig. 9 PMID:4538195

  19. Duke Power Company's control rod wear program

    International Nuclear Information System (INIS)

    Culp, D.C.; Kitlan, M.S. Jr.

    1990-01-01

    Recent examinations performed at several foreign and domestic pressurized water reactors have identified significant control rod cladding wear, leading to the conclusion that previously believed control rod lifetimes are not attainable. To monitor control rod performance and reduce safety concerns associated with wear, Duke Power Company has developed a comprehensive control rod wear program for Ag-In-Cd and boron carbide (B 4 C) rods at the McGuire and Catawba nuclear stations. Duke Power currently uses the Westinghouse 17 x 17 Ag-In-Cd control rod design at McGuire Unit 1 and the Westinghouse 17 x 17 hybrid B 4 C control rod design with a Ag-In-Cd tip at McGuire Unit 2 and Catawba Units 1 and 2. The designs are similar, with the exception of the absorber material and clad thickness. There are 53 control rods per unit

  20. Electromyography function, disability degree, and pain in leprosy patients undergoing neural mobilization treatment

    Directory of Open Access Journals (Sweden)

    Larissa Sales Téles Véras

    2012-02-01

    Full Text Available INTRODUCTION: This study aimed to evaluate the effect of the neural mobilization technique on electromyography function, disability degree, and pain in patients with leprosy. METHODS: A sample of 56 individuals with leprosy was randomized into an experimental group, composed of 29 individuals undergoing treatment with neural mobilization, and a control group of 27 individuals who underwent conventional treatment. In both groups, the lesions in the lower limbs were treated. In the treatment with neural mobilization, the procedure used was mobilization of the lumbosacral roots and sciatic nerve biased to the peroneal nerve that innervates the anterior tibial muscle, which was evaluated in the electromyography. RESULTS: Analysis of the electromyography function showed a significant increase (p<0.05 in the experimental group in both the right (Δ%=22.1, p=0.013 and the left anterior tibial muscles (Δ%=27.7, p=0.009, compared with the control group pre- and post-test. Analysis of the strength both in the movement of horizontal extension (Δ%right=11.7, p=0.003/Δ%left=27.4, p=0.002 and in the movement of back flexion (Δ%right=31.1; p=0.000/Δ%left=34.7, p=0.000 showed a significant increase (p<0.05 in both the right and the left segments when comparing the experimental group pre- and post-test. The experimental group showed a significant reduction (p=0.000 in pain perception and disability degree when the pre- and post-test were compared and when compared with the control group in the post-test. CONCLUSIONS: Leprosy patients undergoing the technique of neural mobilization had an improvement in electromyography function and muscle strength, reducing disability degree and pain.

  1. A comparison of stigma among patients with leprosy in rural Tanzania and urban United States: a role for public health in dermatology.

    Science.gov (United States)

    Roosta, Neda; Black, David S; Rea, Thomas H

    2013-04-01

    Leprosy is a chronic infection of the skin and peripheral nerves caused by the bacterium Mycobacterium leprae, which causes peripheral insensitivity and disfigurements of the skin, limbs, and digits. Social stigma is a common consequence of leprosy and may differ according to level of physical disfigurement and geographic location. The objective of this study was to assess social stigma encountered by patients with leprosy in clinical settings located in rural Tanzania and urban USA and to compare the social stigma reported in these regions.   A total of 56 respondents were recruited from one leprosy inpatient facility in Shirati, Tanzania (n = 28), and one outpatient clinic in Los Angeles, USA (n = 28). Cross-sectional data were obtained from face-to-face interviews, which were conducted with respondents at each clinic location. Measures of perceived stigma were assessed in family relationship, vocational, social interaction, and interpersonal contexts.   Patients in Tanzania, as compared with those in the USA, reported significantly higher levels of stigma in family relationship and vocational contexts. Tanzanian patients also reported higher levels of stigma in social interaction and self-esteem contexts, but these differences were marginally significant and may reflect the small sample size.   Leprosy-related social stigma is a major problem in regions of both developed and developing countries; however, patients with leprosy in developing countries reported higher levels of stigma in four social contexts. A public health role in dermatology is discussed as an agent of early diagnosis, control, and education in order to reduce social stigma and promote social rehabilitation. © 2013 The International Society of Dermatology.

  2. Polymorphisms in genes TLR1, 2 and 4 are associated with differential cytokine and chemokine serum production in patients with leprosy

    Directory of Open Access Journals (Sweden)

    Nadja de Lima Santana

    Full Text Available BACKGROUND Leprosy or hansen’s disease is a spectral disease whose clinical forms mostly depends on host’s immune and genetic factors. Different Toll-like receptors (TLR variants have been described associated with leprosy, but with some lack of replication across different populations. OBJECTIVES To evaluate the role of polymorphisms in genes TLR1, TLR2 and TLR4 and susceptibility to leprosy in a genetic case control study; to verify the association between genotypes of these markers and the immunological profile in the serum of patients with leprosy. METHODS Pre-designed TaqMan® assays were used to genotype markers at TLR1 (rs4833095, rs5743551, TLR2 (rs7656411, rs3804099 and TLR4 (rs1927914, rs1927911. A panel of cytokines and chemokines was accessed by enzime-linked immunosorbent assay (ELISA test in the serum of a subgroup of patients with and without leprosy reactions. FINDINGS Our results show an association between the T allele of rs3804099 at the TLR2 gene and increased risk for leprosy per se [Odds ratio (OR = 1.296, p = 0,022]. In addition, evaluating the association between different genotypes of the TLR1, 2 and 4 markers and cytokine/chemokine serological levels, IL-17 appears as an immunological marker regulated by the polymorphism of the three TLR genes evaluated, whereas different TLR1 genotypes were associated with differential production of IL-12p40 and MCP-1(CCL2. Furthermore, other relevant serum markers such as CXCL-10 and IL-6 seemed to be regulated by TLR2 variants and IL-1β was related to TLR4 genotypes. MAIN CONCLUSIONS All together our data points that the tested TLR markers may have a regulatory role in the immunity against Mycobacterium leprae, by driving the host’s production of key cytokines and chemokines involved in the pathogenesis of this disease.

  3. HEALS Hypertension Control Program: Training Church Members as Program Leaders.

    Science.gov (United States)

    Dodani, Sunita; Beayler, Irmatine; Lewis, Jennifer; Sowders, Lindsey A

    2014-01-01

    Health disparities related to cardiovascular diseases (CVDs) including stroke have remained higher in the African-Americans (AAs) than in other populations. HEALS is a faith-based hypertension (HTN) control program modified according to AA community needs, and delivered by the church-lay members called church health advisors (CHAs). This study examined the feasibility and acceptability of training CHAs as HEALS program leaders. Four CHAs completed a 10-hour HEALS program training workshop at the Church, conducted by the nutrition experts. Workshop was evaluated by CHAs on their level of satisfaction, clarity of contents covered and comfort in delivery the program to the church congregation. The overall six main HEALS curriculum components were completed. Workshop was highly evaluated by CHAs on length of training, balance between content and skills development, and level of satisfaction with program delivery. Church-based culturally modified health promotion interventions conducted by the community lay members may be a way to reduce health disparities in ethnic minorities.

  4. Effectiveness of rifampicin chemoprophylaxis in preventing leprosy in patient contacts: a systematic review of quantitative and qualitative evidence.

    Science.gov (United States)

    Ferreira, Silvana Margarida Benevides; Yonekura, Tatiana; Ignotti, Eliane; Oliveira, Larissa Bertacchini de; Takahashi, Juliana; Soares, Cassia Baldini

    2017-10-01

    studies. Studies published from the time of the respective database inception to January 2016 in English, Spanish, Portuguese, Japanese and Chinese were considered. Two reviewers independently assessed the studies for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute. Standardized data extraction tools developed by the Joanna Briggs Institute were used to extract quantitative and qualitative data from papers included in the review. Due to clinical and methodological heterogeneity in the interventions of the included studies, no statistical meta-analysis was possible. Quantitative and qualitative research findings are presented in narrative form. Following critical appraisal, eight studies were included in this review, seven quantitative and one qualitative. The reduction in incidence of leprosy, using one dose of rifampicin in the first two years, was 56.5%; in the follow up period of one to four years, the reduction was 34.9%. The combination of rifampicin and the Bacillus Calmette-Guérin vaccine showed a preventative effect of 80% against the disease. The only controlled clinical trial using two doses of rifampicin was community-based and did not indicate effectiveness of the intervention. The qualitative findings showed social acceptability of rifampicin. Chemoprophylaxis with one dose of rifampicin is found to be effective in preventing contacts of leprosy patients from contracting the disease. Also, there is indication that this strategy is socially accepted.

  5. Effects of environment and education on knowledge and attitude of nursing students towards leprosy.

    Science.gov (United States)

    Rajkumar, E; Julious, S; Salome, A; Jennifer, G; John, A S; Kannan, L; Richard, J

    2011-01-01

    The objective of this cross-sectional comparative study was to find the effects of environment and education on knowledge and attitude of nursing students towards leprosy. Data were collected, using a pretested questionnaire, from the first year and third year students of a School of Nursing attached to a leprosy specialty hospital and also from a comparable School of Nursing attached to a general hospital. The results showed that trainees acquired more knowledge on leprosy during training in both schools of nursing. However, those trained in leprosy hospital environment had higher knowledge and attitude scores than those trained in general hospital environment. The attitude of the trainees attached to leprosy hospital was favourable even before they had formal training in leprosy. Those trained in the general hospital showed more favourable attitude after training compared to before training. School of Nursing attached to leprosy hospital provided an atmosphere conducive to learning and understanding more about leprosy. The trainees retained what was learnt because of regular association with patients affected by leprosy. For employment in hospital or community based services or research related to leprosy, nurses trained in a leprosy hospital would have added value of knowledge and attitude.

  6. Pretty leprosy: Another face of Hansen’s disease! A review

    Directory of Open Access Journals (Sweden)

    P. Prem Anand

    2014-10-01

    Full Text Available Pretty leprosy is one of the rare severe forms of lepromatous leprosy. It is a reaction pattern that occurs in untreated pure primitive diffuse lepromatous leprosy or lepromatous leprosy. The skin of the patient is diffusely infiltrated and shiny, so that natural wrinkles are obliterated. It generates a moist and myxoedematous complexion imparting a healthy aspect to the patient. Thus the disease got the name. In this review we have reviewed almost all available literature to point more light toward the clinical variant pretty leprosy. A search was made in PubMed central to know the availability of information about pretty leprosy, but the response was nil for pretty leprosy. 37 articles were spotted in PubMed media on Lucioleprosy; 3 review articles are present and the rest were case reports.

  7. Leprosy. An update: definition, pathogenesis, classification, diagnosis, and treatment.

    Science.gov (United States)

    Eichelmann, K; González González, S E; Salas-Alanis, J C; Ocampo-Candiani, J

    2013-09-01

    Leprosy is a chronic granulomatous disease caused by the bacillus Mycobacterium leprae. It primarily affects the skin and peripheral nerves and is still endemic in various regions of the world. Clinical presentation depends on the patient's immune status at the time of infection and during the course of the disease. Leprosy is associated with disability and marginalization. Diagnosis is clinical and is made when the patient has at least 1 of the following cardinal signs specified by the World Health Organization: hypopigmented or erythematous macules with sensory loss; thickened peripheral nerves; or positive acid-fast skin smear or skin biopsy with loss of adnexa at affected sites. Leprosy is treated with a multidrug combination of rifampicin, clofazimine, and dapsone. Two main regimens are used depending on whether the patient has paucibacillary or multibacillary disease. Copyright © 2011 Elsevier España, S.L. and AEDV. All rights reserved.

  8. Leprosy, a Pleitropic infectious disease: a challenging diagnosis

    Directory of Open Access Journals (Sweden)

    Manal El Meniawy

    2018-01-01

    Full Text Available This is a case report of 22-year-old man who was suffering from epididymo-orchitis for more than 2 years. Several months after the onset of the condition, the patient developed bilateral upper-limb and lower-limb numbness and tingling sensation with hypothesia, which was further complicated by nonhealing foot ulcer, arthralgia, and generalized maculopapular skin rash. The patient was initially managed as rheumatoid arthritis associated with vasculitis, which was later diagnosed as lepromatous leprosy. Musculoskeletal complaints are not exclusive to only autoimmune diseases; it can also be observed in several disorders, such as infectious diseases. It is challenging for any physician to properly diagnose patients with leprosy as differentiating leprosy from other systemic rheumatic disease is pivotal.

  9. Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases.

    Directory of Open Access Journals (Sweden)

    Mariane M A Stefani

    2017-06-01

    Full Text Available 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 between the strains from the first and second disease episodes in all three patients. In one case, clear evidence was obtained for reinfection with an unrelated strain whereas in the other two cases, relapse appeared more probable.This is the first report of using M. leprae whole genome sequencing to reveal that treated and cured leprosy patients who remain in endemic areas can be reinfected by another strain. Next generation sequencing can be applied reliably to M. leprae DNA extracted from biopsies to discriminate between cases of relapse and reinfection, thereby providing a powerful tool for evaluating different outcomes of therapeutic regimens and for following disease transmission.

  10. Neuro-lepra: valor de la electromiografia Neuro-leprosy: electromyographic studies

    Directory of Open Access Journals (Sweden)

    Ernesto Herskovits

    1971-09-01

    Full Text Available Dada la frecuencia con que la lepra afecta al sistema nervioso, consideramos de interés realizar un estudio electromiográfico en zonas corporales clínicamente sanas. Hemos elegido para tal fin 14 enfermos que no tenían lesión sensitivo-motora clínicamente perceptible en el nervio cubital izquierdo. Hemos estudiado tambén un grupo de control de 5 enfermos con lesión evidente del mismo nervio. Se ha comprobado que de los 14 enfermos que aparentemente no tenían lesión del nervio cubital izquierdo, en 12 de ellos surgieron alteraciones electromiográficas que señalan la lesión del nervio, aunque en um grado menor que en el grupo de control. Este hecho nos hace pensar que la agresión que sufre el sistema nervioso periférico es de una extensión mayor que lo hace suponer la clínica, o que las lesiones anatómicas no retrogradan como nos lo sugiere el examen de los pacientes.Considering the frequency of the peripheral nervous system envolvement in leprosy 14 patients without clinical signs indicating impairment of the left ulnar nerve were submitted to electromyographic studies. All were chronic cases in which the disease had an evolution of three years for the most recent one, the longest during thirty one years. All patients were under leprosy treatment: nine had lepromatous leprosy, four had tuberculoid form, one had a dimorfous form. At the same time, as a control group, were studied 5 patients presenting clinical signis of injury of the left ulnar nerve. An electromiograph DISA with 3 channels, a Multistin estimulator and concentric electrodes were employed. In all the 19 cases the espontaneous activity, the type of recruiting reaction and the conduction velocity were analysed. Results were synthetized in Tables 1 and 2. The finding of electromyographic abnormalities in clinically healthy territores of 12/14 patients examined lead to the conclusion that in leprosy the agression to the peripheral nervous system is more extensive than

  11. Object oriented programming interfaces for accelerator control

    International Nuclear Information System (INIS)

    Hoff, L.T.

    1997-01-01

    Several years ago, the AGS controls group was given the task of developing software for the RHIC accelerator. Like the AGS, the RHIC control system needs to control and monitor equipment distributed around a relatively large geographic area. A local area network connects this equipment to a collection of UNIX workstations in a central control room. Similar software had been developed for the AGS about a decade earlier, but isn't well suited for RHIC use for a number of reasons. Rather than adapt the AGS software for RHIC use, the controls group opted to start with a clean slate. To develop software that would address the shortcomings of the AGS software, while preserving the useful features that evolved through years of use. A current trend in control system design is to provide an object oriented programming interface for application developers. This talk will discuss important aspects and features of object oriented application programming interfaces (APIs) for accelerator control systems, and explore why such interfaces are becoming the norm

  12. Divison of Environmental Control Technology program, 1978

    Energy Technology Data Exchange (ETDEWEB)

    Mott, William E.

    1979-06-01

    This report covers Division of Environmental Control Technology projects in progress during FY 1978, within the Office of the Assistant Secretary for Environment, Department of Energy. It is the second in a planned series of annual reports. The Division of Environmental Control Technology (ECT) continues to support the Assistant Secretary for Environment (EV) in discharging two primary responsibilities: (1) under the Environmental Engineering (EE) Program, the independent overview and assessment of environmental control aspects of both the U.S. Department of Energy's (DOE) research, development, and demonstration (RD and D) programs and the Nation's energy policies, and (2) under the Decontamination and Decommissioning Program, the reduction of potential environmental hazards at the radioactively contaminated sites that are presently owned or were formerly used by the Government. This report presents a short summary of objectives, approach, progress and results, future plans, and a reference bibliography for each research, development, or assessment project within the program areas described above.

  13. Need for a national epilepsy control program

    Directory of Open Access Journals (Sweden)

    M Tripathi

    2012-01-01

    Full Text Available This article briefly outlines the proposed national epilepsy control program. The content of the article is based on four meetings held by invitation of the Ministry of Health. Invitees by ministry - Drs. D. C. Jain, M. Gourie Devi, V. Saxena, S. Jain, P. Satish. Chandra, M. Gupta, K. Bala, V. Puri, K. S. Anand, S. Gulati, S. Johri, P. S. Chandra, M. Behari, K. Radhakrishnan, D. Bachani. Presentations were made by Dr. M. Tripathi.The program will involve all neurologists across the country in teaching and training at state levels and a central monitoring committee.

  14. Misericordia and leprosy in the 20th century.

    Science.gov (United States)

    Grzybowski, Andrzej; Sak, Jarosław; Korecki, Krzysztof

    2016-01-01

    Leprosy, which in particular affects poor people of developing countries, was also a challenge for social and charitable activities. This was possible due to the engagement of "great community workers," people who devoted their professional and family life, passions, and their own material goods to conduct socio-medical activities among leprosy affected persons. This contribution discusses the work of the lepro-activists of international fame, Albert Schweitzer and Mother Teresa of Calcutta, as well as those who are less well known, Wanda Maria Błeńska and Marian Żelazek. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Elimination of leprosy as a public health problem by 2000 AD: an epidemiological perspective.

    Science.gov (United States)

    Nsagha, Dickson Shey; Bamgboye, Elijah Afolabi; Assob, Jules Clement Nguedia; Njunda, Anna Longdoh; Kamga, Henri Lucien Foumou; Zoung-Kanyi Bissek, Anne-Cécile; Tabah, Earnest Nji; Oyediran, Alain Bankole O O; Njamnshi, Alfred Kongnyu

    2011-01-01

    Leprosy is caused by Mycobacterium leprae and manifests as damage to the skin and peripheral nerves. The disease is dreaded because it causes deformities, blindness and disfigurement. Worldwide, 2 million people are estimated to be disabled by leprosy. Multidrug therapy is highly effective in curing leprosy, but treating the nerve damage is much more difficult. The World Health Assembly targeted to eliminate leprosy as a public health problem from the world by 2000. The objective of the review was to assess the successes of the leprosy elimination strategy, elimination hurdles and the way forward for leprosy eradication. A structured search was used to identify publications on the elimination strategy. The keywords used were leprosy, elimination and 2000. To identify potential publications, we included papers on leprosy elimination monitoring, special action projects for the elimination of leprosy, modified leprosy elimination campaigns, and the Global Alliance to eliminate leprosy from the following principal data bases: Cochrane data base of systematic reviews, PubMed, Medline, EMBASE, and the Leprosy data base. We also scanned reference lists for important citations. Key leprosy journals including WHO publications were also reviewed. The search identified 63 journal publications on leprosy-related terms that included a form of elimination of which 19 comprehensively tackled the keywords including a book on leprosy elimination. In 1991, the 44th World Health Assembly called for the elimination of leprosy as a public health problem in the world by 2000. Elimination was defined as less than one case of leprosy per 10000-population. Elimination has been made possible by a confluence of several orders of opportunities: the scientific (the natural history of leprosy at the present state of knowledge), technological (multi-drug therapy and the blister pack); political (commitment of governments) and financial (support from NGOs for example the Nippon Foundation that

  16. Systematic control of large computer programs

    International Nuclear Information System (INIS)

    Goedbloed, J.P.; Klieb, L.

    1986-07-01

    A package of CCL, UPDATE, and FORTRAN procedures is described which facilitates the systematic control and development of large scientific computer programs. The package provides a general tool box for this purpose which contains many conveniences for the systematic administration of files, editing, reformating of line printer output files, etc. In addition, a small number of procedures is devoted to the problem of structured development of a large computer program which is used by a group of scientists. The essence of the method is contained in three procedures N, R, and X for the creation of a new UPDATE program library, its revision, and execution, resp., and a procedure REVISE which provides a joint editor - UPDATE session which combines the advantages of the two systems, viz. speed and rigor. (Auth.)

  17. Citrus leprosis virus cytoplasmic type 2 (CiLV-C2 detection in Meta and Casanare States

    Directory of Open Access Journals (Sweden)

    Guillermo León

    2014-07-01

    Full Text Available This study discusses the diagnosis and detection of the new citrus leprosis virus cytoplasmic type 2 (CiLV-C2 in samples collected in Meta and Casanare States, using molecular techniques performed RT-PCR on plant tissue and mite vectors Brevipalpus phoenicis (Geijskes. RT-PCR tests were carry out using specific primers MP and CPG. The use of CPG primers allows the detection of CiLV-C2, in tissue plant samples with leprosis symptoms on fruits and leaves of Valencia orange (Citrus sinensis L. and Swinglea gluinosa Merr. leaves, which confirms the presence of this virus in Colombia. The MP primers did not detect the CiLV-C2 in any of performed tests. The RT-PCR technique allows detection of CiLV-C2 in samples of B. phoenicis mite vectors, with the specific CPG primers. Molecular detection of CiLV-C2 by RT-PCR technique is a fundamental tool for the virus diagnosis in Colombia, and should be used in diagnosis and prevention programs of citrus leprosis in the country.

  18. The Impact of a Rights-Based Counselling Intervention to Reduce Stigma in People Affected by Leprosy in Indonesia

    Science.gov (United States)

    Lusli, Mimi; Peters, Ruth; van Brakel, Wim; Zweekhorst, Marjolein; Iancu, Sorana; Bunders, Joske; Irwanto; Regeer, Barbara

    2016-01-01

    Background This paper assesses the impact of a counselling intervention on reducing leprosy-related stigma in Cirebon District, Indonesia. The unique features of this intervention are its rights-based approach, the underlying Cognitive Behavioural Therapy (CBT) model, the three types of counselling and the lay and peer counsellors who were involved. Methodology/principal findings Mixed methods (e.g. three scales, interviews, focus group discussions and reflection notes) were used to assess the impact of the intervention, which ran over a two-year period. There was a control area with no interventions. The study participants were people affected by leprosy and other key persons (e.g. family members). The sample size differs per method, for example, data regarding 67 counselling clients and 57 controls from a cohort, and notes from 207 counselling clients were examined. The notes showed that most clients faced stigma on a daily basis, whether internalized, anticipated and/or enacted. A significant reduction was found between the before and after total scores of the SARI Stigma Scale (p-value stigma, promoting the rights of people with leprosy and facilitating their social participation. More research is needed on how to create a more sustainable intervention, preferably structurally embedded in the health or social services. PMID:27959932

  19. Modifications to the control program HASP

    International Nuclear Information System (INIS)

    Bartoli, M.; Dall'Olio, L.; Mareso, T.; Ricci, F.

    1973-01-01

    Modification to HASP version 3, level 0, a control program for an electronic computer, was described with the purpose of solving some operative and managing problems not solved by the standard version for the IBM 360/75 computer. The application and utilization of these facilities require a deep knowledge of the HASP II design, version 3, level 0, 360D-05.1.014

  20. Modeling both of the number of pausibacillary and multibacillary leprosy patients by using bivariate poisson regression

    Science.gov (United States)

    Winahju, W. S.; Mukarromah, A.; Putri, S.

    2015-03-01

    Leprosy is a chronic infectious disease caused by bacteria of leprosy (Mycobacterium leprae). Leprosy has become an important thing in Indonesia because its morbidity is quite high. Based on WHO data in 2014, in 2012 Indonesia has the highest number of new leprosy patients after India and Brazil with a contribution of 18.994 people (8.7% of the world). This number makes Indonesia automatically placed as the country with the highest number of leprosy morbidity of ASEAN countries. The province that most contributes to the number of leprosy patients in Indonesia is East Java. There are two kind of leprosy. They consist of pausibacillary and multibacillary. The morbidity of multibacillary leprosy is higher than pausibacillary leprosy. This paper will discuss modeling both of the number of multibacillary and pausibacillary leprosy patients as responses variables. These responses are count variables, so modeling will be conducted by using bivariate poisson regression method. Unit experiment used is in East Java, and predictors involved are: environment, demography, and poverty. The model uses data in 2012, and the result indicates that all predictors influence significantly.

  1. Malassezia pachydermatis fungemia in an adult with multibacillary leprosy

    Directory of Open Access Journals (Sweden)

    Jorge Roman

    2016-06-01

    Full Text Available Malassezia pachydermatis is a relatively rare agent of bloodstream infections. We describe an unusual case of Malassezia fungemia in an adult patient hospitalized for Staphylococcus aureus bacteremia who was also found to have multibacillary leprosy. Treatment of the patient required extensive medical management but resulted in a good outcome.

  2. Vitiligo occurring after thyroidectomy at sites of leprosy lesions

    Directory of Open Access Journals (Sweden)

    George Anuja

    1992-01-01

    Full Text Available A 51-year-old female patient developed vitiligo at the previous sites of treated leprosy immediately after thyroidectomy. A neurological factor in association with thyroid dysfunction is considered as the possible aetiology of vitiligo in this case.

  3. Childhood Leprosy In Essimbiland of Cameroon: Results of Chart ...

    African Journals Online (AJOL)

    Background: The WHO targeted to eliminate leprosy from the world as a public health problem by reducing the prevalence to less than 1 case per 10000 population based on the use of multi-drug therapy (MDT). Despite the success of MDT, endemic pools still exist in some countries that have attained the national ...

  4. Malassezia pachydermatis fungemia in an adult with multibacillary leprosy

    OpenAIRE

    Jorge Roman; Prabhava Bagla; Ping Ren; Lucas S. Blanton; Megan A. Berman

    2016-01-01

    Malassezia pachydermatis is a relatively rare agent of bloodstream infections. We describe an unusual case of Malassezia fungemia in an adult patient hospitalized for Staphylococcus aureus bacteremia who was also found to have multibacillary leprosy. Treatment of the patient required extensive medical management but resulted in a good outcome.

  5. Psychiatric Morbidity among Subjects with Leprosy and Albinism in ...

    African Journals Online (AJOL)

    Background: Skin, which is the largest organ in the body, carries immense psychological significance. Disfiguring skin disorders may impact negatively on the mental health of individuals. Aim: This study compared the psychiatric morbidity of subjects with leprosy and albinism. Subjects and Methods: One hundred subjects ...

  6. Analysis, Diagnosis and Prognosis of Leprosy Utilizing Fuzzy ...

    African Journals Online (AJOL)

    Leprosy (Hensen's Disease) is an infectious disease that progressively deteriorates over time and is associated with mycobacterium leprae (M.leprae). Although human-to-human transmission is the primary source of infection, three other species can carry and (rarely) transfer M.leprae to humans: chimpanzees, mangabey ...

  7. Structural and functional changes in the microcirculation of lepromatous leprosy patients - Observation using orthogonal polarization spectral imaging and laser Doppler flowmetry iontophoresis

    Science.gov (United States)

    Treu, Curt; de Souza, Maria das Graças Coelho; Lupi, Omar; Sicuro, Fernando Lencastre; Maranhão, Priscila Alves; Kraemer-Aguiar, Luiz Guilherme; Bouskela, Eliete

    2017-01-01

    Leprosy is a chronic granulomatous infection of skin and peripheral nerves caused by Mycobacterium leprae and is considered the main infectious cause of disability worldwide. Despite the several studies regarding leprosy, little is known about its effects on microvascular structure and function in vivo. Thus, we have aimed to compare skin capillary structure and functional density, cutaneous vasomotion (spontaneous oscillations of arteriolar diameter), which ensures optimal blood flow distribution to skin capillaries) and cutaneous microvascular blood flow and reactivity between ten men with lepromatous leprosy (without any other comorbidity) and ten age- and gender-matched healthy controls. Orthogonal polarization spectral imaging was used to evaluate skin capillary morphology and functional density and laser Doppler flowmetry to evaluate blood flow, vasomotion and spectral analysis of flowmotion (oscillations of blood flow generated by vasomotion) and microvascular reactivity, in response to iontophoresis of acetylcholine and sodium nitroprusside. The contribution of different frequency components of flowmotion (endothelial, neurogenic, myogenic, respiratory and cardiac) was not statistically different between groups. However, endothelial-dependent and -independent vasodilatations elicited by acetylcholine and sodium nitroprusside iontophoresis, respectively, were significantly reduced in lepromatous leprosy patients compared to controls, characterizing the existence of microvascular dysfunction. These patients also presented a significant increase in the number of capillaries with morphological abnormalities and in the diameters of the dermal papilla and capillary bulk when compared to controls. Our results suggest that lepromatous leprosy causes severe microvascular dysfunction and significant alterations in capillary structure. These structural and functional changes are probably induced by exposure of the microvascular bed to chronic inflammation evoked by

  8. Current strategy for leprosy control in Brazil: time to pursue alternative preventive strategies? Estrategia actual para el control de la lepra en Brasil: ¿es hora de investigar otras estrategias de prevención?

    OpenAIRE

    Sérgio S. Cunha; Laura C. Rodrigues; Nádia Cristina Duppre

    2004-01-01

    La estrategia actual para el control de la lepra en Brasil se basa en dos actividades principales: la detección precoz de casos y el tratamiento de casos con farmacoterapia combinada. Además de dichas medidas, se realizan esfuerzos complementarios para identificar los contactos domésticos para el diagnóstico precoz y la vacunación con el bacilo de Calmette-Guérin (BCG). Sin embargo, la eficacia de estas acciones a la hora de reducir la incidencia de la lepra es aún discutible. Esto genera dud...

  9. Leprosy reactions: coinfections as a possible risk factor

    Directory of Open Access Journals (Sweden)

    Ana Carolina F. Motta

    2012-10-01

    Full Text Available OBJECTIVE: This study aimed to determine the frequency of coinfections in leprosy patients and whether there is a relationship between the presence of coinfections and the development of leprosy reactional episodes. METHOD: A cross-sectional study based on an analysis of the medical records of the patients who were treated at the Leprosy Clinics of the Ribeirão Preto Medical School, University of São Paulo, was conducted from 2000 to 2010. Information was recorded regarding the age, sex, clinical status, WHO classification, treatment, presence of reactions and coinfections. Focal and systemic infections were diagnosed based on the history, physical examination, and laboratory tests. Multinomial logistic regression was used to evaluate the associations between the leprosy reactions and the patients' gender, age, WHO classification and coinfections. RESULTS: Two hundred twenty-five patients were studied. Most of these patients were males (155/225 = 68.8% of an average age of 49.31±15.92 years, and the most prevalent clinical manifestation was the multibacillary (MB form (n = 146, followed by the paucibacillary (PB form (n = 79. Erythema nodosum leprosum (ENL was more prevalent (78/122 = 63.9% than the reversal reaction (RR (44/122 = 36.1%, especially in the MB patients (OR 5.07; CI 2.86-8.99; p<0.0001 who exhibited coinfections (OR 2.26; CI 1.56-3.27; p,<0.0001. Eighty-eight (88/225 = 39.1% patients exhibited coinfections. Oral coinfections were the most prevalent (40/88 = 45.5%, followed by urinary tract infections (17/88 = 19.3%, sinusopathy (6/88 = 6.8%, hepatitis C (6/88 = 6.8%, and hepatitis B (6/88 = 6.8%. CONCLUSIONS: Coinfections may be involved in the development and maintenance of leprosy reactions.

  10. An improved instrument setpoint control program

    International Nuclear Information System (INIS)

    Cash, J.S. Jr.; George, R.T.; Kincaid, S.C.

    1991-01-01

    Instrument setpoints have a definite and often significant impact on plant safety, reliability, and availability. Although typically overshadowed by plant design, modification, and physical change activities, instrument setpoints can alter plant status and system operating characteristics just as significantly. Recognizing the need for a formal program that provides configuration control of instrument setpoints, provides a readily accessible and clearly documented basis for instrument setpoints, and integrates and coordinates operations, engineering, and maintenance activities that influence the basis for instrument setpoints, Philadelphia Electric Company (PECo) is developing an Improved Instrument Setpoint Control Program (IISCP) that incorporates current industry guidance and practices and state-of-the-art information systems technology. The IISCP was designed around PECo's then existing business processes for setpoint control, determination, and maintenance. A task force representing the various constituencies from both plants and the engineering and services organizations were formed to identify objectives and design features for the IISCP. Utilizing industry standards and guidance, regulatory documents, the experiences and good practices obtained from other utilities, and PECo's nuclear group strategies, objectives, and goals, specific objectives were identified to enhance the business processes

  11. Prevalence of hepatitis B and C virus infection among leprosy patients in a leprosy-endemic region of central Brazil

    Directory of Open Access Journals (Sweden)

    José María Hernández Ramos

    2011-08-01

    Full Text Available Leprosy and hepatitis B virus (HBV are highly endemic in some regions of the state of Mato Grosso, in central Brazil. The association of leprosy with HBV and hepatitis C virus (HCV was assessed using a seroprevalence study and 191 leprosy outpatients were included. Demographic data and the clinical classification of leprosy were recorded. Evidence of previous HBV infection was present in 53 patients (27.7%, 95% confidence interval: 21.9-34.5 and two (1% were HBsAg positive. Five (2.6% had antibodies to HCV. The prevalence of previous exposure to HBV was higher than expected for an adult population in central Brazil. In contrast, the prevalence of anti-HCV antibodies was not much higher regarding the age range of participants. HBV markers were associated with a higher number of sex partners and the use of injections without proper sterilisation of the syringes. The number of HBV carriers was small, suggesting that there was no increased likelihood of chronification among these patients.

  12. [Social reproduction of leprosy: a study of patients profile with leprosy in the city of São Paulo].

    Science.gov (United States)

    Helene, Lúcia Maria Frazão; Salum, Maria Josefina Leuba

    2002-01-01

    This study discusses the relationship between work and living conditions among leprosy patients enrolled in the São Paulo municipal public health system in 1996. Social patterns were studied based on the theory of social determination of the health-disease process. The main purpose of the study was to emphasize evidence of the disease determination network, seeking new knowledge to improve public policies on leprosy. Data were gathered from a sample of leprosy patients registered in the city's public health system. Although patients' families are characterized by a common social thread, different work/life possibilities allow for a classification of patients into three social groups. The majority belong to groups that are marginalized from social production, living in areas where social exclusion is more extreme, on the outskirts of the city. If the trends in this study persist, incident leprosy cases will result from the social exclusion of migrants from Brazil's Southeast and Northeast. The study also discusses the position of young people and female patients in the determination network of this infectious disease in the city of São Paulo.

  13. Multibacillary leprosy mimicking systemic lupus erythematosus: case report and literature review.

    Science.gov (United States)

    Horta-Baas, G; Hernández-Cabrera, M F; Barile-Fabris, L A; Romero-Figueroa, M del S; Arenas-Guzmán, R

    2015-09-01

    Leprosy is an infectious chronic disease with a wide range of clinical and serological manifestations. We report a case of a woman presenting with a malar rash, painless oral ulcers, photosensitivity, arthritis, positive antinuclear antibodies test and leuko-lymphopenia. Our case illustrates an unusual presentation of leprosy initially diagnosed as systemic lupus erythematosus (SLE). After the confirmation of multibacillary leprosy and multidrug therapy recommended by the World Health Organization, a good clinical response was observed. Recognition of rheumatic manifestations in leprosy is important as they may be confused with SLE. A literature review is presented to encourage clinicians to consider leprosy as a differential diagnosis. Specifically in patients with unusual rheumatic manifestations and persistent skin lesions, and when neurological symptoms are present. Leprosy has not been eradicated, so misdiagnosis can be frequent. It is necessary to increase medical practitioner awareness in order start proper treatment. © The Author(s) 2015.

  14. A cooperação entre uma ONG e os Estados "anfitriões" no controle da hanseníase na América Latina Cooperation between an NGO and "host" states in the control of leprosy in Latin America

    Directory of Open Access Journals (Sweden)

    Andreas Kalk

    2003-04-01

    Full Text Available A proliferação das Organizações Não-Governamentais (ONGs, pode ser considerada como um resultado da incapacidade do sistema democrático atual de desempenhar todas as tarefas desejadas pelos seus cidadãos. Embora que as ONGs muitas vezes realizem um trabalho bastante positivo, elas têm uma tendência de diminuir o poder governamental e são capazes de interferir nos assuntos internos de outros países. Neste contexto, observam-se esforços de controlar as suas atividades e este controle pode resultar em efeitos negativos (bloqueio da defesa dos direitos humanos e efeitos positivos (correção da falta de coordenação no trabalho das ONGs. ONGs ativas no controle da hanseníase têm uma história longa de cooperação com Estados "anfitriões" na América Latina. No pior dos casos, trabalham num vácuo deixado pelo Estado. Num país como o Brasil - onde o Governo dá prioriade ao controle da hanseníase e à participação da comunidade no processo político - as ONGs trabalham geralmente de um modo "harmônico" com as autoridades nacionais. A contribução mais útil aos esforços estaduais tem sido o apoio técnico-financeiro à capacitação do pessoal de saúde, à supervisão e às campanhas de conscientização. Assim, a ONG torna-se "quase-governamental" na execução das suas tarefas.The proliferation of nongovernmental organizations (NGOs can be considered the result of the inability of the current democratic system to perform all the tasks desired by its citizens. Although NGOs often do quite positive work, they tend to diminish governmental power and are capable of interfering in the internal affairs of other countries. In this context, there are efforts to control their activities, and this control can produce both negative effects (blocking the defense of human rights and positive ones (correcting the lack of coordination in the work by NGOs. NGOs working with the control of leprosy have a long history of cooperation with

  15. The colonial world as mission and mandate: leprosy and empire, 1900-1940.

    Science.gov (United States)

    Worboys, M

    2000-01-01

    The history of medicine in twentieth-century empires has been dominated by studies of "imperial tropical medicine" (ITM) and its consequences. Historians have been fascinated by the work of medical scientists and doctors in the age of high imperialism, and there are many studies of medicine as a "tool of empire." This paper reviews work that explores colonial medicine as a broader enterprise than ITM in three spheres: missionary activity, modernization, and protection of the health and welfare of indigenous peoples. To illustrate the themes of mission and mandate, it discusses the development of policies to control leprosy in the tropical African and Asian colonies of Britain in the first half of this century, especially the work of the British Empire Leprosy Relief Association (BELRA). Although BELRA's efforts did little to change imperial medical and health agendas, they had an important impact locally and ideologically, and show how closely interwoven the themes of Christian caring, medical humanism, colonial development, and welfare policy had become by the outbreak of the Second World War.

  16. Hanseníase: uma doença genética? Leprosy: a genetic disease?

    Directory of Open Access Journals (Sweden)

    Flávia Costa Prevedello

    2007-10-01

    Full Text Available A hanseníase é doença infecciosa milenar que, apesar da existência de terapêutica eficaz, ainda persiste como problema de saúde pública em seis países, entre eles o Brasil, líder mundial em prevalência da doença. Ao longo das últimas décadas, a hanseníase vem sendo estudada por perspectiva talvez inesperada para uma doença infecciosa: modernos métodos de análise experimental têm sido empregados para evidenciar a importância do componente genético no controle da susceptibilidade do hospedeiro à hanseníase e seus fenótipos. Esses estudos indicam que constituição genética favorável do hospedeiro, somada a fatores propícios, ambientais e relativos ao agente patogênico, tem alto impacto na definição da susceptibilidade tanto à infecção propriamente dita quanto à evolução clínica da doença. Hoje, diversos genes e regiões genômicas já foram relacionados ao controle da susceptibilidade à hanseníase. Outros estudos estão em andamento, visando ao avanço no entendimento das bases moleculares de controle da susceptibilidade do hospedeiro à doença. O conjunto de resultados desses estudos pode levar a formas mais eficazes de diagnóstico, tratamento e prevenção da hanseníase e outras doenças infecciosas.Leprosy is an ancient chronic infectious disease that, despite the existence of efficient therapy, still persists as a public health problem in six countries, including Brazil, the world leader in leprosy prevalence. During the past decades, leprosy has been studied from a somewhat unusual perspective for an infectious disease: modern methods for experimental analysis have been applied to demonstrate the existence of an important genetic effect controlling host susceptibility to leprosy and its phenotypes. These studies indicate that a favorable host genetic make-up, combined with environmental and pathogen-related variables, has a high impact on the definition of susceptibility to both infection and clinical

  17. Opening a Can of Worms: Leprosy Reactions and Complicit Soil-Transmitted Helminths

    OpenAIRE

    Deanna A. Hagge; Pawan Parajuli; Chhatra B. Kunwar; Divya R.S.J.B. Rana; Ruby Thapa; Kapil D. Neupane; Peter Nicholls; Linda B. Adams; Annemieke Geluk; Mahesh Shah; Indra B. Napit

    2017-01-01

    Background > 94% of new annual leprosy cases are diagnosed in populations co-endemic for soil-transmitted helminths (STH). STH can profoundly dysregulate host immune responses towards Th2 bias, which can be restored over time after deworming. We hypothesize that STH co-infection is associated with leprosy reaction (denoted as simply “reaction” herein) occurrence within a co-endemic population. Methods A cohort study was performed on a cohort of Nepalese leprosy patients across treatment and d...

  18. Association analysis of the genetic polymorphisms with leprosy subtypes in Chinese Han population from Northern China.

    Science.gov (United States)

    Wang, Chuan; Wang, Zhenzhen; Wang, Honglei; Pan, Qing; Fu, Xi'an; Liu, Tingting; Yu, Gongqi; Liu, Hong; Zhang, Furen

    2018-03-24

    Leprosy is characterized by a broad spectrum of clinical manifestations that extend from paucibacillary (PB) to multibacillary (MB) depending upon the different immunologic response to the invading of M. leprae 3,4 . It has been widely accepted that genetic predisposition plays the crucial role in the different clinical manifestations. Host susceptibility to leprosy is modified by number of genes via two stages. In the first stage, a group of genes confers susceptibility to leprosy per se; A second group of genes are associated to the type of host immune response and leprosy subtype 5 . This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  19. Antioxidant factors, nitric oxide levels, and cellular damage in leprosy patients

    Directory of Open Access Journals (Sweden)

    Taysa Ribeiro Schalcher

    2013-09-01

    Full Text Available Introduction The immune response caused by Mycobacterium leprae is a risk factor for the development of oxidative stress (OS in leprosy patients. This study aimed to assess OS in leprosy patients before the use of a multidrug therapy. Methods We evaluated the nitric oxide (NO concentration; antioxidant capacity; levels of malondialdehyde, methemoglobin and reduced glutathione; and the activity of catalase and superoxide dismutase (SOD in leprosy patients. Results We observed lower SOD activity in these leprosy patients; however, the NO levels and antioxidant capacity were increased. Conclusions The infectious process in response to M. leprae could primarily be responsible for the OS observed in these patients.

  20. Orofacial lesions in treated southeast Brazilian leprosy patients: a cross-sectional study.

    Science.gov (United States)

    Martins, M D; Russo, M P; Lemos, J B D; Fernandes, K P S; Bussadori, S K; Corrêa, C T; Martins, M A T

    2007-05-01

    The aim of the present study was to clinically evaluate the oral mucosa lesions of leprosy patients during and after multi-drug therapy. Clinical examination, medical and dental history examination was performed in 100 leprosy patients. The results revealed that 71 patients, 50 men and 21 women, exibited oral lesions. The most frequent lesions were: fissured tongue (18 cases), inflammatory papillary hyperplasia (16 cases), chronic atrophic candidiasis (10 cases), fibroma (10 cases), erythematous candidiasis (eight cases), and traumatic ulceration (seven cases). We conclude that leprosy-related lesions are not present in patients undergoing treatment for leprosy, probably due to response to multidrug therapy.

  1. Leprosy trends at a tertiary care hospital in Mumbai, India, from 2008 to 2015.

    Science.gov (United States)

    Muthuvel, Thirumugam; Isaakidis, Petros; Shewade, Hemant Deepak; Kattuppara, Lucy; Singh, Rajbir; Govindarajulu, Srinivas

    2016-01-01

    Leprosy remains an important cause of preventable disabilities. After the advent of multidrug therapy, new leprosy cases have come down dramatically. Despite this achievement, India, which contributes 60% of the global leprosy burden, faces some challenges to eliminate the disease, including active transmission in the community and delayed diagnosis of leprosy patients. The objectives of the study were 1) to determine sociodemographic and clinical characteristics of newly diagnosed adults and children (less than 15 years) with leprosy and their trends over time (2008-2015) and 2) to describe the profile of surgical procedures among leprosy patients registered for reconstructive surgeries during 2006-2015. Retrospective descriptive study was conducted involving a record review of new patients with leprosy registered in Vimala Dermatological Centre, Mumbai. A total of 578 new leprosy cases were registered in the hospital during 2008-2015. There has been a steady increase in the trend of child cases (less than 15 years) registered in the facility (from 3% in 2008 to 18% in 2015), x 2 =12.11, p< 0.01. The majority of the patients (68%) were migrants of Uttar Pradesh and Bihar. Targeting children and migrants and ensuring early diagnosis and treatment initiation are essential components for leprosy elimination in an urban metropolis in India.

  2. PLC & DTAM Software Programs for Pumping Instrumentation & Control Skid P

    Energy Technology Data Exchange (ETDEWEB)

    HORNER, T.M.

    2001-07-19

    This document describes the software programs for the programmable logic controller and the datable access module for pumping instrumentation and control skid P. The appendices contains copies of the printouts of these software programs.

  3. The Programming Language for Fuzzy Control and It's Application

    OpenAIRE

    古川, 万寿夫; 三浦, 健史; 松田, 孝史

    1994-01-01

    We designed the programming language for fuzzy control using micro processor. This language permits to describe if-then rule into the program for fuzzy control. This language is easy to understand for fuzzy control engineer. We developed the Fuzzy to C translator which translates this programming language into C language. The program generated by the translator is compiled by C compiler to apply to target for fuzzy control.

  4. Maintenance accountability, jobs, and inventory control (MAJIC) program

    Energy Technology Data Exchange (ETDEWEB)

    Adkisson, B P

    1990-01-01

    This document describes the operating procedures for the maintenance accountability, jobs, and inventory control (MAJIC) program for the Maintenance Management Department of the ORNL Instrumentation and Controls Division.

  5. Mycobacterial r32-kDa antigen-specific T-cell responses correlate with successful treatment and a heightened anti-microbial response in human leprosy patients.

    Science.gov (United States)

    Neela, Venkata Sanjeev Kumar; Devalraju, Kamakshi Prudhula; Pydi, Satya Sudheer; Sunder, Sharada Ramaseri; Adiraju, Kameswara Rao; Singh, Surya Satyanarayana; Anandaraj, M P J S; Valluri, Vijaya Lakshmi

    2016-09-01

    Immunological characterization of mycobacterial peptides may help not only in the preparation of a vaccine for leprosy but also in developing in vitro T-cell assays that could perhaps be used as an in vitro correlate for treatment outcome. The main goal of this study was to evaluate the use of Mycobacterium bovis recombinant 32-kDa protein (r32-kDa) antigen-stimulated T-cell assay as a surrogate marker for treatment outcome and monitor vitamin D receptor (VDR)-mediated anti-microbial responses during multidrug therapy (MDT) in leprosy. Newly diagnosed tuberculoid and lepromatous leprosy patients were enrolled and followed up during their course of MDT at 6 and 12 months. IFN-γ, IL-10, IL-17 and IL-23 levels in culture supernatants and expression of VDR, TLR2, LL37 and DEFB in r32-kDa-stimulated PBMCs were measured. Controls comprised household contacts (HHCs) and healthy endemic subjects (HCs). Significant differences were observed in the levels of IFN-γ, IL-17, IL-23, VDR and anti-microbial peptides LL37 and DEFB after treatment and when compared with that of HHCs and HCs, respectively. These findings suggest that responses to r32-kDa antigen reflect an improved immunological and anti-microbial response in leprosy patients during therapy, thereby indicating its potential use as an immune correlate in the treatment of leprosy patients. © The Japanese Society for Immunology. 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. 7 CFR 58.247 - Insect and rodent control program.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Insect and rodent control program. 58.247 Section 58... Service 1 Operations and Operating Procedures § 58.247 Insect and rodent control program. In addition to... made responsible for the performance of a regularly scheduled insect and rodent control program as...

  7. Programming for controlling of pulse radiolysis setup. Program RADIO96

    International Nuclear Information System (INIS)

    Mirkowski, J.; Grodkowski, J.

    1998-01-01

    Program RADIO96 was written in Pascal using DELPHI 1.0 (Borland) programming platform. It can operate on IBM PC compatible computers in WINDOWS 3x or WINDOWS'95 environment. The program is dedicated to the pulse radiolysis setup based on the linear electron accelerator LAE 13/9 of the Department of Radiation Chemistry and Technology of the INCT. This work was based on apparatus and results described before and also on programming manuals of used equipment and technical data of programming platform. (author)

  8. The citrus leprosis pathosystem O patossistema leprose dos citros

    Directory of Open Access Journals (Sweden)

    Marinês Bastianel

    2006-09-01

    Full Text Available Citrus leprosis is considered the main viral disease for the Brazilian citrus production, particularly for the State of São Paulo, due to the high costs spent for the chemical control of its vector, the tenuipalpid mite Brevipalpus phoenicis. In addition, its global importance has significantly increased in the last years, with the dissemination of the virus to new countries in South and Central America. In Brazil, despite its economical importance and occurrence for more than seven decades, the most significant advances towards understanding the pathosystem interactions have been obtained only in the last ten years. This review focuses on various aspects of the disease, beginning with a historical view, its main characteristics, alternatives for its control, its increasing economical importance in Brazil and abroad, and the new data on the search for understanding the interactions amongst the mite vector, the virus, and the plant host.A leprose dos citros é considerada a principal virose na citricultura brasileira, com maior destaque no Estado de São Paulo, principalmente pelos altos custos demandados para o controle químico do vetor, o ácaro Brevipalpus phoenicis. Além da relevância dessa virose para a citricultura local, sua importância mundial vem sendo ampliada consideravelmente nos últimos anos, principalmente com a disseminação do vírus em novos países da América do Sul e Central. No Brasil, apesar da sua importância econômica e ocorrência por mais de sete décadas, os mais importantes avanços no entendimento das interações do patossistema leprose têm sido obtidos apenas nos últimos dez anos. Essa revisão aborda os diferentes aspectos dessa doença, trazendo um breve histórico da doença, principais características da leprose, alternativas de controle, sua crescente importância econômica na cadeia citrícola nacional, os mais recentes relatos de sua ocorrência em outros países e os novos resultados obtidos

  9. A study of social status of people with disabilities due to leprosy in desert part of Rajasthan, India.

    Science.gov (United States)

    Yadav, S P

    2011-09-01

    Leprosy is a stigmatized disease in our society. Ninety-eight disabled leprosy patients were studied in areas of Pokaran CHC and Ramdeora PHC of Jaisalmer district. About ninety-five per cent (94.6%) leprosy patients were found discarded by their life partners due to disabilities. A positive relationship was found between social stigma and deformity due to disease. IEC need to be done at community level also for changing attitude and behaviour towards leprosy patients.

  10. Optimal control rod programs in power reactors

    International Nuclear Information System (INIS)

    Fadilah, S.M.; Lewins, J.

    1975-01-01

    Control rod programming is investigated with respect to optimising the power peaking factor and hence the utilisation of a nuclear reactor. A simplified diffusion model, initially with a finite number of regions, in cylindrical geometry, is used to enable optimal trajectories to be completely synthesised. The average discharge burnup problem is posed both as an external and as an internal optimisation. The connection between optimum power shape and the maximisation of the average discharge burnup is explored in a wider context. It is shown that optimum trajectories combine an initial singular solution of the Haling type with a terminal bang-bang solution. An extension to a higher number of regions and, on passing to the limit, to a diffusion model, provides an alternative proof of Haling's principle without the restriction to monotonic reactivity decrease with burnup. Numerical results in the two-region model are given to show the general scope of optimisation available. (author)

  11. Negligible risk of inducing resistance in Mycobacterium tuberculosis with single-dose rifampicin as post-exposure prophylaxis for leprosy

    NARCIS (Netherlands)

    Mieras, L. (Liesbeth); R. Anthony (Richard); W.H. van Brakel (Wim); Bratschi, M.W. (Martin W.); van den Broek, J. (Jacques); Cambau, E. (Emmanuelle); Cavaliero, A. (Arielle); Kasang, C. (Christa); Perera, G. (Geethal); Reichman, L. (Lee); J.H. Richardus (Jan Hendrik); P. Saunderson (Paul); Steinmann, P. (Peter); Yew, W.W. (Wing Wai)

    2016-01-01

    textabstractPost-exposure prophylaxis (PEP) for leprosy is administered as one single dose of rifampicin (SDR) to the contacts of newly diagnosed leprosy patients. SDR reduces the risk of developing leprosy among contacts by around 60 % in the first 2-3 years after receiving SDR. In countries where

  12. Dapsone and body mass index in subjects with multibacillary leprosy.

    Science.gov (United States)

    Moura, Fernanda M L; Dias, Rosa M; Araujo, Eliete C; Brasil, Laélia M B F; Ferreira, Michelle V D; Vieira, Jose L F

    2014-04-01

    The physiological changes in obese subjects can modify the pharmacokinetic profiles of drugs influencing the therapeutic efficacy. In this study, the authors compare plasma dapsone trough levels of multibacillary leprosy subjects stratified by body mass index (BMI) to evaluate if obesity plays a significant role on drug levels. The relationship between drug levels and BMI was also determined. Dapsone was measured by high-performance liquid chromatography and BMI based on World Health Organization criteria. At steady state, the median plasma dapsone trough level was significantly lower in obesity class 2 group, when compared with other groups, but they were similar between normal weight and preobesity groups. A weak association between drug levels and BMI was observed. Obesity promotes a significant reduction in plasma dapsone trough levels of subjects with multibacillary leprosy with a weak association between drug levels and BMI.

  13. Diagnostic challenges of single plaque-like lesion paucibacillary leprosy

    Directory of Open Access Journals (Sweden)

    Raquel Rodrigues Barbieri

    2014-11-01

    Full Text Available The diagnosis of single-lesion paucibacillary leprosy remains a challenge. Reviews by expert dermatopathologists and quantitative polymerase chain reaction (qPCR results obtained from 66 single-plaque biopsy samples were compared. Histological findings were graded as high (HP, medium (MP or low (LP probability of leprosy or other dermatopathy (OD. Mycobacterium leprae-specific genes were detected using qPCR. The biopsies of 47 out of 57 clinically diagnosed patients who received multidrug therapy were classified as HP/MP, eight of which were qPCR negative. In the LP/OD (n = 19, two out of eight untreated patients showed positive qPCR results. In the absence of typical histopathological features, qPCR may be utilised to aid in final patient diagnosis, thus reducing overtreatment and delay in diagnosis.

  14. SUCCESSFUL TREATMENT OF OSTEOMYELITIS IN LEPROSY PATIENTS BY HOMEOPATHIC MEDICINE

    Directory of Open Access Journals (Sweden)

    D. Chakraborty

    2013-12-01

    Full Text Available Osteomyelitis, a major complication of neuropathic feet in leprosy may occur as a result of infiltration of Mycobacterium leprae in the periosteum of bones or due to secondary bacterial infection of chronic plantar ulcer. There is no effective treatment for healing of planter ulcer and osteomyelitis. Keeping in mind of the limitation of conservative treatment, twenty patients who completed with multi drug therapy but suffering from neuropathic foot with ulcer was treated with Mercurius solubilis, a homoeopathic medicine in 200 potency for one year. All these patients had different degrees of osteomyelitic changes and after treatment showed regeneration and remodeling of bones which may be considered as significant improvement. Based on the radiological finding it may be concluded that Mercurius solubilis found to be effective in the treatment of osteomyelitis in leprosy affected patients.

  15. Genetic diversity of mycobacterium leprae isolates from Brazilian leprosy patients.

    Science.gov (United States)

    Fontes, Amanda Nogueira Brum; Sakamuri, Rama Murthy; Baptista, Ida Maria Foschiani Dias; Ura, Somei; Moraes, Milton Ozório; Martínez, Alejandra Nóbrega; Sarno, Euzenir Nunes; Brennan, Patrick J; Vissa, Varalakshmi D; Suffys, Philip Noel

    2009-09-01

    Leprosy is a chronic disease caused by infection with Mycobacterium leprae, an obligate intracellular parasite. A problem in studying the transmission of leprosy is the small amount of variation in bacterial genomic DNA. The discovery of variable number of tandem repeats (VNTRs) allowed the detection of strain variation in areas with a high prevalence of leprosy. Four genotypes of M. leprae based on three single-nucleotide polymorphism (SNPs) were also discovered to be useful for analysis of the global spread of leprosy. In this present study, we examined the allelic diversity of M. leprae at 16 select VNTR and three SNP loci using 89 clinical isolates obtained from patients mainly from the neighbouring states of São Paulo and Rio de Janeiro Brazil. By use of a PCR-RFLP-based procedure that allows the recognition of SNP types 3 and 4 without the need for the more expensive DNA sequencing steps, characterisation of the main M. leprae genotypes was easy. When applied on the study population, it was found that the SNP type 3 is most frequent in these two states of Brazil, and that VNTRs provided further discrimination of the isolates. Two Short Tandem Repeats (STRs) were monomorphic, with the remaining 14 STRs represented by two to 18 alleles. Epidemiological associations with township or state were not evident in this random collection and require further investigations. In phylogenetic trees, branches formed by all 16 STRs clearly separated SNP type 3 organisms from the other types while the allelic patterns of two minisatellite loci 27-5 and 12-5 were highly correlated with SNP type 3. This strain typing study provide the basis for comparison of M. leprae strain types within Brazil and with those from other countries, and informed selection of genomic markers and methods for future studies.

  16. [Dapsone-induced photodermatitis in a patient with leprosy].

    Science.gov (United States)

    Fumey, S M

    1988-01-18

    We report on a 60-year-old man suffering from borderline leprosy. He was treated many times with DDS and Clofazimin and underwent the so-called multiple drug treatment (MDT). Under this therapy, the patient developed allergic photodermatitis. Unfortunately his file was lost and, as nobody was informed about his allergic reaction, he was again treated with the preparations mentioned above. Consequently, he responded once more with photodermatitis.

  17. Synthetic RNA Controllers for Programming Mammalian Cell Fate and Function

    Science.gov (United States)

    2015-11-04

    Final report for “Synthetic RNA controllers for programming mammalian cell fate and function” Principal Investigator: Christina D. Smolke...SUBTITLE Synthetic RNA controllers for programming mammalian cell fate and function 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER...Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18   2 Synthetic RNA controllers for programming mammalian cell fate and function Task 1

  18. The oral mucosa in leprosy: a clinical and histopathological study.

    Science.gov (United States)

    de Abreu, Marilda Aparecida Milanez Morgado; Michalany, Nilceo Schwery; Weckx, Luc Louis Maurice; Neto Pimentel, Dalva Regina; Hirata, Cleonice Hitomi Watashi; de Avelar Alchorne, Maurício Mota

    2006-01-01

    Multibacillary leprosy may involve the oral mucosa, with or without apparent lesions. There are few studies that deal with this issue in the era of multidrug therapy. To assess the frequency of oral mucosa involvement in multibacillary leprosy patients. A transversal study with twenty non-treated multibacillary leprosy patients. The patients were treated in Dracena, São Paulo, between 2000 and 2002. Clinical examination of the oral mucosa was carried out. All patients were submitted to jugal mucosa, soft palate and tongue biopsies, in altered or in pre-established sites. The cross-sections were stained by techniques of hematoxilin-eosin and Ziehl-Neelsen. Granuloma and alcohol-acid-resistant bacilli findings determined the specific histopathological involvement. The study involved 19 patients with an average of 2.5 years of disease progression. Specific histopathological involvement occurred in the tongue and soft palate of one lepromatous patient with an apparently normal oral mucosa. (1) Clinical alterations in the oral mucosa does not imply disease involvement, it is necessary to have histopathological confirmation. (2) Apparent specific clinical alterations are rare. (3) The clinically normal oral mucosa can show specific histopathological involvement.

  19. Dapsone hypersensitivity syndrome among leprosy patients in China.

    Science.gov (United States)

    Tian, Weiwei; Shen, Jianping; Zhou, Min; Yan, Liangbin; Zhang, Guocheng

    2012-12-01

    To Study the incidence and clinical characteristics of dapsone hypersensitivity syndrome (DHS) among MDT-treated leprosy patients from 2006 to 2009 in China. A retrospective survey was carried out throughout China using a specially designed questionnaire. From 2006 to 2009, there were 63 new patients reported to have DHS with an incidence of 1.0%. Among these patients, 13 were complete types of DHS, the others were incomplete ones. The average age of patients with DHS was 38 years and the male to female ratio was 2.15. The average incubation period from taking dapsone to DHS onset was 32.8 days (2-6 weeks). There were 60 (95.2%) patients who presented with various skin lesions, 56 (88.9%) with fever, 40 (63.5%) with hepatic damage and 22 (34.9%) with lymphopathy. Seven patients died with a death rate of 11.1% among all patients with DHS. DHS is a serious adverse event resulted from dapsone. It can occur in a small number of new leprosy patients treated with dapsone containing regimen. Some patients may die of DHS if not taking timely and adequate management. Therefore local doctors should pay an attention to DHS among leprosy patients newly treated with the dapsone-containing MDT regimen.

  20. [Leprosy, a pillar of human genetics of infectious diseases].

    Science.gov (United States)

    Gaschignard, J; Scurr, E; Alcaïs, A

    2013-06-01

    Despite a natural reservoir of Mycobacterium leprae limited to humans and free availability of an effective antibiotic treatment, more than 200,000 people develop leprosy each year. This disease remains a major cause of disability and social stigma worldwide. The cause of this constant incidence is currently unknown and indicates that important aspects of the complex relationship between the pathogen and its human host remain to be discovered. An important contribution of host genetics to susceptibility to leprosy has long been suggested to account for the considerable variability between individuals sustainably exposed to M. leprae. Given the inability to cultivate M. leprae in vitro and in the absence of relevant animal model, genetic epidemiology is the main strategy used to identify the genes and, consequently, the immunological pathways involved in protective immunity to M. leprae. Recent genome-wide studies have identified new pathophysiological pathways which importance is only beginning to be understood. In addition, the prism of human genetics placed leprosy at the crossroads of other common diseases such as Crohn's disease, asthma or myocardial infarction. Therefore, novel lights on the pathogenesis of many common diseases could eventually emerge from the detailed understanding of a disease of the shadows. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  1. Challenges of Tobacco Control Program in Iran.

    Science.gov (United States)

    Poorolajal, Jalal; Mohammadi, Younes; Mahmoodi, Azam

    2017-04-01

    This study assessed the status of cigarette marketing in Iran as well as the attitude of smokers toward smoking and the policies and tobacco control programs in the country. This cross-sectional study was conducted on 3480 volunteer smokers in six provinces, using a stratified cluster random sampling method. The study population consisted of smokers who used at least one cigarette per day. The data collection tool was an anonymous self-administered questionnaire including basic information and 20 five-choice questions related to participants' attitude toward smoking habits (Cronbach's alpha; 79.73%.). The majority (66.9%) of participants started smoking at the age of 10 to 19 years and 61.1% used foreign cigarettes. Of 160 marketed brands, 38 (23.8%) were domestic and 122 (76.2%) were foreign, including 63 (39.3%) imported and 59 (36.9%) smuggled brands. Being tempted (25.0%), getting nervous (24.1%), and seeking euphoria (24.1%) were the most common reasons for restarting cigarette smoking after cessation. The majority of participants believed that smoking in public places was a violation of the rights of others and smoking should be avoided in such places. Smoking prevention programs should focus on adolescents as the most vulnerable age group. Raising the retail price of tobacco products through increasing taxes can reduce consumption, particularly among first starters and youth. However, increasing taxes and prices of tobacco products may be effective when simultaneous effective measures are implemented to eliminate all kinds of illicit trade in all forms of tobacco products.

  2. Coastal nonpoint pollution control program: Program development and approval guidance

    International Nuclear Information System (INIS)

    1993-01-01

    The document, developed by NOAA and EPA, contains guidance for states in developing and implementing their coastal nonpoint pollutant source programs. It describes the requirements that must be met, including: the geographic scope of the program; the pollutant sources to be addressed; the types of management measures used; the establishment of critical areas; technical assistance, public participation, and administrative coordination; and, the process for program submission and Federal approval. The document also contains the criteria by which NOAA and EPA will review the states' submissions

  3. Correlation between ELISA and ML Flow assays applied to 60 Brazilian patients affected by leprosy

    NARCIS (Netherlands)

    Da Silva, Rozana C.; Lyon, Sandra; Lyon, Ana C.; Grossi, Maria A. F.; Lyon, Silvia H.; Bührer-Sékula, Samira; Antunes, Carlos M. F.

    2010-01-01

    Serological tests can be helpful in classifying leprosy patients as having either the paucibacillary or the multibacillary form. The aim of this study was to evaluate the concordance between two serological assays, i.e. ML Flow and ELISA, in a population of leprosy patients in Brazil. The

  4. [Active search for leprosy and other skin diseases in school children from Agua de Dios, Colombia].

    Science.gov (United States)

    Rodríguez, Gerzaín; González, Rosalba; Gonzalez, Deysy; Granados, Carolina; Pinto, Rafael; Herrera, Hilda; Gutiérrez, Luisa F; Hernández, Elkin; López, Fernando; Gómez, Yenny

    2007-01-01

    Actively searching for leprosy, other skin diseases and BCG vaccination scars amongst school children from Agua de Dios, the municipality having the highest prevalence of leprosy in Colombia. A clinical examination of the children was carried out by nurses, interns, general practitioners and experts on leprosy. Skin smear tests and skin biopsies were performed when the clinical findings suggested leprosy. Anti-phenolic glycolipid antibodies in blood were determined in special cases. 86 % of the 2 844 school children were examined; 833 had skin diseases and 16 % of these required evaluation by specialists. Four new cases of paucibacillary leprosy, two indeterminate and two primary polyneuritic cases were found. Pediculosis capitis, pityriasis alba, tinea versicolor, hypopigmented nevus, insect bites and miliaria were frequently detected. BCG vaccination scars were absent in 387 children; following several logistical problems, they were vaccinated. Four children had signs of childhood abuse. An 11-year-old girl presented hypopigmented mycosis fungoides. All diseases and conditions found were treated. The community received information regarding the results, emphasising the importance of an early diagnosis of leprosy. The incidence of leprosy found (16/10,000) was 123 times higher than the rest of the country's incidence. It is advisable to continue clinical examinations in Agua de Dios and research into risk factors for acquiring leprosy.

  5. Investigation of neuropathic pain in treated leprosy patients in Ethiopia: a cross-sectional study

    NARCIS (Netherlands)

    Haroun, O. M; Hietaharju, A.; Bizuneh, E.; Brandsma, J.W.; Tesfaye, F.; Haanpää, M.; Rice, A.S.; Lockwood, D.N.

    2012-01-01

    Pain can be a significant problem for treated leprosy patients. It can be nociceptive due to tissue inflammation occurring during episodes of immune mediated reactions, or neuropathic due to leprosy affecting the somatosensory system. There are sparse epidemiological data on the prevalence and

  6. The Meaning of Leprosy and Everyday Experiences: An Exploration in Cirebon, Indonesia

    Directory of Open Access Journals (Sweden)

    Ruth M. H. Peters

    2013-01-01

    Full Text Available It is imperative to consider the meaning of leprosy and everyday experiences of people affected by leprosy and key persons in the community if one aims to make leprosy services more effective, which appears necessary in Indonesia given the large numbers of new cases detected annually. However, little is written in the international literature about the experiences of people currently being treated for leprosy, those cured, or other key informants. This paper analyses the narratives of the people by drawing upon in-depth interviews with 53 participants and 20 focus groups discussions. The participants were purposively selected. We provide insights into the experiences of people and the meaning they give to leprosy and highlight aspect of aetiology, spirituality, religion, darkening of the skin, and sorcery. We also examine experiences of seeking care and focused on the impact of the disease in particular on the elderly and children. In conclusion, the continued need for implementation of leprosy services in Indonesia is very evident. The diversities in people’s experiences with leprosy indicate a demand for responsive leprosy services to serve the diverse needs, including services for those formally declared to be “cured.”

  7. 7 CFR 58.141 - Alternate quality control program.

    Science.gov (United States)

    2010-01-01

    ... Service 1 Quality Specifications for Raw Milk § 58.141 Alternate quality control program. When a plant has in operation an acceptable quality program, at the producer level, which is approved by the... 7 Agriculture 3 2010-01-01 2010-01-01 false Alternate quality control program. 58.141 Section 58...

  8. Burden of leprosy in Malawi: community camp-based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Msyamboza Kelias P

    2012-08-01

    Full Text Available Abstract Background Although leprosy was eliminated globally in 2000, the disease continues to be the significant cause of peripheral neuropathy, disability and disfigurement in some developing countries. However, recent population-based prevalence data are lacking to inform evidence-based renewed commitment for the final push for leprosy elimination at national and sub-national levels. Methods Community camp-based cross-sectional descriptive study was conducted in four selected districts. World Health Organisation guidelines and tools for leprosy elimination monitoring were used to evaluate the Malawi National Leprosy Programme. Results A total of 6,338 people (60% females, 35% children aged less than 15 years were examined for leprosy and other skin diseases. Prevalence of skin diseases was 18%, the commonest being fungal (9%, eczema/dermatitis (3% and leprosy (1%. Of the fungal skin conditions, pityriasis versicolor and Tinea capatis were the commonest (22% and 21% respectively then Tinea corporis (9%, Tinea cruris (6% and Tinea pedis (2%. A total of 66 leprosy cases were detected out of 6,338 people screened giving a prevalence of 104.1 per 10,000 population (range by district 67.1 to 194.1. Of the leprosy cases, 37 were new, 6 were defaulters and 23 were on treatment, 30 were females and 9 were children aged less than 15 years old. Of the 37 new leprosy cases, 9 (24.3% were children, 25 (67.6% had 1–5 leprosy lesions and 8 (21.6% had grade 2 disability. The most frequent location of leprosy lesions was the head and neck (24.1%, arms (24.1%, chest (17.2%, legs (13.8%, back (13.8% and abdomen (7.0%. Between 2006 and 2011, trends of leprosy prevalence and detection increased, prevalence/detection ratios were over 1 and cure rates by cohort analysis of 2009 multibacillary and 2010 paucibacillary cases were 33% and 63% respectively far below the expected 80% although the national prevalence remained at less than 1 case per 10

  9. Communities of the afflicted: constituting leprosy through place in South India.

    Science.gov (United States)

    Staples, James

    2014-01-01

    With the promotion of community-based rehabilitation (CBR) as a solution to health-related issues across the global South, leprosy colonies have long been out of vogue for nongovernmental organizations and State institutions alike. Such colonies, however, have endured. As is being increasingly recognized by those working in the leprosy field, such places have played a particular role not only in the provision of leprosy-related care but also in forging new and collective identities for people affected by leprosy that might otherwise not have been possible. In this article, I draw on ethnographic fieldwork in one such colony in coastal Andhra Pradesh, South India, and explore the values invested in it as a particular kind of place; its geographical location on the peripheries; and its architecture and layout (inspired in part by colonial sanatoriums), which have particular implications for how leprosy and its ramifications are constituted and managed.

  10. Transcriptional programs controlling perinatal lung maturation.

    Science.gov (United States)

    Xu, Yan; Wang, Yanhua; Besnard, Valérie; Ikegami, Machiko; Wert, Susan E; Heffner, Caleb; Murray, Stephen A; Donahue, Leah Rae; Whitsett, Jeffrey A

    2012-01-01

    The timing of lung maturation is controlled precisely by complex genetic and cellular programs. Lung immaturity following preterm birth frequently results in Respiratory Distress Syndrome (RDS) and Broncho-Pulmonary Dysplasia (BPD), which are leading causes of mortality and morbidity in preterm infants. Mechanisms synchronizing gestational length and lung maturation remain to be elucidated. In this study, we designed a genome-wide mRNA expression time-course study from E15.5 to Postnatal Day 0 (PN0) using lung RNAs from C57BL/6J (B6) and A/J mice that differ in gestational length by ∼30 hr (B6controlling lung maturation. We identified both temporal and strain dependent gene expression patterns during lung maturation. For time dependent changes, cell adhesion, vasculature development, and lipid metabolism/transport were major bioprocesses induced during the saccular stage of lung development at E16.5-E17.5. CEBPA, PPARG, VEGFA, CAV1 and CDH1 were found to be key signaling and transcriptional regulators of these processes. Innate defense/immune responses were induced at later gestational ages (E18.5-20.5), STAT1, AP1, and EGFR being important regulators of these responses. Expression of RNAs associated with the cell cycle and chromatin assembly was repressed during prenatal lung maturation and was regulated by FOXM1, PLK1, chromobox, and high mobility group families of transcription factors. Strain dependent lung mRNA expression differences peaked at E18.5. At this time, mRNAs regulating surfactant and innate immunity were more abundantly expressed in lungs of B6 (short gestation) than in A/J (long gestation) mice, while expression of genes involved in chromatin assembly and histone modification were expressed at lower levels in B6 than in A/J mice. The present study systemically mapped key regulators, bioprocesses, and transcriptional networks controlling lung maturation, providing the basis for new therapeutic strategies to enhance lung function in preterm

  11. A method of numerically controlled machine part programming

    Science.gov (United States)

    1970-01-01

    Computer program is designed for automatically programmed tools. Preprocessor computes desired tool path and postprocessor computes actual commands causing machine tool to follow specific path. It is used on a Cincinnati ATC-430 numerically controlled machine tool.

  12. Control Robotics Programming Technology. Technology Learning Activity. Teacher Edition.

    Science.gov (United States)

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This Technology Learning Activity (TLA) for control robotics programming technology in grades 6-10 is designed to teach students to construct and program computer-controlled devices using a LEGO DACTA set and computer interface and to help them understand how control technology and robotics affect them and their lifestyle. The suggested time for…

  13. 18 CFR 12.40 - Quality control programs.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Quality control... PROJECT WORKS Other Responsibilities of Applicant or Licensee § 12.40 Quality control programs. (a... meeting any requirements or standards set by the Regional Engineer. If a quality control program is...

  14. Problems, acceptance and social inequality: a study of the deformed leprosy patients and their families.

    Science.gov (United States)

    Kopparty, S N

    1995-09-01

    of the nature and the extent of handicaps and acceptance in the family. This factor needs to be appropriately taken care of for rehabilitation and disability management in leprosy control programmes.

  15. Resource control of object-oriented programs

    OpenAIRE

    Marion, Jean-Yves; Pechoux, Romain

    2007-01-01

    International audience; A sup-interpretation is a tool which provides an upper bound on the size of a value computed by some symbol of a program. Sup-interpretations have shown their interest to deal with the complexity of first order functional programs. For instance, they allow to characterize all the functions bitwise computable in \\texttt{Alogtime}. This paper is an attempt to adapt the framework of sup-interpretations to a fragment of oriented-object programs, including distinct encoding...

  16. Kinship and Leprosy in the Contacts of Leprosy Patients: Cohort at the Souza Araújo Outpatient Clinic, Rio de Janeiro, RJ, 1987–2010

    Directory of Open Access Journals (Sweden)

    Daiane Santos dos Santos

    2013-01-01

    Full Text Available A broad variety of factors have been associated with leprosy among contacts, including socioeconomic, epidemiological, and genetic characteristics. Data from 7,174 contacts of leprosy patients from a leprosy outpatient clinic in Rio de Janeiro, Brazil, 1987–2010, were analyzed to investigate the effects of kinship, individual, and contextual factors on leprosy. Multivariate analyses were performed using a robust estimation method. In the prevalence analysis, close kinship (sibling OR = 2.75, offspring OR = 2.00, and other relatives OR = 1.70, socioeconomic factors, and the duration of exposure to the bacillus were associated to leprosy. In the incidence analysis, significant risks were found for all categories of kinship (parents RR = 10.93, spouse, boyfriend/girlfriend, and bride/groom RR = 7.53, sibling RR = 7.03, offspring RR = 5.34, and other relatives RR = 3.71. Once the treatment of the index case was initiated, other factors lost their significance, and the index case bacteriological index and BCG (Bacillus Calmette-Guérin vaccine protection had a greater impact. Our findings suggested that both genetic susceptibility and physical exposure play an important role in the epidemiology of leprosy, but it was not possible establishing the role of genetic factor. Analyses of other factors related to the genotype of individuals, such as genetic polymorphisms, are needed.

  17. Kinship and Leprosy in the Contacts of Leprosy Patients: Cohort at the Souza Araújo Outpatient Clinic, Rio de Janeiro, RJ, 1987–2010

    Science.gov (United States)

    dos Santos, Daiane Santos; Duppre, Nadia Cristina; Nery, José Augusto da Costa; Sarno, Euzenir Nunes; Hacker, Mariana Andréa

    2013-01-01

    A broad variety of factors have been associated with leprosy among contacts, including socioeconomic, epidemiological, and genetic characteristics. Data from 7,174 contacts of leprosy patients from a leprosy outpatient clinic in Rio de Janeiro, Brazil, 1987–2010, were analyzed to investigate the effects of kinship, individual, and contextual factors on leprosy. Multivariate analyses were performed using a robust estimation method. In the prevalence analysis, close kinship (sibling OR = 2.75, offspring OR = 2.00, and other relatives OR = 1.70), socioeconomic factors, and the duration of exposure to the bacillus were associated to leprosy. In the incidence analysis, significant risks were found for all categories of kinship (parents RR = 10.93, spouse, boyfriend/girlfriend, and bride/groom RR = 7.53, sibling RR = 7.03, offspring RR = 5.34, and other relatives RR = 3.71). Once the treatment of the index case was initiated, other factors lost their significance, and the index case bacteriological index and BCG (Bacillus Calmette-Guérin vaccine) protection had a greater impact. Our findings suggested that both genetic susceptibility and physical exposure play an important role in the epidemiology of leprosy, but it was not possible establishing the role of genetic factor. Analyses of other factors related to the genotype of individuals, such as genetic polymorphisms, are needed. PMID:23690793

  18. CDC Best Practices for Comprehensive Tobacco Control Programs - 2007

    Data.gov (United States)

    U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...

  19. CDC Best Practices for Comprehensive Tobacco Control Programs - 2014

    Data.gov (United States)

    U.S. Department of Health & Human Services — Centers for Disease Control and Prevention (CDC). Best Practices for Comprehensive Tobacco Control Programs. Funding. CDC's Best Practices for Comprehensive Tobacco...

  20. Division of Environmental Control Technology program, 1977

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-06-01

    Environmental engineering programs are reviewed for the following technologies; coal; petroleum and gas; oil shale; solar; geothermal and energy conservation; nuclear energy; and decontamination and decommissioning. Separate abstracts were prepared for each technology. (MHR)

  1. Fatality Assessment and Control Evaluation (FACE) Program

    Data.gov (United States)

    U.S. Department of Health & Human Services — Each day, between 12 to 13 U.S. workers die as a result of a traumatic injury on the job. Investigations conducted through the FACE program allow the identification...

  2. Stretching School Construction Dollars with Controlled Insurance Programs.

    Science.gov (United States)

    Mitchell, James W.

    2000-01-01

    Discusses reducing school construction costs through alternative insurance programs. How a Controlled Insurance Program can reduce insurance costs up to 40 percent and lead to savings of up to 5 percent of total construction costs over the life of a program are explained. (GR)

  3. Resposta diferencial de espécies e de híbridos de citros à leprose Differential response of citrus species and hybrids to leprosis

    Directory of Open Access Journals (Sweden)

    Juliana Freitas-Astúa

    2008-07-01

    Full Text Available O objetivo deste trabalho foi buscar novas fontes de resistência à leprose-dos-citros, no Banco Ativo de Germoplasma do Centro APTA Citros Sylvio Moreira, Instituto Agronômico, em Cordeirópolis, SP. Foram utilizadas plantas obtidas por sementes de 26 acessos, infectadas com o vírus da leprose-dos-citros (Citrus leprosis virus - CiLV, por meio do seu vetor Brevipalpus phoenicis. O aparecimento de lesões, a partir de 21 dias após a inoculação, foi observado em 11 dos genótipos testados (42,3%. Quinze espécies, entre elas Citrus pennivesiculata e C. celebica, comportaram-se como altamente resistentes, enquanto outras, como C. keraji, foram mais suscetíveis que o padrão C. sinensis. Os dados mostraram grande variação de respostas de Citrus spp. à leprose, com elevado número de espécies resisentes, que podem ser utilizadas como fonte de resistência à doença em programas de melhoramento.The objective of this work was to prospect for new sources of resistance to leprosis in the Citrus Germplasm Bank of Centro APTA Citros Sylvio Moreira, Instituto Agronômico, in Cordeirópolis, SP, Brazil. Plants obtained through seeds from 26 citrus accessions were mite-infected with Citrus leprosis virus (CiLV. Typical lesions started to appear in 11 genotypes (42.3% of the tested accessions 21 days after inoculation. Fifteen species, among them Citrus pennivesiculata and C. celebica, behaved as highly resistant, while other genotypes, as C. keraji, were more susceptible than the standard C. sinensis. The data showed a wide variation in the response of Citrus spp. to leprosis, with a large number of resistant species, wich can be used as source of resistance to this disease, in breeding programs.

  4. Diagnosis and medical treatment of neuropathic pain in leprosy

    Directory of Open Access Journals (Sweden)

    Rogerio Del Arco

    Full Text Available ABSTRACT Objective: to identify the difficulties in diagnosing and treating neuropathic pain caused by leprosy and to understand the main characteristics of this situation. Methods: 85 patients were treated in outpatient units with reference to leprosy and the accompanying pain. We used a questionnaire known as the Douleur Neuropathic 4 test and we conducted detailed neurological exams. As a result, 42 patients were excluded from the study for not having proved their pain. Results: Out of the 37 patients that experienced pain, 22 (59.5% had neuropathic pain (or a mixture of this pain and their existing pain and of these 90.8% considered this pain to be moderate or severe. 81.8% of the sample suffered with this pain for more than 6 months. Only 12 (54.5% of the patients had been diagnosed with neuropathic pain and in almost half of these cases, this pain had not been diagnosed. With reference to medical treatment (n=12 for neuropathic pain, 5 (41.6% responded that they became better. For the other 7 (58.4% there were no changes in relation to the pain or in some cases the pain worsened in comparison to their previous state. Statistical analysis comparing improvements in relation to the pain amongst the patients that were treated (n=12 and those that were not, showed significant differences (value p=0.020. Conclusion: we noted difficulties in diagnosing neuropathic pain for leprosy in that almost half of the patients that were studied had not had their pain diagnosed. We attributed this to some factors such as the non-adoption of the appropriate protocols which led to inadequate diagnosis and treatment that overlooked the true picture.

  5. Leprosy on Reunion Island, 2005-2013: Situation and Perspectives.

    Directory of Open Access Journals (Sweden)

    Guillaume Camuset

    2016-04-01

    Full Text Available Reunion Island is a French overseas territory located in the south-western of Indian Ocean, 700 km east of Madagascar. Leprosy first arrived on Reunion Island in the early 1700s with the African slaves and immigration from Madagascar. The disease was endemic until 1980 but improvement of health care and life conditions of inhabitants in the island have allowed a strong decrease in new cases of leprosy. However, the reintroduction of the disease by migrants from endemic neighbouring countries like Comoros and Madagascar is a real and continuing risk. This observational study was then conducted to measure the number of new cases detected annually on Reunion Island between 2005 and 2013, and to describe the clinical features of these patients.Data were collected over two distinct periods. Incident cases between 2005 and 2010 come from a retrospective study conducted in 2010 by the regional Office of French Institute for Public Health Surveillance (CIRE of Indian Ocean, when no surveillance system exist. Cases between 2011 and 2013 come from a prospective collection of all new cases, following the implementation of systematic notification of all new cases. All patient data were anonymized. Among the 25 new cases, 12 are Reunion Island residents who never lived outside Reunion Island, and hence are considered to be confirmed autochthonous patients. Registered prevalence in 2014 was 0.05 /10 000 habitants, less than the WHO's eradication goal (1/10 000.Leprosy is no longer a major public health problem on Reunion Island, as its low prevalence rate indicates. However, the risk of recrudescence of the disease and of renewed autochthonous transmission remains real. In this context, active case detection must be pursued through the active declaration and rapid treatment of all new cases.

  6. Psychosocial consequences of leprosy and the related deformity in Bangladesh

    Directory of Open Access Journals (Sweden)

    Qazi Azad-uz-zaman

    2017-01-01

    Full Text Available Objective: To explore the psychosocial condition and consequences of the people affected by leprosy and the related deformity in some selected areas of Bangladesh. Methods: A cross-sectional study was conducted from July to December 2015 among 92 leprosy-affected people. A pretested semi-structure questionnaire was used for collecting data by face to face interview from both the low prevalent areas of Khulna and the high prevalent area of Rangpur Division in Bangladesh. Results: Nearly two-fifth of respondents were observed having deformity. Among them, around four-fifth was from Khulna region, about half were above 50 years of age and more than half had monthly family income lower than 5 000 BDT. The development of deformity is found having highly significant association with region (P < 0.001, residence (P < 0.004, and family income (P < 0.004. Differences in consequences between ‘with deformity’ and ‘without deformity’ were found very high. About 65% of the respondents with deformity ‘think less’ of himself, and nearly 60% felt ashamed or embarrassed, 53% had to change job, and 47% was used to think having less respect in the society where the percentage was much lower in all cases to ‘without deformity’ group. Conclusions: Early diagnosis and start multidrug therapy at the earliest stages have chanced to reduce the leprosy-resulted deformity, disfigurement and disability. For those who already have had some nerve damages, health education is highly important to prevent further injury and hence psychosocial consequences.

  7. Leprosy in Denmark 1980-2010: a review of 15 cases.

    Science.gov (United States)

    Aftab, Huma; Nielsen, Susanne D; Bygbjerg, Ib C

    2016-01-05

    Leprosy, caused by Mycobacterium leprae, is a chronic and progressive granulomatous disease affecting mainly the skin and the peripheral nervous system. If left unrecognized, the infection can lead to permanent nerve damage and disability. The clinical presentation depends on the immune response of the patient and can result in a wide spectrum of symptoms. Leprosy is a rare encounter in Scandinavia but remains endemic in some parts of the world, with some areas reporting an increasing incidence. We performed a retrospective record review of leprosy cases in Denmark from 1980 to 2010 with the purpose of presenting the most common geographical, demographic and clinical findings and to discuss the diagnostic and therapeutic challenges of patients with leprosy. In total 15 cases were reviewed. The majority (87%) of leprosy patients in Denmark were born in South- and Southeast Asia, and were presumed to have contracted the infection in their countries of origin. Patients were predominately young males (mean age: 28.6 years). Anaesthetic skin lesion with or without nerve enlargement were the most common clinical presentations (73%). Immunological leprosy reactions were seen in 40% of the cases. Diagnoses were based on clinical findings and skin biopsies. Treatment length varied but all patients received multidrug regimens. Leprosy should be kept in mind when encountering patients with suspicious skin lesions originating from leprosy endemic areas or with history of travel or work in the tropics. Due to the long incubation period with symptoms presenting long after immigration or return, clinicians often do not have the diagnosis in mind. The wide spectrum of symptoms and immunological reactions further complicates the diagnostic process. Treatment of leprosy and the complicated immunological reactions, which frequently accompanies the infection, should be performed in collaboration with a specialist.

  8. Evaluation of qPCR-based assays for leprosy diagnosis directly in clinical specimens.

    Directory of Open Access Journals (Sweden)

    Alejandra Nóbrega Martinez

    2011-10-01

    Full Text Available The increased reliability and efficiency of the quantitative polymerase chain reaction (qPCR makes it a promising tool for performing large-scale screening for infectious disease among high-risk individuals. To date, no study has evaluated the specificity and sensitivity of different qPCR assays for leprosy diagnosis using a range of clinical samples that could bias molecular results such as difficult-to-diagnose cases. In this study, qPCR assays amplifying different M. leprae gene targets, sodA, 16S rRNA, RLEP and Ag 85B were compared for leprosy differential diagnosis. qPCR assays were performed on frozen skin biopsy samples from a total of 62 patients: 21 untreated multibacillary (MB, 26 untreated paucibacillary (PB leprosy patients, as well as 10 patients suffering from other dermatological diseases and 5 healthy donors. To develop standardized protocols and to overcome the bias resulted from using chromosome count cutoffs arbitrarily defined for different assays, decision tree classifiers were used to estimate optimum cutoffs and to evaluate the assays. As a result, we found a decreasing sensitivity for Ag 85B (66.1%, 16S rRNA (62.9%, and sodA (59.7% optimized assay classifiers, but with similar maximum specificity for leprosy diagnosis. Conversely, the RLEP assay showed to be the most sensitive (87.1%. Moreover, RLEP assay was positive for 3 samples of patients originally not diagnosed as having leprosy, but these patients developed leprosy 5-10 years after the collection of the biopsy. In addition, 4 other samples of patients clinically classified as non-leprosy presented detectable chromosome counts in their samples by the RLEP assay suggesting that those patients either had leprosy that was misdiagnosed or a subclinical state of leprosy. Overall, these results are encouraging and suggest that RLEP assay could be useful as a sensitive diagnostic test to detect M. leprae infection before major clinical manifestations.

  9. Factors preventing early case detection for women affected by leprosy: a review of the literature.

    Science.gov (United States)

    Price, Victoria Grace

    Although leprosy can affect both sexes equally, it is globally reported that men are affected, or simply report, more often than females at the average ratio of 2:1. If cases are simply not being reported, women may be suffering in silence more often than men, and, therefore, understanding the social reasons for this in a number of countries could support the prevention of long-term disabilities caused as a result of leprosy. The objective of this review is to recognise the current academic literature surrounding the potential factors for late diagnosis of women affected by leprosy, giving possible explanations for the 2:1 gender disparity observed in case detection globally. It is hoped that health practitioners will become more equipped to recognise these barriers and ensure they are doing whatever possible to encourage women to report the early symptoms of leprosy. The review used a systematic search process in order to identify gender-related publications using robust research, useful for gleaning a cross-cultural perception of issues women may confront on the prospect of a diagnosis of leprosy. Identifying 12 publications from just five countries, the review found there to be four overarching areas which may be considered barriers more often faced by women: societal stigma; women's dependence and low status; self-stigmatising attitudes; and the gender insensitivity of leprosy services. Stigma surrounding leprosy experienced from these four overarching areas can all be attributed to the later diagnosis of women affected by leprosy, in relation to their male counterparts. The need for future research surrounding the specific experience of women affected by leprosy is pressing.

  10. An integrated pest management program as a pests control strategy ...

    African Journals Online (AJOL)

    Phukubje, Justice

    and document analysis tools. The findings of ... prevention and pest control measures at UB-Library, lack of supportive .... The proper control of pests require that institutions should develop official policy statement that provides a useful first step in changing from a conventional pesticide program to user- friendly programs ...

  11. Computer program for automatic generation of BWR control rod patterns

    International Nuclear Information System (INIS)

    Taner, M.S.; Levine, S.H.; Hsia, M.Y.

    1990-01-01

    A computer program named OCTOPUS has been developed to automatically determine a control rod pattern that approximates some desired target power distribution as closely as possible without violating any thermal safety or reactor criticality constraints. The program OCTOPUS performs a semi-optimization task based on the method of approximation programming (MAP) to develop control rod patterns. The SIMULATE-E code is used to determine the nucleonic characteristics of the reactor core state

  12. The advanced controls program at Oak Ridge National Laboratory

    International Nuclear Information System (INIS)

    Knee, H.E.; White, J.D.

    1990-01-01

    The Oak Ridge National Laboratory (ORNL), under sponsorship of the US Department of Energy (DOE), is conducting research that will lead to advanced, automated control of new liquid-metal-reactor (LMR) nuclear power plants. Although this program of research (entitled the ''Advanced Controls Program'') is focused on LMR technology, it will be capable of providing control design, test, and qualification capability for other advanced reactor designs (e.g., the advanced light water reactor [ALWR] and high temperature gas-cooled reactor [HTGR] designs), while also benefiting existing nuclear plants. The Program will also have applicability to complex, non-nuclear process control environments (e.g., petrochemical, aerospace, etc.). The Advanced Controls Program will support capabilities throughout the entire plant design life cycle, i.e., from the initial interactive first-principle dynamic model development for the process, systems, components, and instruments through advanced control room qualification. The current program involves five principal areas of research activities: (1) demonstrations of advanced control system designs, (2) development of an advanced controls design environment, (3) development of advanced control strategies, (4) research and development (R ampersand D) in human-system integration for advanced control system designs, and (5) testing and validation of advanced control system designs. Discussion of the research in these five areas forms the basis of this paper. Also included is a description of the research directions of the program. 8 refs

  13. Maryland controlled fusion research program. Volume I

    International Nuclear Information System (INIS)

    1985-01-01

    This renewal proposal describes the University of Maryland research program on Magnetic Fusion Energy for a three-year period beginning January 1, 1986. This program consists of five tasks: (I) Plasma Theory; (II) Electron Cyclotron Emission Diagnostics for Mirror Machines; (III) Electron Cyclotron Emission Diagnostics on TFTR; (IV) Atomic Physics; and (V) Magnetic Field Measurement by Ion Beams. The four separate tasks of continuing research (Tasks I to IV) and the new experimental task (Task V) are described in detail. The task descriptions contain estimated budgets for CY 86, 87, and 88

  14. Factors contributing to delay in diagnosis and start of treatment of leprosy

    DEFF Research Database (Denmark)

    Nicholls, P.G.; Chhina, N; Aaen, Karen Bro

    2005-01-01

    The objective of our research was to identify factors contributing to delay in diagnosis and start of treatment in leprosy, focussing on patients' narratives of help-seeking behaviour. Our research took place in Purulia, West Bengal, India and in Nilphamari, northern Bangladesh. Between January...... and August 2000, we conducted semi-structured interviews with 104 patients that explored each individual's narrative of help-seeking behaviour and the context of beliefs and attitudes towards leprosy. Subsequently we surveyed 356 patients currently receiving treatment for leprosy and recorded specific...

  15. Leprosy and international adoption: a case report and review of diagnostic and treatment dilemmas.

    Science.gov (United States)

    King, Katherine; Browning, John C; Metry, Denise W; Prestigiacomo, John; Scollard, David; Schutze, Gordon E; Stryjewska, Barbara; Schwarzwald, Heidi

    2009-04-01

    Hansen disease, commonly known as leprosy, is uncommon in the United States and poses difficult diagnostic and treatment challenges. A 10-year-old girl was adopted from Ethiopia with a history of "multibacillary leprosy" and "multidrug treatment" for 12 months. Three months after her arrival in the United States and 4 months after treatment was completed, she presented with new papules and plaques on her left nose and ear. Herein, we present her case and review current treatment options in leprosy in children and the management of immunologic reactions.

  16. Circulating levels of insulin-like growth factor-I (IGF-I correlate with disease status in leprosy

    Directory of Open Access Journals (Sweden)

    Rodrigues Luciana

    2011-12-01

    Full Text Available Abstract Background Caused by Mycobacterium leprae (ML, leprosy presents a strong immune-inflammatory component, whose status dictates both the clinical form of the disease and the occurrence of reactional episodes. Evidence has shown that, during the immune-inflammatory response to infection, the growth hormone/insulin-like growth factor-I (GH/IGF-I plays a prominent regulatory role. However, in leprosy, little, if anything, is known about the interaction between the immune and neuroendocrine systems. Methods In the present retrospective study, we measured the serum levels of IGF-I and IGBP-3, its major binding protein. These measurements were taken at diagnosis in nonreactional borderline tuberculoid (NR BT, borderline lepromatous (NR BL, and lepromatous (NR LL leprosy patients in addition to healthy controls (HC. LL and BL patients who developed reaction during the course of the disease were also included in the study. The serum levels of IGF-I, IGFBP-3 and tumor necrosis factor-alpha (TNF-α were evaluated at diagnosis and during development of reversal (RR or erythema nodosum leprosum (ENL reaction by the solid phase, enzyme-labeled, chemiluminescent-immunometric method. Results The circulating IGF-I/IGFBP-3 levels showed significant differences according to disease status and occurrence of reactional episodes. At the time of leprosy diagnosis, significantly lower levels of circulating IGF-I/IGFBP-3 were found in NR BL and NR LL patients in contrast to NR BT patients and HCs. However, after treatment, serum IGF-I levels in BL/LL patients returned to normal. Notably, the levels of circulating IGF-I at diagnosis were low in 75% of patients who did not undergo ENL during treatment (NR LL patients in opposition to the normal levels observed in those who suffered ENL during treatment (R LL patients. Nonetheless, during ENL episodes, the levels observed in RLL sera tended to decrease, attaining similar levels to those found in NR LL patients

  17. Does programmed CTL proliferation optimize virus control?

    DEFF Research Database (Denmark)

    Wodarz, Dominik; Thomsen, Allan Randrup

    2005-01-01

    CD8 T-cell or cytotoxic T-lymphocyte responses develop through an antigen-independent proliferation and differentiation program. This is in contrast to the previous thinking, which was that continuous antigenic stimulation was required. This Opinion discusses why nature has chosen the proliferati...

  18. Refinement from a control problem to program

    DEFF Research Database (Denmark)

    Schenke, Michael; Ravn, Anders P.

    1996-01-01

    The distinguishing feature of the presented refinement approach is that it links formalisms from a top level requirements notation down to programs together in a mathematically coherent development trajectory. The approach uses Duration Calculus, a real-time interval logic, to specifyrequirements...

  19. 76 FR 9585 - Poison Control Program

    Science.gov (United States)

    2011-02-18

    ... public education about poison prevention and clinical toxicology training for many different healthcare... Control Center. These transfers are necessary in order to maintain poison control services and education... currently provide poison center services to the citizens of New York, 24 hours a day, 7 days a week. These...

  20. Social determinants of leprosy in a hyperendemic State in North Brazil.

    Science.gov (United States)

    Monteiro, Lorena Dias; Mota, Rosa Maria Salani; Martins-Melo, Francisco Rogerlândio; Alencar, Carlos Henrique; Heukelbach, Jorg

    2017-07-20

    To identify the socioeconomic, demographic, operational, and health service-related factors associated with the occurrence of leprosy in a hyperendemic State in North Brazil. This is an ecological study based on secondary data from the Sistema de Informações de Agravos de Notificação in municipalities of the State of Tocantins from 2001 to 2012. Units of analysis were the 139 municipalities of the State. Negative binomial log linear regression models were used to estimate incidence rate ratios. In bivariate analysis, the incidence rate ratios were significantly higher for municipalities with higher income ratio of the poorest 20.0% (1.47; 95%CI 1.19-1.81) and better Municipal Human Development Index (1.53; 95%CI 1.14-2.06). In multivariate analysis, the incidence rate ratios were significantly higher in municipalities with higher proportion of immigrants (1.31; 95%CI 1.11-1.55) and higher proportion of households with waste collection (1.37; 95%CI 1.11-1.69). There was a significant reduction in the incidence rate ratio with increased coverage of the Bolsa Família Program (0.98; 95%CI 0.96-0.99). Control programs need to focus on activities in municipalities of greater social vulnerability with intersectoral investment for the improvement of the living conditions of the population. Identificar fatores socioeconômicos, demográficos, operacionais e de serviços de saúde associados à ocorrência da hanseníase em um estado hiperendêmico do norte do Brasil. Estudo ecológico com dados secundários do Sistema de Informações de Agravos de Notificação em municípios do estado do Tocantins de 2001 a 2012. As unidades de análise foram os 139 municípios do estado. Modelos de regressão log linear binomial negativa foram utilizados para estimar as razões de taxas de incidência. Na análise bivariada, a razão de taxa de incidência foi significativamente maior para os municípios com maior razão de renda dos 20,0% mais pobres (1,47; IC95% 1,19-1,81) e

  1. Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial.

    Science.gov (United States)

    Barreto, Josafá G; Salgado, Claudio G

    2010-08-10

    Mycobacterium leprae is the only pathogenic bacteria able to infect peripheral nerves. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. The study objectives were to analyze the clinic-epidemiological characteristics of patients attended at one specialized dressing service from a leprosy-endemic region of the Brazilian Amazon and to evaluate the effect of low level laser therapy (LLLT) on wound healing of these patients. Clinic-epidemiological evaluation of patients with leprosy sequelae was performed at the reference unit in sanitary dermatology of the state of Pará in Brazil. We conducted anamnesis, identification of the regions affected by the lesions and measurement of ulcer depth and surface area. After that, we performed a randomized clinical trial. Fifty-one patients with ulcers related to leprosy were evaluated, twenty-five of them were randomly assigned to a low level laser therapy group or a control group. Patients were treated 3 times per week for 12 weeks. Outcome measures were ulcer surface area, ulcer depth and the pressure ulcer scale for healing score (PUSH). Ninety-seven ulcers were identified, with a mean (SD) duration of 97.6 (111.7) months, surface area of 7.3 (11.5) cm2, and depth of 6.0 (6.2) mm. Statistical analysis of the data determined that there were no significant differences in the variables analyzed before and after treatment with low level laser therapy. Ulcers in patients with leprosy remain a major source of economic and social losses, even many years after they have been cured of M. leprae infection. Our results indicate that it is necessary to develop new and more effective therapeutic tools, as low level laser therapy did not demonstrate any additional benefits to ulcer healing with the parameters used in this study. The trial was registered at ClinicalTrials.gov as NCT00860717.

  2. Vigilância da hanseníase em Olinda, Brasil, utilizando técnicas de análise espacial Leprosy surveillance in Olinda, Brazil, using spatial analysis techniques

    Directory of Open Access Journals (Sweden)

    Tiago Lapa

    2001-10-01

    Full Text Available Contribui-se com o sistema de Vigilância Epidemiológica em nível local por meio de análise espacial em razão do predomínio do caráter urbano da hanseníase em nosso meio e por sua distribuição não homogênea - em parte, pela forma de ocupação e transformação do espaço urbano. Trabalha-se o conceito de risco coletivo pela definição de micro-áreas homogêneas mediante o indicador de carência social, verificando-se sua coerência com padrões da distribuição da hanseníase obtidos da base de dados do SINAN para o Município de Olinda no período 1991-96. Para cada estrato, definido segundo níveis semelhantes dos indicadores, foi calculado o coeficiente de detecção médio para o período. Ao exame da associação entre carência social (risco e coeficiente de detecção de hanseníase obteve-se coeficiente de explicação de 66,1% no modelo multiplicativo, acrescido para 84,3% com a variável renda. Para atender à lógica de intervenção, definiram-se estratos de alto, médio e baixo risco nos distritos sanitários e área programática. A construção desses mapas mostrou-se útil a instrumentalizar o planejamento em nível local.In the State of Pernambuco, Brazil, leprosy has been mainly an urban disease, with an uneven geographical distribution related at least partially to the way urban space has been occupied and transformed. Spatial analysis may thus become an important tool to establish an epidemiological surveillance system for leprosy. Homogeneous micro-areas were defined in the city of Olinda through the integration of two databases, the Population Census and SINAN, and through the use of digital maps and geoprocessing techniques. Census tracts were classified according to a social deprivation index (SDI, and micro-area homogeneity was based on similar values for this indicator. Cluster analysis (K-means was used to define cut-offs between strata. The same procedure was repeated using the income variable only

  3. Study of thyroid function, using iodine 131, in leprosy patients

    International Nuclear Information System (INIS)

    Tatit, E.D.; Carvalho, N.

    1973-01-01

    A study was made in a group of 117 leprosy patients in differents clinical conditions, under treatment, in drug rest or virgins of treatment. They were divided in sub-groups for the following tests: the radioiodine uptake of 2-24 hours; neck-thigh ratio; thyrobinding index; protein-bound radioiodine (PB 131 I) levels of plasma. The results led to the following conclusions: 1) Leprosy patients present a low uptake in conjunction with a decrease in the velocity of thyroid clearance in the majority of the cases. Even the remaining presented values within the low limit of normality; 2) In view of these results, the tests were repeated after thyroid stimulating hormone (TSH) with exogenous TSH, in the sub-group of patients virgin of treatment. With the positive response observed (increase in the uptake, in the neck-thigh ratio and the PB 131 I) the low uptake was considered secondary with regard to a deficit of the endogenous TSH; 3) The TBI and PB 131 I tests were not in sufficient agreement for an appraisal of the phase of organic binding and release of hormone [pt

  4. Mast cell subsets and neuropeptides in leprosy reactions

    Directory of Open Access Journals (Sweden)

    Antunes Sérgio Luiz Gomes

    2003-01-01

    Full Text Available The immunohistochemical identification of neuropeptides (calcitonin gene-related peptide, vasoactive intestinal polypeptide, substance P, alpha-melanocyte stimulating hormone and gamma-melanocyte stimulating hormone quantification of mast cells and their subsets (tryptase/chymase-immunoreactive mast cells = TCMC and tryptase-immunoreactive mast cells = TMC were determined in biopsies of six patients with leprosy reactions (three patients with type I reaction and three with type II. Biopsies were compared with those taken from the same body site in the remission stage of the same patient. We found a relative increase of TMC in the inflammatory infiltrate of the reactional biopsies compared to the post-reactional biopsy. Also, the total number of mast cells and the TMC/TCMC ratio in the inflammatory infiltrate was significantly higher than in the intervening dermis of the biopsies of both periods. No significant difference was found regarding neuroptide expression in the reactional and post-reactional biopsies. The relative increase of TMC in the reactional infiltrates could implicate this mast cell subset in the reported increase of the immune response in leprosy reactions.

  5. Interactive flight control system analysis program

    Science.gov (United States)

    Mahesh, J. K.; Konar, A. F.; Ward, M. D.

    1984-01-01

    A summary of the development, use, and documentation of the interactive software (DIGIKON IV) for flight control system analyses is presented. A list of recommendations for future development is also included.

  6. Computer program CDCID: an automated quality control program using CDC update

    International Nuclear Information System (INIS)

    Singer, G.L.; Aguilar, F.

    1984-04-01

    A computer program, CDCID, has been developed in coordination with a quality control program to provide a highly automated method of documenting changes to computer codes at EG and G Idaho, Inc. The method uses the standard CDC UPDATE program in such a manner that updates and their associated documentation are easily made and retrieved in various formats. The method allows each card image of a source program to point to the document which describes it, who created the card, and when it was created. The method described is applicable to the quality control of computer programs in general. The computer program described is executable only on CDC computing systems, but the program could be modified and applied to any computing system with an adequate updating program

  7. Educating for early diagnosis of leprosy in the municipality of Mato Grosso Rondonópolis

    Directory of Open Access Journals (Sweden)

    Débora Aparecida da Silva Santos

    2016-09-01

    Full Text Available Rondonópolis-MT has shown high rates of leprosy cases, leading to the need for preventive educational activities. The extension project "Leprosy: Early diagnosis is the solution" is carried out in partnership with the Health Department for 4 years with the Nursing Course UFMT / ICEN / CUR. This article aimed to describe the realization of educational activities on prevention of leprosy in the areas of health facilities, in-service education, lectures in schools and participation in joint efforts between March 2014 and March 2015. The audience were 1764 residents, in addition to students and professionals schools and health teams. They were referred 22 suspected cases and confirmed 11 new, professional training and schools. This citizenship action, the project significantly contributed to the early diagnosis of leprosy and the public health of the city. It is suggested that new projects are undertaken to promote the quality of primary care, encouraging the participation of academia through the university extension.

  8. Nodular melanoma in trophic ulceration of a leprosy patient: a case study.

    Science.gov (United States)

    Zhu, J; Shi, C; Jing, Z; Liu, Y

    2016-05-01

    Non-healing chronic trophic ulceration is very common in leprosy patients. Marjolin's ulcer consists of the malignant transformation of a chronic ulcerative lesion. Nodular melanoma developing from Marjolin's ulcer, caused by a trophic ulceration of a leprosy patient, is very rare with only a few cases reported in the literature. Due to the disguised presentation of these malignancies within trophic ulceration lesions in leprosy, neoplastic transformation is frequently overlooked, leading to misdiagnosed and delayed treatment. This paper reports a case of an 83-year-old man with lepromatous leprosy and chronic ulceration on the foot for 22 years. Over a period of 2 months, the ulcer enlarged, turned black, and became more painful. The patient underwent regional excision and immunotherapy after the diagnosis of malignant nodular melanoma. After 9 months follow-up, no metastasis was found. There were no external sources of funding for this study. The authors have no conflicts of interest to declare.

  9. Leprosy and its socio-cultural perception in Indian religions and ancient texts.

    Science.gov (United States)

    Sinha, A K; Banerjee, B G; Singh, S

    2010-01-01

    Leprosy is one of the oldest ailments known to the mankind. Many of the ancient texts and scriptures reveal that leprosy was not categorised as a specified disease but was grouped along with other skin diseases. However, in certain texts categorical mention of this disease does exist. The prime objective of this article is to highlight the age old traditional line of perception about this disease. A literature review was done to up-date the socio-cultural perception of leprosy in Indian religions and ancient texts. References were obtained through examining relevant bibliographies and the views/suggestions of eminent scholars engaged in this field were also included. An analysis of the secondary sources of data, particularly the ancient texts reveals that in good old days, leprosy had been considered to be an infliction of wrong-doings and sins. This viewpoint has been significantly reflected in these texts.

  10. Comparison and Contrast of the Elimination Campaigns for Poliomyelitis and Leprosy: Which is More Feasible?

    Science.gov (United States)

    Malheiro, Luís; Pinto, Sofia Correia; Sarmento, Antonio; Santos, Lurdes

    2016-04-01

    As we approach the third decade since the WHO started addressing the eradication of poliomyelitis and leprosy, a reflection of the previous campaigns efficacy and an evaluation of further elimination feasibility is important to adapt and intensify the next steps. We performed a critical review of the poliomyelitis and leprosy eradication campaigns to evaluate their technical and operational feasibilities. Vaccination and active case search are highly effective tools against poliomyelitis. If political stability and good vaccination coverage is achieved, poliomyelitis will be an easy target for eradication. Leprosy, on the other hand, faces many barriers towards elimination. The lack of a high efficacy vaccine, the long asymptomatic but infective period, the lack of screening tests and a poorly established elimination target, prevents this disease from being eliminated. In a world where resources and funding are limited, it is apparent that poliomyelitis is a more feasible target for elimination than leprosy.

  11. Formative Evaluation of a University Birth Control Education Program.

    Science.gov (United States)

    Huettman, Julie K. Doidge; Sarvela, Paul D.

    1992-01-01

    A university birth control education program was created to improve student knowledge, attitudes, and behaviors. Students attended a birth control class before visiting the health clinic for prescriptions. Pre- and posttest questionnaires and clinician assessments indicated knowledge of birth control improved significantly, and students became…

  12. Déjà vu: leprosy and immigration discourse in the twenty-first century United States.

    Science.gov (United States)

    White, Cassandra

    2010-03-01

    Leprosy, or Hansen's disease, continues to be feared and poorly understood in the United States, where knowledge of the disease is limited and prevalence is low. The presence of leprosy among immigrants, however, provides fuel for those with an anti-immigration agenda. In recent years, there have been several examples of popular media distortions of statistics and of information on leprosy's properties and contagiousness. As in previous eras of U.S. history, public fears about leprosy seem to be related to anti-immigration or nativist sentiment, which often mask underlying concerns about the potential economic threat of immigrant populations. In this article, I analyse the role of the U.S. media and other stakeholders who may have an interest in generating public fear associated with leprosy, in presenting and at times manipulating data about the disease to create an association between leprosy and undocumented immigration.

  13. Psychiatric Morbidity among Subjects with Leprosy and Albinism in South East Nigeria: A Comparative Study

    Science.gov (United States)

    Attama, CM; Uwakwe, R; Onyeama, GM; Igwe, MN

    2015-01-01

    Background: Skin, which is the largest organ in the body, carries immense psychological significance. Disfiguring skin disorders may impact negatively on the mental health of individuals. Aim: This study compared the psychiatric morbidity of subjects with leprosy and albinism. Subjects and Methods: One hundred subjects with leprosy and 100 with albinism were interviewed. Sociodemographic questionnaire and General Health Questionnaire (GHQ-28) assessed the sociodemographic characteristics and psychiatric morbidity, respectively. GHQ positive cases and 10% of noncases for each group were interviewed with Mini International Neuropsychiatric Inventory for specific ICD-10 diagnoses. Results: Fifty-five percent (55/100) subjects with leprosy were GHQ positive cases while 41% (41/100) with albinism were GHQ positive cases. The risk of developing psychiatric morbidity was significantly higher in subjects with leprosy than in subjects with albinism (OR = 1.76, CI = 1.00 – 3.08, P = 0.04). The prevalence of specific psychiatric disorders among subjects with leprosy were depression 49% (49/100), generalized anxiety disorder (GAD) 18% (18/100), alcohol/drug abuse 16% (16/100), whereas in albinism depression was 51% (51/100), GAD 27% (27/100), and alcohol/drug abuse 7% (7/100). Male, married and uneducated subjects with leprosy had significantly higher psychiatric morbidity than the male, married and uneducated subjects with albinism, respectively. Conclusion: Psychiatric morbidity was higher in subjects with leprosy than in subjects with albinism. Male, married and uneducated subjects with leprosy significantly had higher morbidity than male, married and uneducated subjects with albinism respectively. PMID:26097762

  14. An unusual case of isolated sixth cranial nerve palsy in leprosy.

    Science.gov (United States)

    Vaishampayan, Sanjeev; Borde, Priyanka

    2012-08-15

    Cranial nerve involvement is not common in leprosy. The fifth and seventh cranial nerves are the most commonly affected in leprosy. Herein we present a patient with Hansen disease (BL) with type I reaction who developed isolated involvement of the sixth cranial nerve leading to lateral rectus muscle palsy. He responded to timely anti-reactional therapy and it produced a good response. Careful observation of patients with lepra reaction is needed to avoid damage to important organs.

  15. Coexistence of lupus vulgaris with pure neuritic leprosy with incomplete claw hand

    Directory of Open Access Journals (Sweden)

    Angoori Gnaneshwar Rao

    2016-01-01

    Full Text Available Coexistence of two chronic granulomatous diseases in an individual is rare. Here, we present coexistence of lupus vulgaris (LV and pure neuritic leprosy with incomplete claw hand deformity in an 11-year-old immunocompetent girl, who presented with deformity and ulcer involving right upper limb. Characteristic clinical features and histopathology of biopsy from the ulcer assisted in establishing the diagnosis of LV and leprosy.

  16. Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

    OpenAIRE

    van Brakel, Wim H.; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I.; Wilder-Smith, Annelies

    2012-01-01

    Background: Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. Methods: We conducted a survey on disability among persons affecte...

  17. Synthesis and evaluation of novel dapsone-thalidomide hybrids for the treatment of type 2 leprosy reactions.

    Science.gov (United States)

    Yamasaki, Paulo Renato; do Nascimento, Dejair Caetano; Chelucci, Rafael Consolin; de Faria Fernandes Belone, Andréa; Rosa, Patrícia Sammarco; Diório, Suzana Madeira; de Melo, Thais Regina Ferreira; Barbieri, Karina Pereira; Placeres, Marisa Campos Polési; Carlos, Iracilda Zepone; Chung, Man Chin; dos Santos, Jean Leandro

    2014-07-15

    We synthesized a series of novel dapsone-thalidomide hybrids (3a-i) by molecular hybridization and evaluated their potential for the treatment of type 2 leprosy reactions. All of the compounds had analgesic properties. Compounds 3c and 3h were the most active antinociceptive compounds and reduced acetic acid-induced abdominal constrictions by 49.8% and 39.1%, respectively. The hybrid compounds also reduced tumor necrosis factor-α levels in lipopolysaccharide-stimulated L929 cells. Compound 3i was the most active compound; at concentrations of 15.62 and 125 μM, compound 3i decreased tumor necrosis factor-α levels by 86.33% and 87.80%, respectively. In nude mice infected with Mycobacterium leprae in vivo, compound 3i did not reduce the number of bacilli compared with controls. Compound 3i did not have mutagenic effects in Salmonella typhimurium strains TA100 and TA102, with or without metabolic activation (S9 mixture). Our results indicate that compound 3i is a novel lead compound for the treatment of type 2 leprosy reactions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Helicopter trimming and tracking control using direct neural dynamic programming.

    Science.gov (United States)

    Enns, R; Si, Jennie

    2003-01-01

    This paper advances a neural-network-based approximate dynamic programming control mechanism that can be applied to complex control problems such as helicopter flight control design. Based on direct neural dynamic programming (DNDP), an approximate dynamic programming methodology, the control system is tailored to learn to maneuver a helicopter. The paper consists of a comprehensive treatise of this DNDP-based tracking control framework and extensive simulation studies for an Apache helicopter. A trim network is developed and seamlessly integrated into the neural dynamic programming (NDP) controller as part of a baseline structure for controlling complex nonlinear systems such as a helicopter. Design robustness is addressed by performing simulations under various disturbance conditions. All designs are tested using FLYRT, a sophisticated industrial scale nonlinear validated model of the Apache helicopter. This is probably the first time that an approximate dynamic programming methodology has been systematically applied to, and evaluated on, a complex, continuous state, multiple-input multiple-output nonlinear system with uncertainty. Though illustrated for helicopters, the DNDP control system framework should be applicable to general purpose tracking control.

  19. Tank waste remediation system heat stress control program report, 1995

    International Nuclear Information System (INIS)

    Carls, D.R.

    1995-01-01

    Protecting employees from heat stress within tank farms during the summer months is challenging. Work constraints typically experienced in tank farms complicate the measures taken to protect employees from heat stress. TWRS-Industrial Hygiene (IH) has endeavored to control heat stress injuries by anticipating, recognizing, evaluating and controlling the factors which lead or contribute to heat stress in Tank Farms. The TWRS Heat Stress Control Program covers such areas as: employee and PIC training, communication of daily heat stress alerts to tank farm personnel, setting work/rest regimens, and the use of engineering and personal protective controls when applicable. The program has increased worker awareness of heat stress and prevention, established provisions for worker rest periods, increased drinking water availability to help ensure worker hydration, and allowed for the increased use of other protective controls to combat heat stress. The TWRS Heat Stress Control Program is the cornerstone for controlling heat stress among tank farm employees. The program has made great strides since it's inception during the summer of 1994. Some improvements can still be made to enhance the program for the summer of 1996, such as: (1) procurement and use of personal heat stress monitoring equipment to ensure appropriate application of administrative controls, (2) decrease the need for use of containment tents and anti-contamination clothing, and (3) providing a wider variety of engineering and personal protective controls for heat stress prevention

  20. Tank waste remediation system heat stress control program report, 1995

    Energy Technology Data Exchange (ETDEWEB)

    Carls, D.R.

    1995-09-28

    Protecting employees from heat stress within tank farms during the summer months is challenging. Work constraints typically experienced in tank farms complicate the measures taken to protect employees from heat stress. TWRS-Industrial Hygiene (IH) has endeavored to control heat stress injuries by anticipating, recognizing, evaluating and controlling the factors which lead or contribute to heat stress in Tank Farms. The TWRS Heat Stress Control Program covers such areas as: employee and PIC training, communication of daily heat stress alerts to tank farm personnel, setting work/rest regimens, and the use of engineering and personal protective controls when applicable. The program has increased worker awareness of heat stress and prevention, established provisions for worker rest periods, increased drinking water availability to help ensure worker hydration, and allowed for the increased use of other protective controls to combat heat stress. The TWRS Heat Stress Control Program is the cornerstone for controlling heat stress among tank farm employees. The program has made great strides since it`s inception during the summer of 1994. Some improvements can still be made to enhance the program for the summer of 1996, such as: (1) procurement and use of personal heat stress monitoring equipment to ensure appropriate application of administrative controls, (2) decrease the need for use of containment tents and anti-contamination clothing, and (3) providing a wider variety of engineering and personal protective controls for heat stress prevention

  1. Evaluation of Nosocomial Infection Control Programs in health services.

    Science.gov (United States)

    Menegueti, Mayra Gonçalves; Canini, Silvia Rita Marin da Silva; Bellissimo-Rodrigues, Fernando; Laus, Ana Maria

    2015-01-01

    to evaluate the Nosocomial Infection Control Programs in hospital institutions regarding structure and process indicators. this is a descriptive, exploratory and quantitative study conducted in 2013. The study population comprised 13 Nosocomial Infection Control Programs of health services in a Brazilian city of the state of São Paulo. Public domain instruments available in the Manual of Evaluation Indicators of Nosocomial Infection Control Practices were used. The indicators with the highest average compliance were "Evaluation of the Structure of the Nosocomial Infection Control Programs" (75%) and "Evaluation of the Epidemiological Surveillance System of Nosocomial Infection" (82%) and those with the lowest mean compliance scores were "Evaluation of Operational Guidelines" (58.97%) and "Evaluation of Activities of Control and Prevention of Nosocomial Infection" (60.29%). The use of indicators identified that, despite having produced knowledge about prevention and control of nosocomial infections, there is still a large gap between the practice and the recommendations.

  2. Automation of program model developing for complex structure control objects

    International Nuclear Information System (INIS)

    Ivanov, A.P.; Sizova, T.B.; Mikhejkina, N.D.; Sankovskij, G.A.; Tyufyagin, A.N.

    1991-01-01

    A brief description of software for automated developing the models of integrating modular programming system, program module generator and program module library providing thermal-hydraulic calcualtion of process dynamics in power unit equipment components and on-line control system operation simulation is given. Technical recommendations for model development are based on experience in creation of concrete models of NPP power units. 8 refs., 1 tab., 4 figs

  3. Monitor system for stored-program control

    International Nuclear Information System (INIS)

    Fassbender, A.

    1988-06-01

    A brief description of the COSY control system shows that the control functions in COSY are realised by a distributed system. The marginal conditions of the operating system components are explained using the COSY waterworks as an example. From this example and some subsequent considerations, important parameters for the COSY operating system are derived and are used for the system realisation. The result with regard to process communication and process synchronisation is the channel, for which data formats and functionalities are defined. The main functions and the four basic calls are also defined. Implementation of the channel is explained, showing that the required functions are well achieved. Adjustments to the distributed MOSI standard are feasible and appropriate. (orig./DG) [de

  4. Adipocyte lipid synthesis coupled to neuronal control of thermogenic programming

    Directory of Open Access Journals (Sweden)

    Adilson Guilherme

    2017-08-01

    Conclusions: These results demonstrate that downregulation of fatty acid synthesis via FASN depletion in white adipocytes of mature mice can stimulate neuronal signaling to control thermogenic programming in iWAT.

  5. Derivation of sequential, real-time, process-control programs

    Science.gov (United States)

    Marzullo, Keith; Schneider, Fred B.; Budhiraja, Navin

    1991-01-01

    The use of weakest-precondition predicate transformers in the derivation of sequential, process-control software is discussed. Only one extension to Dijkstra's calculus for deriving ordinary sequential programs was found to be necessary: function-valued auxiliary variables. These auxiliary variables are needed for reasoning about states of a physical process that exists during program transitions.

  6. Food and Nutrition Services Quality Control Management Program.

    Science.gov (United States)

    Wimsatt-Fraim, Teresa S.

    A program was conducted to improve the quality of food service through the training of 44 food and nutrition service employees in a 200-bed hospital. A 12-week quality control program was implemented to address four key areas: food temperatures, food accuracy, food quality, and dietary personnel. Learning strategies, emphasizing critical thinking…

  7. 40 CFR 125.66 - Toxics control program.

    Science.gov (United States)

    2010-07-01

    ... Secondary Treatment Requirements Under Section 301(h) of the Clean Water Act § 125.66 Toxics control program... 125.66 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS CRITERIA...). Applicants may supplement or substitute chemical analyses if composition of the supplemental or substitute...

  8. A distributed implementation of a mode switching control program

    DEFF Research Database (Denmark)

    Holdgaard, Michael; Eriksen, Thomas Juul; Ravn, Anders P.

    1995-01-01

    A distributed implementation of a mode switched control program for a robot is described. The design of the control program is given by a set of real-time automatons. One of them plans a schedule for switching between a fixed set of control functions, another dispatches the control functions...... according to the schedule, and a final one monitors the system for exceptions that shall lead to a halt. The implementation uses four transputers with a distribution of phases of the automatons over the individual processors. The main technical result of the paper is calculations that illustrate how...

  9. Human migration, railways and the geographic distribution of leprosy in Rio Grande do Norte State – Brazil

    Science.gov (United States)

    Nobre, Mauricio Lisboa; Dupnik, Kathryn Margaret; Nobre, Paulo José Lisboa; De Souza, Márcia Célia Freitas; Dűppre, Nádia Cristina; Sarno, Euzenir Nunes; Jerŏnimo, Selma Maria Bezerra

    2016-01-01

    Summary Introduction Leprosy is a public health problem in Brazil where 31,044 new cases were detected in 2013. Rio Grande do Norte is a small Brazilian state with a rate of leprosy lower than other areas in the same region, for unknown reasons. Objectives We present here a review based on the analysis of a database of registered leprosy cases in Rio Grande do Norte state, comparing leprosy's geographic distribution among municipalities with local socio-economic and public health indicators and with historical documents about human migration in this Brazilian region. Results The current distribution of leprosy in Rio Grande do Norte did not show correlation with socio-economic or public health indicators at the municipal level, but it appears related to economically emerging municipalities 100 years ago, with spread facilitated by railroads and train stations. Drought-related migratory movements which occurred from this state to leprosy endemic areas within the same period may be involved in the introduction of leprosy and with its present distribution within Rio Grande do Norte. Conclusions Leprosy may disseminate slowly, over many decades in certain circumstances, such as in small cities with few cases. This is a very unusual situation currently and a unique opportunity for epidemiologic studies of leprosy as an emerging disease. PMID:26964429

  10. Leprosy control in the post leprosaria abolition years in Nigeria ...

    African Journals Online (AJOL)

    The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, and work with PDFs, Highwire Press provides a helpful Frequently Asked Questions about PDFs.

  11. The role of ERBB2 gene polymorphisms in leprosy susceptibility

    Directory of Open Access Journals (Sweden)

    Jamile Leão Rêgo

    2015-03-01

    Full Text Available Mycobacterium leprae infects skin and peripheral nerves causing deformities and disability. The M. leprae bacterium binds to ErbB2 on the Schwann cell surface causing demyelination and favoring spread of the bacilli and causing nerve injury. Polymorphisms at the ERBB2 gene were previously investigated as genetic risk factors for leprosy in two Brazilian populations but with inconsistent results. Herein we extend the analysis of ERBB2 variants to a third geographically distinct population in Brazil. Our results show that there is no association between the genotyped SNPs and the disease (p > 0.05 in this population. A gene set or pathway analysis under the genomic region of ERBB2 will be necessary to clarify its regulation under M. leprae stimulus.

  12. Lepromatous leprosy treated with recombinant interferon gamma: cutaneous histologic changes.

    Science.gov (United States)

    Bottasso, O; Besuschio, S; Merlin, V; Morini, J C; Bernabo, J; Falcoff, R; Falcoff, E

    1992-11-01

    We report on the histologic changes occurring in single cutaneous lesions, from six active lepromatous patients, 1 week following the administration of three daily intradermal injections, 35 micrograms each, of recombinant interferon gamma (rIFN-gamma). Except for a strong induration at the injection site, rIFN-gamma produced no adverse systemic reactions and was able to promote a remarkable influx of T-lymphocytes, mononuclear phagocytes with large nuclei, nonvacuolated cytoplasm, and reduced lysozyme reactivity. Furthermore, despite no clear-cut reduction of mycobacterial dermal burden, bacilli showed a clear increase in the granular appearance. Present findings provide a basis for further elucidation of rIFN-gamma as an additional tool for leprosy treatment.

  13. miRNome Expression Analysis Reveals New Players on Leprosy Immune Physiopathology

    Directory of Open Access Journals (Sweden)

    Claudio Guedes Salgado

    2018-03-01

    Full Text Available Leprosy remains as a public health problem and its physiopathology is still not fully understood. MicroRNAs (miRNA are small RNA non-coding that can interfere with mRNA to regulate gene expression. A few studies using DNA chip microarrays have explored the expression of miRNA in leprosy patients using a predetermined set of genes as targets, providing interesting findings regarding the regulation of immune genes. However, using a predetermined set of genes restricted the possibility of finding new miRNAs that might be involved in different mechanisms of disease. Thus, we examined the miRNome of tuberculoid (TT and lepromatous (LL patients using both blood and lesional biopsies from classical leprosy patients (LP who visited the Dr. Marcello Candia Reference Unit in Sanitary Dermatology in the State of Pará and compared them with healthy subjects. Using a set of tools to correlate significantly differentially expressed miRNAs with their gene targets, we identified possible interactions and networks of miRNAs that might be involved in leprosy immunophysiopathology. Using this approach, we showed that the leprosy miRNA profile in blood is distinct from that in lesional skin as well as that four main groups of genes are the targets of leprosy miRNA: (1 recognition and phagocytosis, with activation of immune effector cells, where the immunosuppressant profile of LL and immunoresponsive profile of TT are clearly affected by miRNA expression; (2 apoptosis, with supportive data for an antiapoptotic leprosy profile based on BCL2, MCL1, and CASP8 expression; (3 Schwann cells (SCs, demyelination and epithelial–mesenchymal transition (EMT, supporting a role for different developmental or differentiation gene families, such as Sox, Zeb, and Hox; and (4 loss of sensation and neuropathic pain, revealing that RHOA, ROCK1, SIGMAR1, and aquaporin-1 (AQP1 may be involved in the loss of sensation or leprosy pain, indicating possible new therapeutic targets

  14. A computer program for the algebraic determination of control coefficients in Metabolic Control Analysis.

    OpenAIRE

    Thomas, S; Fell, D A

    1993-01-01

    A computer program (MetaCon) is described for the evaluation of flux control, concentration control and branch-point distribution control coefficients of a metabolic pathway. Requiring only the reaction scheme as input, the program produces algebraic expressions for the control coefficients in terms of elasticity coefficients, metabolite concentrations and pathway fluxes. Any of these variables can be substituted by numeric or simple algebraic expressions; the expressions will then be automat...

  15. Purwarupa Sistem Kontrol Elevator Berbasis Programable Logic Control

    Directory of Open Access Journals (Sweden)

    Fathahillah Fathahillah

    2017-12-01

    Full Text Available Various methods / types of controls developed in accordance with industry needs one of them in the field of building automation system. One of the controls in the field of building automation system is the elevator control system (elevator. Early elevator control systems that transport humans or goods as vertical transportation vehicles are still conventional using human power, then evolved using steam engines, until now the elevators use AC motors equipped with control systems. The purpose of this research is to design the prototype of elevator control system using programmable logic control (PLC. The type of PLC controller used in the study using Omron PLC. The results show the design of prototype of elevator control system using PLC successfully and can control eleveator in accordance with its function, besides its programming form can be more simple.

  16. Interruption and defaulting of multidrug therapy against leprosy: population-based study in Brazil's Savannah Region.

    Directory of Open Access Journals (Sweden)

    Jorg Heukelbach

    Full Text Available BACKGROUND: Low adherence to multidrug therapy against leprosy (MDT is still an important obstacle of disease control, and may lead to remaining sources of infection, incomplete cure, irreversible complications, and multidrug resistance. METHODOLOGY/PRINCIPAL FINDING: We performed a population-based study in 78 municipalities in Tocantins State, central Brazil, and applied structured questionnaires on leprosy-affected individuals. We used two outcomes for assessment of risk factors: defaulting (not presenting to health care center for supervised treatment for >12 months; and interruption of MDT. In total, 28/936 (3.0% patients defaulted, and 147/806 (18.2% interrupted MDT. Defaulting was significantly associated with: low number of rooms per household (OR = 3.43; 0.98-9.69; p = 0.03; moving to another residence after diagnosis (OR = 2.90; 0.95-5.28; p = 0.04; and low family income (OR = 2.42; 1.02-5.63: p = 0.04. Interruption of treatment was associated with: low number of rooms per household (OR = 1.95; 0.98-3.70; p = 0.04; difficulty in swallowing MDT drugs (OR = 1.66; 1.03-2.63; p = 0.02; temporal non-availability of MDT at the health center (OR = 1.67; 1.11-2.46; p = 0.01; and moving to another residence (OR = 1.58; 95% confidence interval: 1.03-2.40; p = 0.03. Logistic regression identified temporal non-availability of MDT as an independent risk factor for treatment interruption (adjusted OR = 1.56; 1.05-2.33; p = 0.03, and residence size as a protective factor (adjusted OR = 0.89 per additional number of rooms; 0.80-0.99; p = 0.03. Residence size was also independently associated with defaulting (adjusted OR = 0.67; 0.52-0.88; p = 0.003. CONCLUSIONS: Defaulting and interruption of MDT are associated with some poverty-related variables such as family income, household size, and migration. Intermittent problems of drug supply need to be resolved, mainly on the municipality level. MDT producers should consider oral drug formulations that may

  17. Adaptive Dynamic Programming for Control Algorithms and Stability

    CERN Document Server

    Zhang, Huaguang; Luo, Yanhong; Wang, Ding

    2013-01-01

    There are many methods of stable controller design for nonlinear systems. In seeking to go beyond the minimum requirement of stability, Adaptive Dynamic Programming for Control approaches the challenging topic of optimal control for nonlinear systems using the tools of  adaptive dynamic programming (ADP). The range of systems treated is extensive; affine, switched, singularly perturbed and time-delay nonlinear systems are discussed as are the uses of neural networks and techniques of value and policy iteration. The text features three main aspects of ADP in which the methods proposed for stabilization and for tracking and games benefit from the incorporation of optimal control methods: • infinite-horizon control for which the difficulty of solving partial differential Hamilton–Jacobi–Bellman equations directly is overcome, and  proof provided that the iterative value function updating sequence converges to the infimum of all the value functions obtained by admissible control law sequences; • finite-...

  18. Household expenditure on leprosy outpatient services in the Indian health system: A comparative study.

    Directory of Open Access Journals (Sweden)

    Anuj Tiwari

    2018-01-01

    Full Text Available Leprosy is a major public health problem in many low and middle income countries, especially in India, and contributes considerably to the global burden of the disease. Leprosy and poverty are closely associated, and therefore the economic burden of leprosy is a concern. However, evidence on patient's expenditure is scarce. In this study, we estimate the expenditure in primary care (outpatient by leprosy households in two different public health settings.We performed a cross-sectional study, comparing the Union Territory of Dadra and Nagar Haveli with the Umbergaon block of Valsad, Gujrat, India. A household (HH survey was conducted between May and October, 2016. We calculated direct and indirect expenditure by zero inflated negative binomial and negative binomial regression. The sampled households were comparable on socioeconomic indicators. The mean direct expenditure was USD 6.5 (95% CI: 2.4-17.9 in Dadra and Nagar Haveli and USD 5.4 (95% CI: 3.8-7.9 per visit in Umbergaon. The mean indirect expenditure was USD 8.7 (95% CI: 7.2-10.6 in Dadra and Nagar Haveli and USD 12.4 (95% CI: 7.0-21.9 in Umbergaon. The age of the leprosy patients and type of health facilities were the major predictors of total expenditure on leprosy primary care. The higher the age, the higher the expenditure at both sites. The private facilities are more expensive than the government facilities at both sites. If the public health system is enhanced, government facilities are the first preference for patients.An enhanced public health system reduces the patient's expenditure and improves the health seeking behaviour. We recommend investing in health system strengthening to reduce the economic burden of leprosy.

  19. Household expenditure on leprosy outpatient services in the Indian health system: A comparative study.

    Science.gov (United States)

    Tiwari, Anuj; Suryawanshi, Pramilesh; Raikwar, Akash; Arif, Mohammad; Richardus, Jan Hendrik

    2018-01-01

    Leprosy is a major public health problem in many low and middle income countries, especially in India, and contributes considerably to the global burden of the disease. Leprosy and poverty are closely associated, and therefore the economic burden of leprosy is a concern. However, evidence on patient's expenditure is scarce. In this study, we estimate the expenditure in primary care (outpatient) by leprosy households in two different public health settings. We performed a cross-sectional study, comparing the Union Territory of Dadra and Nagar Haveli with the Umbergaon block of Valsad, Gujrat, India. A household (HH) survey was conducted between May and October, 2016. We calculated direct and indirect expenditure by zero inflated negative binomial and negative binomial regression. The sampled households were comparable on socioeconomic indicators. The mean direct expenditure was USD 6.5 (95% CI: 2.4-17.9) in Dadra and Nagar Haveli and USD 5.4 (95% CI: 3.8-7.9) per visit in Umbergaon. The mean indirect expenditure was USD 8.7 (95% CI: 7.2-10.6) in Dadra and Nagar Haveli and USD 12.4 (95% CI: 7.0-21.9) in Umbergaon. The age of the leprosy patients and type of health facilities were the major predictors of total expenditure on leprosy primary care. The higher the age, the higher the expenditure at both sites. The private facilities are more expensive than the government facilities at both sites. If the public health system is enhanced, government facilities are the first preference for patients. An enhanced public health system reduces the patient's expenditure and improves the health seeking behaviour. We recommend investing in health system strengthening to reduce the economic burden of leprosy.

  20. PCR-based techniques for leprosy diagnosis: from the laboratory to the clinic.

    Directory of Open Access Journals (Sweden)

    Alejandra Nóbrega Martinez

    2014-04-01

    Full Text Available In leprosy, classic diagnostic tools based on bacillary counts and histopathology have been facing hurdles, especially in distinguishing latent infection from active disease and diagnosing paucibacillary clinical forms. Serological tests and IFN-gamma releasing assays (IGRA that employ humoral and cellular immune parameters, respectively, are also being used, but recent results indicate that quantitative PCR (qPCR is a key technique due to its higher sensitivity and specificity. In fact, advances concerning the structure and function of the Mycobacterium leprae genome led to the development of specific PCR-based gene amplification assays for leprosy diagnosis and monitoring of household contacts. Also, based on the validation of point-of-care technologies for M. tuberculosis DNA detection, it is clear that the same advantages of rapid DNA detection could be observed in respect to leprosy. So far, PCR has proven useful in the determination of transmission routes, M. leprae viability, and drug resistance in leprosy. However, PCR has been ascertained to be especially valuable in diagnosing difficult cases like pure neural leprosy (PNL, paucibacillary (PB, and patients with atypical clinical presentation and histopathological features compatible with leprosy. Also, the detection of M. leprae DNA in different samples of the household contacts of leprosy patients is very promising. Although a positive PCR result is not sufficient to establish a causal relationship with disease outcome, quantitation provided by qPCR is clearly capable of indicating increased risk of developing the disease and could alert clinicians to follow these contacts more closely or even define rules for chemoprophylaxis.

  1. Survey on child leprosy patients and problems resulted from the disease in China.

    Science.gov (United States)

    Yan, Liangbin; Shen, Jianping; Zhou, Min; Zhang, Guocheng

    2015-03-01

    To understand the situation of child leprosy patients in the low prevalence situation pertaining in China. A retrospective survey by questionnaire was carried out in all 32 provinces of mainland of China in 2011. All data concerning child cases detected from January 2005 to December 2009 were collected by professional health workers working at county level. During the study, only 165 questionnaires were collected for analysis. Among 165 child cases, 96 were boys, 69 were girls with an average age of 11-7 years old. 80% of child cases were members of families with other leprosy affected people. 145 (85%) child cases took their MDT secretly (nobody outside the family knew the child suffered from leprosy), and three (1.8%) children died, one each from dapsone syndrome, suicide and severe pneumonia. During follow-up, four child cases developed new disability increasing the Grade 2 disability rate to 13.3% (22/165). At end of the study, 8.2% of children had discontinued their study at school, and 7.5% had moved to a remote place to do casual work, while 6.3% stayed at home. 31% of child patients thought that leprosy caused a negative impact on their daily life. Two children had a hostile attitude toward society due to the stigma caused by leprosy. In both high and low endemic areas, as long as there is an infectious source of leprosy in the family, there is a possibility for children to develop leprosy. Contact surveys should be done to detect early disease, especially when there are children in the household.

  2. Cross-cultural adaptation of the EMIC Stigma Scale for people with leprosy in Brazil

    Directory of Open Access Journals (Sweden)

    Fabiane Frota da Rocha Morgado

    2017-09-01

    Full Text Available ABSTRACT OBJECTIVE Describe the process of cross-cultural adaptation of the “Explanatory Model Interview Catalog – Stigma Scale” for people affected by leprosy in Brazil. METHODS After being authorized by the author of the scale to use it in the national context, we initiated the five steps process of cross-cultural adaptation: (1 translation, (2 synthesis meeting, (3 back-translation, (4 committee of experts and (5 pre-test. The internal consistency of the scale was evaluated using Cronbach’s alpha coefficient. RESULTS The 15 items of the scale’s original version were translated into Brazilian Portuguese. The adapted scale showed evidence of a good understanding of its content, attested both by experts and members of the target population. Its internal consistency was 0.64. CONCLUSIONS The adapted instrument shows satisfactory internal consistency. It may be useful in future studies that intend to provide broad situational analysis that supports solid public health programs with a focus on effective stigma reduction. In a later study, the construct’s validity, criterion, and reproducibility will be evaluated.

  3. Applied Research of Enterprise Cost Control Based on Linear Programming

    Directory of Open Access Journals (Sweden)

    Yu Shuo

    2015-01-01

    This paper researches the enterprise cost control through the linear programming model, and analyzes the restriction factors of the labor of enterprise production, raw materials, processing equipment, sales price, and other factors affecting the enterprise income, so as to obtain an enterprise cost control model based on the linear programming. This model can calculate rational production mode in the case of limited resources, and acquire optimal enterprise income. The production guiding program and scheduling arrangement of the enterprise can be obtained through calculation results, so as to provide scientific and effective guidance for the enterprise production. This paper adds the sensitivity analysis in the linear programming model, so as to learn about the stability of the enterprise cost control model based on linear programming through the sensitivity analysis, and verify the rationality of the model, and indicate the direction for the enterprise cost control. The calculation results of the model can provide a certain reference for the enterprise planning in the market economy environment, which have strong reference and practical significance in terms of the enterprise cost control.

  4. Nuclear materials control and accountability internal audit program

    International Nuclear Information System (INIS)

    Barham, M.A.; Abbott, R.R.

    1991-01-01

    This paper reports that the Department of Energy Order (DOE) 5633.3, Control and Accountability for Nuclear Materials, includes several requirements for development and implementation of an internal audit program. Martin Marietta Energy System, Inc., manages five sites in Tennessee, Kentucky, and Ohio for the DOE Field Office, Oak Ridge and has a Central Nuclear Materials Control and Accountability (NMC and A) Manager with matrixed responsibility for the NMC and A program at the five sites. The Energy Systems Central NMC and A Manager has developed an NMC and A Internal Audit Handbook which defines the functional responsibilities, performance criteria, and reporting and documentation requirements for the Energy Systems NMC and A Internal Audit Program. The initial work to develop and implement these standards was tested at the K-25 Site when the site hired an internal auditor to meet the DOE requirements for an NMC and A Internal Audit program

  5. A role for vector control in dengue vaccine programs.

    Science.gov (United States)

    Christofferson, Rebecca C; Mores, Christopher N

    2015-12-10

    Development and deployment of a successful dengue virus (DENV) vaccine has confounded research and pharmaceutical entities owing to the complex nature of DENV immunity and concerns over exacerbating the risk of DENV hemorrhagic fever (DHF) as a consequence of vaccination. Thus, consensus is growing that a combination of mitigation strategies will be needed for DENV to be successfully controlled, likely involving some form of vector control to enhance a vaccine program. We present here a deterministic compartmental model to illustrate that vector control may enhance vaccination campaigns with imperfect coverage and efficacy. Though we recognize the costs and challenges associated with continuous control programs, simultaneous application of vector control methods coincident with vaccine roll out can have a positive effect by further reducing the number of human cases. The success of such an integrative strategy is predicated on closing gaps in our understanding of the DENV transmission cycle in hyperedemic locations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Integration of leprosy in general health system vis-à-vis leprosy endemicity, health situation and socioeconomic development: observations from Chhattisgarh & Kerala.

    Science.gov (United States)

    Pandey, Aparna; Rathod, Harish

    2010-06-01

    This study looked at the integration of leprosy services in the GHS in context of health and socioeconomic situations using predefined indicators. It also looked at clients' perception of MDT services. The Indian states of Chhattisgarh and Kerala, which are at two extremes in leprosy endemicity, health situation and socioeconomic development, have been compared using predefined integration indicators related to the training of health workers, availability of MDT services, maintenance of MDT stock and involvement of Sub-centres in leprosy care. Data was collected by surveys of health facilities, sub-centres and communities in the two states, during 2006-2007. Information was collected by interviewing health personnel and clients, checking of records and on the spot observations using specifically designed formats. Results showed that integration is more inclusive in Chhattisgarh and has reached up to Sub-centre level. Both the community and health systems are sensitive and responsive to leprosy as it is perceived to be a major public health threat. But in Kerala, despite integration, it continues as a vertical programme with dependence on specialists and districts hospitals for diagnosis and treatment. MDT stock management is even poorer. Clients' perception towards MDT services are similar in both states.

  7. Implementation contexts of a Tuberculosis Control Program in Brazilian prisons

    Directory of Open Access Journals (Sweden)

    Luisa Gonçalves Dutra de Oliveira

    2015-01-01

    Full Text Available OBJECTIVE To analyze the influence from context characteristics in the control of tuberculosis in prisons, and the influence from the program implementation degrees in observed effects.METHODS A multiple case study, with a qualitative approach, conducted in the prison systems of two Brazilian states in 2011 and 2012. Two prisons were analyzed in each state, and a prison hospital was analyzed in one of them. The data were submitted to a content analysis, which was based on external, political-organizational, implementation, and effect dimensions. Contextual factors and the ones in the program organization were correlated. The independent variable was the program implementation degree and the dependent one, the effects from the Tuberculosis Control Program in prisons.RESULTS The context with the highest sociodemographic vulnerability, the highest incidence rate of tuberculosis, and the smallest amount of available resources were associated with the low implementation degree of the program. The results from tuberculosis treatment in the prison system were better where the program had already been partially implemented than in the case with low implementation degree in both cases.CONCLUSIONS The implementation degree and its contexts – external and political-organizational dimensions – simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons.

  8. The Atomic Energy Control Board's regulatory research and support program

    International Nuclear Information System (INIS)

    1988-04-01

    The purpose of the Regulatory Research and Support Program is to augment and extend the capability of the Atomic Energy Control Board's (AECB) regulatory program beyond the capability of in-house resources. The overall objective of the program is to produce pertinent and independent scientific and other knowledge and expertise that will assist the AECB in making correct, timely and credible decisions on regulating the development, application and use of atomic energy. The objectives are achieved through contracted research, development, studies, consultant and other kinds of projects administered by the Research and Radiation Protection Branch (RRB) of the AECB

  9. Sensitivity Analysis of Linear Programming and Quadratic Programming Algorithms for Control Allocation

    Science.gov (United States)

    Frost, Susan A.; Bodson, Marc; Acosta, Diana M.

    2009-01-01

    The Next Generation (NextGen) transport aircraft configurations being investigated as part of the NASA Aeronautics Subsonic Fixed Wing Project have more control surfaces, or control effectors, than existing transport aircraft configurations. Conventional flight control is achieved through two symmetric elevators, two antisymmetric ailerons, and a rudder. The five effectors, reduced to three command variables, produce moments along the three main axes of the aircraft and enable the pilot to control the attitude and flight path of the aircraft. The NextGen aircraft will have additional redundant control effectors to control the three moments, creating a situation where the aircraft is over-actuated and where a simple relationship does not exist anymore between the required effector deflections and the desired moments. NextGen flight controllers will incorporate control allocation algorithms to determine the optimal effector commands and attain the desired moments, taking into account the effector limits. Approaches to solving the problem using linear programming and quadratic programming algorithms have been proposed and tested. It is of great interest to understand their relative advantages and disadvantages and how design parameters may affect their properties. In this paper, we investigate the sensitivity of the effector commands with respect to the desired moments and show on some examples that the solutions provided using the l2 norm of quadratic programming are less sensitive than those using the l1 norm of linear programming.

  10. Model-Checking Real-Time Control Programs

    DEFF Research Database (Denmark)

    Iversen, T. K.; Kristoffersen, K. J.; Larsen, Kim Guldstrand

    2000-01-01

    In this paper, we present a method for automatic verification of real-time control programs running on LEGO(R) RCX(TM) bricks using the verification tool UPPALL. The control programs, consisting of a number of tasks running concurrently, are automatically translated into the mixed automata model...... of UPPAAL. The fixed scheduling algorithm used by the LEGO(R) RCX(TM) processor is modeled in UPPALL, and supply of similar (sufficient) timed automata models for the environment allows analysis of the overall real-time system using the tools of UPPALL. To illustrate our technique for sorting LEGO(R) bricks...

  11. Economics of area-wide sit control programs

    International Nuclear Information System (INIS)

    Enkerlin, Walther

    2003-01-01

    The economic feasibility of using the sterile insect technique (SIT) to control certain key insect pests has been demonstrated clearly. The successful implementation of a number of area-wide and large-scale SIT programs has produced substantial economic benefits for the beneficiaries of the technology. The economic advantages of this technology will become more evident as indirect benefits of SIT application are incorporated into total program benefit estimates. Awareness of the technical and economic advantages of the SIT, and market forces favoring the use of environmentally clean pest control methods, will encourage private investment in this technology. (author)

  12. Dedicated Programming Language for Small Distributed Control Divices

    DEFF Research Database (Denmark)

    Madsen, Per Printz; Borch, Ole

    2007-01-01

    . This paper describes a new, flexible and simple language for programming distributed control tasks. The compiler for this language generates a target code that is very easy to interpret. A interpreter, that can be easy ported to different hardwares, is described. The new language is simple and easy to learn...... become a reality if each of these controlling computers can be configured to perform a cooperative task. This again requires the necessary communicating facilities. In other words this requires that all these simple and distributed computers can be programmed in a simple and hardware independent way...

  13. Adaptive feedback control by constrained approximate dynamic programming.

    Science.gov (United States)

    Ferrari, Silvia; Steck, James E; Chandramohan, Rajeev

    2008-08-01

    A constrained approximate dynamic programming (ADP) approach is presented for designing adaptive neural network (NN) controllers with closed-loop stability and performance guarantees. Prior knowledge of the linearized equations of motion is used to guarantee that the closed-loop system meets performance and stability objectives when the plant operates in a linear parameter-varying (LPV) regime. In the presence of unmodeled dynamics or failures, the NN controller adapts to optimize its performance online, whereas constrained ADP guarantees that the LPV baseline performance is preserved at all times. The effectiveness of an adaptive NN flight controller is demonstrated for simulated control failures, parameter variations, and near-stall dynamics.

  14. Analytical chemistry measurements quality control program using computer applications

    International Nuclear Information System (INIS)

    Clark, J.P.; Huff, G.A.

    1978-01-01

    An Analytical Chemistry Measurements Quality Control Program assures the reliability of analytical measurements performed at the Barnwell Nuclear Fuel Plant. The program includes training, methods quality control, replicate samples and measurements, mass measurements, interlaboratory sample exchanges, and standards preparation. This program has been designed to meet the requirements of 10CFR70.57. Portions of the program have been automated by using a PDP 11/35 computer system to provide features which are not readily available in manual systems. These include such items as realtime measurement control, computer calculated bias and precision estimates, various surveillance applications, and evaluation of measurement system variables. The efficiency of the computer system has been demonstrated in gathering and assimilating the results of over 1100 quality control samples during a recent cold chemical checkout campaign. These data were used to determine equations for predicting measurements reliability estimates; to evaluate measurement performance of the analysts, equipment, and measurement period; and to provide directions for chemistry methods modifications and additional training requirements. A procedure of replicate sampling and measuring provides random error estimates. The analytical chemistry measurement quality control activities during the campaign represented about 10% of the total analytical chemistry effort

  15. Opening a Can of Worms: Leprosy Reactions and Complicit Soil-Transmitted Helminths.

    Science.gov (United States)

    Hagge, Deanna A; Parajuli, Pawan; Kunwar, Chhatra B; Rana, Divya R S J B; Thapa, Ruby; Neupane, Kapil D; Nicholls, Peter; Adams, Linda B; Geluk, Annemieke; Shah, Mahesh; Napit, Indra B

    2017-09-01

    >94% of new annual leprosy cases are diagnosed in populations co-endemic for soil-transmitted helminths (STH). STH can profoundly dysregulate host immune responses towards Th2 bias, which can be restored over time after deworming. We hypothesize that STH co-infection is associated with leprosy reaction (denoted as simply "reaction" herein) occurrence within a co-endemic population. A cohort study was performed on a cohort of Nepalese leprosy patients across treatment and diagnostic classifications who were screened by routine fecal smear microscopy and multiplex quantitative PCR (qPCR) for Ascaris lumbricoides (Al), Strongyloides stercoralis (Ss), Ancyclostoma duodenale (Ad) and Necator americanus (Na). Among 145 patients, 55% were positive for ≥1 STH (STH+): 34% Al+, 18% Ss+, 17% Ad+and 5% Na+. Significant inverse STH and reaction relationships were evidenced by the bulk of cases: 63% reaction-negative were STH+ of total cases (p=0.030) while 65% reaction-positive were STH- in new cases (96; p=0.023). Strikingly, the majority of STH+ were reaction-negative, even when considering each species: 59% Al+, 60% Ss+, 62% Ad+and 67% Na+of new leprosy cases. Absence of STH co-infection is associated with leprosy reaction at diagnosis within a co-endemic population. This is likely due to immune reconstitution effects after deworming or interruption of chronic STH-mediated immune dysregulation. Copyright © 2017. Published by Elsevier B.V.

  16. Caregivers’ views on stigmatization and discrimination of people affected by leprosy in Ghana

    Science.gov (United States)

    Dako–Gyeke, Mavis; Oduro, Razak

    2018-01-01

    Background Leprosy is a condition that has long been associated with stigma and discrimination, even when infected persons have been cured. This paper describes stigma and discrimination as viewed by caregivers who are associated with people affected by leprosy in Ghana. Methods A qualitative interview with semi-structured interviews were conducted for twenty caregivers. Results Findings indicated that caregivers were of the view that people affected by leprosy in Ghana are stigmatized and discriminated against by the larger society thus making their movements and interactions restricted to the Leprosarium. Besides, employments opportunities are unavailable to them thus making them exposed to financial challenges. The livelihood Empowerment Against poverty (LEAP) money given them is not sufficient for their daily upkeep. Conclusion People affected by leprosy in Ghana are stigmatized and therefore find it difficult to interact freely with the public. The associated physical deformities with the disease also tend to impede their ability to relate to the general public. The LEAP cash given to people affected by leprosy is helpful however, it could be enhanced to keep pace with prevailing economic conditions in the country. PMID:29377890

  17. Lessons from the evolution of a CBR programme for people affected by leprosy in Northern Nigeria.

    Science.gov (United States)

    Ebenso, Bassey; Idah, Michael; Anyor, Terver; Opakunmi, Femi

    2010-12-01

    This paper reviews the 13-year evolution of the social economic activities in Northern Nigeria from a welfare-oriented to a community-centred programme for people affected by leprosy. The review relied on the analysis of policy and strategy documents, programme guidelines and statistical and evaluation reports. Findings revealed that the transformation among other things, demanded formulation of new programme policies and guidelines; and staff training in CBR principles and practice. Findings also showed that adopting CBR principles and community development projects can stimulate improvements in living conditions, self-esteem and acceptance of people affected by leprosy into the community. Regardless of becoming a more inclusive and participatory programme wherein people affected by leprosy contribute to programme implementation and evaluation; groups affected by leprosy remain economically dependent on the programme and partnership mobilisation is weak. This explains why the priorities for sustaining the processes and impacts generated through CBR in northern Nigeria include: i) empowering groups to access mainline services; ii) working through partners to implement CBR and attract extra funding/ownership of interventions, and iii) promoting human rights of people affected by leprosy and working for a barrier free environment. In the absence of an agreeable understanding and method of assessing sustainability in CBR, we recommend the field-testing of a proposal for evaluating sustainability, to determine its utility in different contexts. Such field-tests have the potential of influencing policy and practice in the future.

  18. Oral health conditions in leprosy cases in hyperendemic area of the Brazilian Amazon

    Directory of Open Access Journals (Sweden)

    Zilanda Martins de Almeida

    2017-08-01

    Full Text Available ABSTRACT Leprosy is a hyperendemic chronic condition in the Rondônia State . Despite the significant impact of oral health on the quality of life and clinical evolution of leprosy patients, systematic evaluation of oral health status has been neglected. To analyze the dental-clinical profile, self-perceived oral health and dental health service access of leprosy cases in the municipality of Cacoal in Rondônia State , North Brazil, from 2001 to 2012. A descriptive, cross-sectional study design was performed based on dental evaluation and standardized structured instruments. We investigated clinically assessed and self-perceived oral health status, as well as dental health service access. A total of 303 leprosy cases were included; 41.6% rated their oral health as good, and 42.6% reported being satisfied with their oral health. Self-reported loss of upper teeth was 45.5%. The clinical evaluation revealed that 54.5% had active caries. Most (97.7% cases reported having been to the dentist at least once in their life and 23.1% used public health services. The poor standard of oral health in this population may increase the risk for leprosy reactions, consequently reducing quality of life. Low access to public health dental services and poor self-perceived oral health reinforce the need to achieve comprehensive health care in this population.

  19. Leprosy in England and Wales 1953-2012: surveillance and challenges in low incidence countries.

    Science.gov (United States)

    Fulton, Nicholas; Anderson, Laura F; Watson, John M; Abubakar, Ibrahim

    2016-05-03

    To review all notified cases of leprosy in England and Wales between 1953 and 2012. National surveillance study of all reported cases. England and Wales. Number and characteristics of reported cases. During this period, a total of 1449 leprosy cases were notified. The incidence fell from 356 new cases notified between 1953 and 1962 to 139 new cases between 2003 and 2012. Where data were available, leprosy was more common in men, 15-45 year olds and those from the Indian subcontinent. There was considerable undernotification in 2001-2012. The high level of under-reporting indicates a need for improved surveillance in the UK. Public Health England, in collaboration with the UK Panel of Leprosy opinion, has revised the UK Memorandum on Leprosy in order to provide updated guidance on diagnostic procedures, treatment, case management, contact tracing and notification. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  20. History and Diversity of Citrus leprosis virus Recorded in Herbarium Specimens.

    Science.gov (United States)

    Hartung, John S; Roy, Avijit; Fu, Shimin; Shao, Jonathan; Schneider, William L; Brlansky, Ronald H

    2015-09-01

    Leprosis refers to two diseases of citrus that present similar necrotic local lesions, often surrounded by chlorotic haloes on citrus. Two distinct viruses are associated with this disease, one that produces particles primarily in the nucleus of infected plant cells (Citrus leprosis virus nuclear type [CiLV-N]; Dichorhavirus) and another type that produces particles in the cytoplasm of infected plant cells (Citrus leprosis virus cytoplasmic type [CiLV-C]; Cilevirus). Both forms are transmitted by Brevipalpid mites and have bipartite, single-stranded, RNA genomes. CiLV-C and CiLV-N are present in South and Central America and as far north as parts of Mexico. Although leprosis disease was originally described from Florida, it disappeared from there in the 1960s. The United States Department of Agriculture-Agricultural Research Service maintains preserved citrus specimens identified at inspection stations 50 or more years ago with symptoms of citrus leprosis. We isolated RNA from these samples and performed degradome sequencing. We obtained nearly full-length genome sequences of both a typical CiLV-C isolate intercepted from Argentina in 1967 and a distinct CiLV-N isolate obtained in Florida in 1948. The latter is a novel form of CiLV-N, not known to exist anywhere in the world today. We have also documented the previously unreported presence of CiLV-N in Mexico in the mid-20th century.

  1. Control and evaluation programs for TANSY-KM5

    International Nuclear Information System (INIS)

    Grosshoeg, G.; Aronsson, D.; Hoek, M.; Rydz, R.; Norberg, L.; Urholm, L.

    1991-01-01

    Our first task was to purchase a computer and to create a basic software library for the preliminary test of the components. Our choice was a Starburst system from CES. The computer was a PDP-11/70 on a chip. It is the same computer as the ones used by the auxiliary CAMAC crate controllers in the TANSY system. However, the host has a 256 kbyte memory instead of the 64 kbyte memory used in the crate controllers. The operation system is RSX11-M. It is a real time system with properties suitable for laboratory works. However, the computer works in 64 kbyte partitions which limits the size of the programs. Four program systems were written. The two first were one-parameter systems for amplitude and time measurements using the ADCs and TDCs which later should be included in the TANSY system. These systems were supplemented with two two-parameter systems, one for time and amplitude measurements and one for time measurements on 16 detectors simultaneously. The display capabilities of these program systems have been used extensively by the TANSY programs. The programs needed for the manipulation of the system give the user a possibility to manually run the system without any intervention from the normal CODAS control system. The programs have been used for calibration measurements as well as test of the TANSY system. The evaluation programs use the output file from a normal measurement. The data file may be tested for errors. The true events can be sorted into different configurations. The final one is the neutron energy sort program, which gives the neutron energy distribution

  2. The diagnosis of leprosy among patients with symptoms of peripheral neuropathy without cutaneous lesions: a follow-up study

    Directory of Open Access Journals (Sweden)

    SKACEL MICHAEL

    2000-01-01

    Full Text Available Forty-four patients with neuritic leprosy were individually followed for periods ranging from 4 months to almost 4 years for the purpose of ascertaining the presence and/ or absence of leprosy. The neural symptoms presented were sensory impairment (41, parasthesia (28, nerve enlargement (22, nerve tenderness (20, paresia (20, amyotrophy (8. Leprosy was diagnosed in ten out of the total number of patients studied. Leprosy was confirmed by the appearance of reactional neuritis (4, reversal reaction (2, biopsy of the hypoesthesic area (3 and the appearance of non-reactional cutaneous lesion. We reported an experience in the diagnosis of neuritic leprosy and its most frequent clinical presentation with which clinicians have to be acquainted. We can also state that the clinical follow-up was an effective strategy for the diagnosis of the disease when diagnostic facilities are not available or have not confirmed the diagnosis.

  3. A geospatial risk assessment model for leprosy in Ethiopia based on environmental thermal-hydrological regime analysis

    Directory of Open Access Journals (Sweden)

    Azeb Tadesse Argaw

    2006-11-01

    Full Text Available Geospatial methods were used to study the associations of the environmental thermal-hydrological regime with leprosy prevalence in the Oromia and Amhara regions of Ethiopia. Prediction models were developed that indicated leprosy prevalence was related to: (i long-term normal climate grid data on temperature and moisture balance (rain/potential evapo-transpiration; (ii satellite surveillance data on the Normalized Difference Vegetation Index (NDVI and daytime earth surface temperature (Tmax from the Advanced Very High Resolution Radiometer (AVHRR; and (iii a Genetic Algorithm Rule-Set Prediction (GARP model based on NDVI and Tmax data in relation to leprosy prevalence data. Our results suggest that vertical transmission is not the only means of acquiring leprosy and support earlier reports that a major factor that governs transmission of leprosy is the viability of Mycobacterium leprae outside the human body which is related to the thermal-hydrologic regime of the environment.

  4. Validation of a proposal for evaluating hospital infection control programs.

    Science.gov (United States)

    Silva, Cristiane Pavanello Rodrigues; Lacerda, Rúbia Aparecida

    2011-02-01

    To validate the construct and discriminant properties of a hospital infection prevention and control program. The program consisted of four indicators: technical-operational structure; operational prevention and control guidelines; epidemiological surveillance system; and prevention and control activities. These indicators, with previously validated content, were applied to 50 healthcare institutions in the city of São Paulo, Southeastern Brazil, in 2009. Descriptive statistics were used to characterize the hospitals and indicator scores, and Cronbach's α coefficient was used to evaluate the internal consistency. The discriminant validity was analyzed by comparing indicator scores between groups of hospitals: with versus without quality certification. The construct validity analysis was based on exploratory factor analysis with a tetrachoric correlation matrix. The indicators for the technical-operational structure and epidemiological surveillance presented almost 100% conformity in the whole sample. The indicators for the operational prevention and control guidelines and the prevention and control activities presented internal consistency ranging from 0.67 to 0.80. The discriminant validity of these indicators indicated higher and statistically significant mean conformity scores among the group of institutions with healthcare certification or accreditation processes. In the construct validation, two dimensions were identified for the operational prevention and control guidelines: recommendations for preventing hospital infection and recommendations for standardizing prophylaxis procedures, with good correlation between the analysis units that formed the guidelines. The same was found for the prevention and control activities: interfaces with treatment units and support units were identified. Validation of the measurement properties of the hospital infection prevention and control program indicators made it possible to develop a tool for evaluating these programs

  5. Detection and Strain Typing of Ancient Mycobacterium leprae from a Medieval Leprosy Hospital

    Science.gov (United States)

    Taylor, G. Michael; Tucker, Katie; Butler, Rachel; Pike, Alistair W. G.; Lewis, Jamie; Roffey, Simon; Marter, Philip; Lee, Oona Y-C; Wu, Houdini H. T.; Minnikin, David E.; Besra, Gurdyal S.; Singh, Pushpendra; Cole, Stewart T.; Stewart, Graham R.

    2013-01-01

    Nine burials excavated from the Magdalen Hill Archaeological Research Project (MHARP) in Winchester, UK, showing skeletal signs of lepromatous leprosy (LL) have been studied using a multidisciplinary approach including osteological, geochemical and biomolecular techniques. DNA from Mycobacterium leprae was amplified from all nine skeletons but not from control skeletons devoid of indicative pathology. In several specimens we corroborated the identification of M. leprae with detection of mycolic acids specific to the cell wall of M. leprae and persistent in the skeletal samples. In five cases, the preservation of the material allowed detailed genotyping using single-nucleotide polymorphism (SNP) and multiple locus variable number tandem repeat analysis (MLVA). Three of the five cases proved to be infected with SNP type 3I-1, ancestral to contemporary M. leprae isolates found in southern states of America and likely carried by European migrants. From the remaining two burials we identified, for the first time in the British Isles, the occurrence of SNP type 2F. Stable isotope analysis conducted on tooth enamel taken from two of the type 3I-1 and one of the type 2F remains revealed that all three individuals had probably spent their formative years in the Winchester area. Previously, type 2F has been implicated as the precursor strain that migrated from the Middle East to India and South-East Asia, subsequently evolving to type 1 strains. Thus we show that type 2F had also spread westwards to Britain by the early medieval period. PMID:23638071

  6. Detection and strain typing of ancient Mycobacterium leprae from a medieval leprosy hospital.

    Directory of Open Access Journals (Sweden)

    G Michael Taylor

    Full Text Available Nine burials excavated from the Magdalen Hill Archaeological Research Project (MHARP in Winchester, UK, showing skeletal signs of lepromatous leprosy (LL have been studied using a multidisciplinary approach including osteological, geochemical and biomolecular techniques. DNA from Mycobacterium leprae was amplified from all nine skeletons but not from control skeletons devoid of indicative pathology. In several specimens we corroborated the identification of M. leprae with detection of mycolic acids specific to the cell wall of M. leprae and persistent in the skeletal samples. In five cases, the preservation of the material allowed detailed genotyping using single-nucleotide polymorphism (SNP and multiple locus variable number tandem repeat analysis (MLVA. Three of the five cases proved to be infected with SNP type 3I-1, ancestral to contemporary M. leprae isolates found in southern states of America and likely carried by European migrants. From the remaining two burials we identified, for the first time in the British Isles, the occurrence of SNP type 2F. Stable isotope analysis conducted on tooth enamel taken from two of the type 3I-1 and one of the type 2F remains revealed that all three individuals had probably spent their formative years in the Winchester area. Previously, type 2F has been implicated as the precursor strain that migrated from the Middle East to India and South-East Asia, subsequently evolving to type 1 strains. Thus we show that type 2F had also spread westwards to Britain by the early medieval period.

  7. Design basis reconstitution for an effective design control program

    International Nuclear Information System (INIS)

    Banerjee, A.K.

    1987-01-01

    Configuration management is a new buzz word in the nuclear power industry. Whatever its definition, everyone agrees that the configuration of a nuclear power plant must be managed effectively. In layman's terms, configuration management means that a plant must be built, operated, and maintained in a manner consistent with its design basis. Thus, control of the design basis is the most important element in any configuration management program. Until recently, the US Nuclear Regulatory Commission's (NRC's) review of design basis focused on the plants that were about to get operating licenses. However, incidents at a few operating nuclear plants and NRC inspections (Safety System Functional Inspection and Safety System Outage Modification Inspection) have indicated weaknesses in older operating plant design basis documentation and design change control programs. Thus, reconstitution of plant design basis has become an important issue. This paper presents the major element of a design basis reconstitution program, which can be an immense undertaking for some of the older operating plants

  8. Gastrointestinal nematode control programs with an emphasis on cattle.

    Science.gov (United States)

    Stromberg, Bert E; Gasbarre, Louis C

    2006-11-01

    Control strategies for nematode parasites rely on knowledge of the relationships between the parasites and their hosts. Specifically, these programs are based on identifying crucial points of interaction in the environment provided by the host, including genetics and the immune response, and critical periods in the physical environment in which the eggs and larval stages must develop. When these targets are identified and the interactions understood, cost-effective sustainable programs can be developed using currently available antiparasitic compounds. Resistance to the major classes of anthelmintic compounds requires consideration of new approaches, such as immunity or genetics of the host. Additionally, the efficacy of these compounds can be expanded with combined or concomitant use. Increased study of the use of novel approaches, including fungi, elements such as copper, and plant products, has also occurred. This article explores each of these areas to allow readers to appreciate how various approaches may be developed and incorporated into an effective parasite control program.

  9. Nuclear-Reaction Control by Multistage Mathematical-Programming

    Directory of Open Access Journals (Sweden)

    I. Leikkonen

    1980-04-01

    Full Text Available The method of Multistage Mathematical Programming (MMP has been adapted for optimal control of the spatial power distribution in nuclear reactors. Changes in power distribution arise from variations in the operational conditions of the reactor, and excite oscillations which in large reactors may approach the stability limit.

  10. Risk Analysis of Loblolly Pine Controlled Mass Pollination Program

    Science.gov (United States)

    T.D. Byram; F.E. Bridgwater

    1999-01-01

    The economic success of controlled mass pollination (CMP) depends both upon the value of the genetic gain obtained and the cost per seed. Crossing the best six loblolly pine (Pinus taeda) parents currently available in each deployment region of the Western Gulf Forest Tree Improvement Program will produce seed with an average additional gain in mean...

  11. Technical support for guidance, navigation and control space shuttle program

    Science.gov (United States)

    1974-01-01

    A review of the guidance, navigation and control projects in support of the space shuttle program was conducted. The subjects considered include the following: (1) functional and performance requirements, (2) mission requirements, (3) operating systems software definition, (4) orbit navigation using various sensors, (5) fault detection, isolation and recovery, and (6) passive rendezvous sensors requirements definition.

  12. Slim Chance: A Weight Control Program for the Learning Disabled.

    Science.gov (United States)

    Rotatori, Anthony J.; And Others

    1982-01-01

    A school-based diet program for learning disabled children stresses modifying eating behavior by learning alternative ways of interacting with the environment. Techniques stress the importance of self regulation, strategies for self monitoring, the establishment of realistic weight goals, use of stimulus control procedures, increased physical…

  13. Incremental approximate dynamic programming for nonlinear flight control design

    NARCIS (Netherlands)

    Zhou, Y.; Van Kampen, E.J.; Chu, Q.P.

    2015-01-01

    A self-learning adaptive flight control design for non-linear systems allows reliable and effective operation of flight vehicles in a dynamic environment. Approximate dynamic programming (ADP) provides a model-free and computationally effective process for designing adaptive linear optimal

  14. External quality control program: Experience in the department of ...

    African Journals Online (AJOL)

    Objective: To share experiences and lessons learned from 2002 National External Quality Assessment Schemes for Leukocyte Immunophenotyping (UK NEQAS) and College of American Pathologists (CAP) proficiency testing (PT) panels received and tested as part of External Quality Control Program Setting: Department ...

  15. Quality control in screening programs for cervical cancer

    International Nuclear Information System (INIS)

    Sarduy Napoles, Miguel

    2012-01-01

    The malignancy of the cervix is one of the few locations avoidable cancers, if detected before it progresses to the infiltration. The most efficient way of early detection is through a screening program to provide women undertaking a regular and quality Pap smear. If this test results abnormal, the program offers easier access to specialized care, effective treatment, and follow-up. The objective of this article is to present usefulness of methods for quality control used in screening programs for cervical cancer to detect their inadequacies. Here are some factors and conditions that must be considered in each of the steps to take, for a cervical cancer screening program to be successful and to meet the objectives proposed in reducing mortality due to this cause. This document contains some useful indexes calculated to ensure quality throughout the process. There should be the measurement of quality throughout the screening process that allows collecting of reliable data as well as correcting deficiencies

  16. Neurolinguistic programming training, trait anxiety, and locus of control.

    Science.gov (United States)

    Konefal, J; Duncan, R C; Reese, M A

    1992-06-01

    Training in the neurolinguistic programming techniques of shifting perceptual position, visual-kinesthetic dissociation, timelines, and change-history, all based on experiential cognitive processing of remembered events, leads to an increased awareness of behavioral contingencies and a more sensitive recognition of environmental cues which could serve to lower trait anxiety and increase the sense of internal control. This study reports on within-person and between-group changes in trait anxiety and locus of control as measured on the Spielberger State-Trait Anxiety Inventory and Wallston, Wallston, and DeVallis' Multiple Health Locus of Control immediately following a 21-day residential training in neurolinguistic programming. Significant with-in-person decreases in trait-anxiety scores and increases in internal locus of control scores were observed as predicted. Chance and powerful other locus of control scores were unchanged. Significant differences were noted on trait anxiety and locus of control scores between European and U.S. participants, although change scores were similar for the two groups. These findings are consistent with the hypothesis that this training may lower trait-anxiety scores and increase internal locus of control scores. A matched control group was not available, and follow-up was unfortunately not possible.

  17. Control Systems Security Test Center - FY 2004 Program Summary

    Energy Technology Data Exchange (ETDEWEB)

    Robert E. Polk; Alen M. Snyder

    2005-04-01

    In May 2004, the US-CERT Control Systems Security Center (CSSC) was established at Idaho National Laboratory to execute assessment activities to reduce the vulnerability of the nation’s critical infrastructure control systems to terrorist attack. The CSSC implements a program to accomplish the five goals presented in the US-CERT National Strategy for Control Systems Security. This report summarizes the first year funding of startup activities and program achievements that took place in FY 2004 and early FY 2005. This document was prepared for the US-CERT Control Systems Security Center of the National Cyber Security Division of the Department of Homeland Security (DHS). DHS has been tasked under the Homeland Security Act of 2002 to coordinate the overall national effort to enhance the protection of the national critical infrastructure. Homeland Security Presidential Directive HSPD-7 directs federal departments to identify and prioritize the critical infrastructure and protect it from terrorist attack. The US-CERT National Strategy for Control Systems Security was prepared by the National Cyber Security Division to address the control system security component addressed in the National Strategy to Secure Cyberspace and the National Strategy for the Physical Protection of Critical Infrastructures and Key Assets. The US-CERT National Strategy for Control Systems Security identified five high-level strategic goals for improving cyber security of control systems.

  18. Gnawing Pains, Festering Ulcers, and Nightmare Suffering: Selling Leprosy as a Humanitarian Cause in the British Empire, c. 1890-1960.

    Science.gov (United States)

    Vongsathorn, Kathleen

    2012-12-01

    When British attention was drawn to the issue of leprosy in the Empire, humanitarian organisations rose to take on responsibility for the 'fight against leprosy'. In an effort to fundraise for a distant cause at a time when hundreds of charities competed for the financial support of British citizens, fundraisers developed propaganda to set leprosy apart from all other humanitarian causes. They drew on leprosy's relationship with Christianity, its debilitating symptoms, and the supposed vulnerability of leprosy sufferers in order to mobilise Britain's sense of humanitarian, Christian, and patriotic duty. This article traces the emergence of leprosy as a popular imperial humanitarian cause in modern Britain and analyses the narratives of religion, suffering, and disease that they created and employed in order to fuel their growth and sell leprosy as a British humanitarian cause.

  19. Coordination Between the HEU Transparency Program and the Material Protection, Control and Accountability Program

    International Nuclear Information System (INIS)

    Glaser, J.; Hernandez, J.; Dougherty, D.; Bieniawski, A.; Cahalane, P.; Mastal, E.

    2000-01-01

    DOE sponsored programs such as Material Protection Control and Accountability (MPC and A) and implementation of the Highly-Enriched Uranium (HEU) Transparency Program send US personnel into Russian nuclear facilities and receive Russian representatives from these programs. While there is overlap in the Russian nuclear facilities visited by these two programs, there had not been any formal mechanism to share information between them. Recently, an MPC and A/HEU Working Group was developed to facilitate the sharing of appropriate information and to address concerns expressed by Minatom and Russian facility personnel such as US visit scheduling conflicts. This paper discusses the goals of the Working Group and ways it has helped to allow the programs to work more efficiently with the Russian facilities

  20. Leprosy diagnosis: a device for testing the thermal sensibility of skin lesions in the field.

    Science.gov (United States)

    Srinivasan, H.; Stumpe, B.

    1989-01-01

    A handy device for testing the thermal sensibility of skin lesions has been developed and field tested in various centres in Africa and India. The instrument performed satisfactorily and its use made testing for thermal sensibility in the field practicable and straightforward. Analysis of the results of testing 260 persons, most of whom exhibited a few lesions that were characteristic of early leprosy, showed that the rate of diagnosis of sensory impairment of such skin lesions, and hence the diagnosis of leprosy, would be about 15-25% more if thermal sensibility testing using this device were added to the other tests of sensibility routinely carried out in the field. Regular use of the device in the field would help to bring more leprosy patients under treatment than at present. Images Fig. 5 PMID:2699276

  1. Courtesy stigma: A concealed consternation among caregivers of people affected by leprosy.

    Science.gov (United States)

    Dako-Gyeke, Mavis

    2018-01-01

    This study explored experiences of courtesy stigma among caregivers of people affected by leprosy. Using a qualitative research approach, twenty participants were purposively selected and in-depth interviews conducted. The interviews were audio-recorded, transcribed, and analyzed to identify emerging themes that addressed objectives of the study. The findings indicated that caregivers of people affected by leprosy experienced courtesy stigma. Evidence showed that fear of contagion underpinned caregivers' experiences, especially in employment and romantic relationships. In addition, participants adopted different strategies (disregarding, concealment, education, faith-based trust) to handle courtesy stigma. The findings demonstrate that psychosocial support and financial assistance to caregivers are necessary considerations for attainment of effective care for people affected by leprosy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Evaluating the Maturity of Cybersecurity Programs for Building Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Glantz, Clifford S.; Somasundaram, Sriram; Mylrea, Michael E.; Underhill, Ronald M.; Nicholls, Andrew K.

    2016-08-29

    The cyber-physical security threat to buildings is complex, non-linear, and rapidly evolving as operational and information technologies converge and connect buildings to cyberspace. Cyberattacks on buildings can exploit smart building controls and breach corporate networks, causing financial and reputational damage. This may result in the loss of sensitive building information or the disruption of, or damage to, the systems necessary for the safe and efficient operation of buildings. For the buildings and facility infrastructure, there is a need for a robust national cybersecurity strategy for buildings, guidance on the selection and implementation of appropriate cybersecurity controls for buildings, an approach to evaluate the maturity and adequacy of the cybersecurity programs. To provide an approach for evaluating the maturity of the cybersecurity programs for building control systems, the US Department of Energy’s widely used Cybersecurity Capability and Maturity Model (C2M2) has been adapted into a building control systems version. The revised model, the Buildings-C2M2 (B-C2M2) provides maturity level indicators for cybersecurity programmatic domains. A “B-C2M2 Lite” version allows facility managers and building control system engineers, or information technology personnel to perform rapid self-assessments of their cybersecurity program. Both tools have been pilot tested on several facilities. This paper outlines the concept of a maturity model, describes the B-C2M2 tools, presents results and observations from the pilot assessments, and lays out plans for future work.

  3. Sand Fly Surveillance and Control on Camp Ramadi, Iraq, as Part of a Leishmaniasis Control Program

    Science.gov (United States)

    2013-12-01

    Vol. 38, no. 2 Journal of Vector Ecology 411 Scientific Note Sand fly surveillance and control on Camp Ramadi, Iraq, as part of a leishmaniasis ...following the 2003 invasion experienced serious risk of infection by several vector-borne pathogens, specifically cutaneous (CL) and visceral leishmaniasis ...as part of a leishmaniasis control program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

  4. Experimental control of a fluidic pinball using genetic programming

    Science.gov (United States)

    Raibaudo, Cedric; Zhong, Peng; Noack, Bernd R.; Martinuzzi, Robert J.

    2017-11-01

    The wake stabilization of a triangular cluster of three rotating cylinders was investigated in the present study. Experiments were performed at Reynolds number Re 6000, and compared with URANS-2D simulations at same flow conditions. 2D2C PIV measurements and constant temperature anemometry were used to characterize the flow without and with actuation. Open-loop actuation was first considered for the identification of particular control strategies. Machine learning control was also implemented for the experimental study. Linear genetic programming has been used for the optimization of open-loop parameters and closed-loop controllers. Considering a cost function J based on the fluctuations of the velocity measured by the hot-wire sensor, significant performances were achieved using the machine learning approach. The present work is supported by the senior author's (R. J. Martinuzzi) NSERC discovery Grant. C. Raibaudo acknowledges the financial support of the University of Calgary Eyes-High PDF program.

  5. Clinical oxidative stress during leprosy multidrug therapy: impact of dapsone oxidation.

    Science.gov (United States)

    Schalcher, Taysa Ribeiro; Borges, Rosivaldo S; Coleman, Michael D; Batista Júnior, João; Salgado, Claudio G; Vieira, Jose Luiz F; Romão, Pedro R T; Oliveira, Fabio R; Monteiro, Marta Chagas

    2014-01-01

    This study aims to assess the oxidative stress in leprosy patients under multidrug therapy (MDT; dapsone, clofazimine and rifampicin), evaluating the nitric oxide (NO) concentration, catalase (CAT) and superoxide dismutase (SOD) activities, glutathione (GSH) levels, total antioxidant capacity, lipid peroxidation, and methemoglobin formation. For this, we analyzed 23 leprosy patients and 20 healthy individuals from the Amazon region, Brazil, aged between 20 and 45 years. Blood sampling enabled the evaluation of leprosy patients prior to starting multidrug therapy (called MDT 0) and until the third month of multidrug therapy (MDT 3). With regard to dapsone (DDS) plasma levels, we showed that there was no statistical difference in drug plasma levels between multibacillary (0.518±0.029 µg/mL) and paucibacillary (0.662±0.123 µg/mL) patients. The methemoglobin levels and numbers of Heinz bodies were significantly enhanced after the third MDT-supervised dose, but this treatment did not significantly change the lipid peroxidation and NO levels in these leprosy patients. In addition, CAT activity was significantly reduced in MDT-treated leprosy patients, while GSH content was increased in these patients. However, SOD and Trolox equivalent antioxidant capacity levels were similar in patients with and without treatment. These data suggest that MDT can reduce the activity of some antioxidant enzyme and influence ROS accumulation, which may induce hematological changes, such as methemoglobinemia in patients with leprosy. We also explored some redox mechanisms associated with DDS and its main oxidative metabolite DDS-NHOH and we explored the possible binding of DDS to the active site of CYP2C19 with the aid of molecular modeling software.

  6. Application oriented programming and control of industrial robots

    International Nuclear Information System (INIS)

    Nilsson, Klas.

    1992-07-01

    Efficient use of industrial robots requires a strong interplay between user level commands, the motion control system, and external equipment. It should also be possible for an experienced application engineer to tailor the motion control to a specific application in a convenient way, instead of deficient utilization of the device or tricky user programming which is often the case today. A layered software architecture has been designed based on an application oriented view, considering typical hardware and software constraints. The top layers or the architecture support improved integration of off-line programming with interactive teach-in programming. The proposed solution is based on a transformation of robot programs between an on-line and an off-line representation. A central part of the architecture is an intermediate software layer, allowing the experienced user to introduce application specific motion primitives, on top of the motion control system. Flexibility during system configuration combined with computing efficiency and performance at run-time is of major importance. The solution is based on so called actions, which are methods to be passed between different software layers. Such methods can be specification of nonlinear control parameters, application specific control strategies, or treatment of external sensor signals. The actions can be implemented efficiently even in the multiprocessor case by using relocatable executable pieces of code generated from a special cross-compilation strategy. The lowest layers, comprising the motion control, have to be efficient and still fit in with the upper layers. In these layers, software solutions include an external sensor interface and a concept of motion pipelining allowing sensor based motions to be partly computed in advance. An experimental platform, built around commercially available robots, has been developed to verify the proposed solutions. (au)

  7. Virtual collaborative environments: programming and controlling robotic devices remotely

    Science.gov (United States)

    Davies, Brady R.; McDonald, Michael J., Jr.; Harrigan, Raymond W.

    1995-12-01

    This paper describes a technology for remote sharing of intelligent electro-mechanical devices. An architecture and actual system have been developed and tested, based on the proposed National Information Infrastructure (NII) or Information Highway, to facilitate programming and control of intelligent programmable machines (like robots, machine tools, etc.). Using appropriate geometric models, integrated sensors, video systems, and computing hardware; computer controlled resources owned and operated by different (in a geographic sense as well as legal sense) entities can be individually or simultaneously programmed and controlled from one or more remote locations. Remote programming and control of intelligent machines will create significant opportunities for sharing of expensive capital equipment. Using the technology described in this paper, university researchers, manufacturing entities, automation consultants, design entities, and others can directly access robotic and machining facilities located across the country. Disparate electro-mechanical resources will be shared in a manner similar to the way supercomputers are accessed by multiple users. Using this technology, it will be possible for researchers developing new robot control algorithms to validate models and algorithms right from their university labs without ever owning a robot. Manufacturers will be able to model, simulate, and measure the performance of prospective robots before selecting robot hardware optimally suited for their intended application. Designers will be able to access CNC machining centers across the country to fabricate prototypic parts during product design validation. An existing prototype architecture and system has been developed and proven. Programming and control of a large gantry robot located at Sandia National Laboratories in Albuquerque, New Mexico, was demonstrated from such remote locations as Washington D.C., Washington State, and Southern California.

  8. Steam generator deposit control program assessment at Comanche Peak

    International Nuclear Information System (INIS)

    Stevens, J.; Fellers, B.; Orbon, S.

    2002-01-01

    Comanche Peak has employed a variety of methods to assess the effectiveness of the deposit control program. These include typical methods such as an extensive visual inspection program and detailed corrosion product analysis and trending. In addition, a recently pioneered technique, low frequency eddy current profile analysis (LFEC) has been utilized. LFEC provides a visual mapping of the magnetite deposit profile of the steam generator. Analysis of the LFEC results not only provides general area deposition rates, but can also provide local deposition patterns, which is indicative of steam generator performance. Other techniques utilized include trending of steam pressure, steam generator hideout-return, and flow assisted corrosion (FAC) results. The sum of this information provides a comprehensive assessment of the deposit control program effectiveness and the condition of the steam generator. It also provides important diagnostic and predictive information relative to steam generator life management and mitigative strategies, such as special cleaning procedures. This paper discusses the techniques employed by Comanche Peak Chemistry to monitor the effectiveness of the deposit control program and describes how this information is used in strategic planning. (authors)

  9. Tuberculosis Control Program and patient satisfaction, Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Margareth Crisóstomo Portela

    2014-06-01

    Full Text Available OBJECTIVE To evaluate factors associated with users’ satisfaction in the Tuberculosis Control Program. METHODS A cross-sectional study of 295 patients aged ≥ 18 years, with two or more outpatient visits in the Tuberculosis Control Program, in five cities in the metropolitan region of Rio de Janeiro, RJ, Southeastern Brazil, in 2010. Considering an estimated population of 4,345 patients, the sampling plan included 15 health care units participating in the program, divided into two strata: units in Rio de Janeiro City, selected with probability proportional to the monthly average number of outpatient visits, and units in the other four cities. In the units, four temporal clusters of five patients each were selected with equal probability, totaling 300 patients. A questionnaire investigating the users’ clinical and sociodemographic variables and aspects of care and service in the program relevant to user satisfaction was applied to the patients. Descriptive statistics about users and their satisfaction with the program were obtained, and the effects of factors associated with satisfaction were estimated. RESULTS Patients were predominantly males (57.7%, with a mean age of 40.9 and with low level of schooling. The mean treatment time was 4.1 months, mostly self-administered (70.4%. Additionally, 25.8% had previously been treated for tuberculosis. There was a high level of satisfaction, especially regarding medication provision, and respect to patients by the health professionals. Patients who were younger (≤ 30, those on self-administered treatment, and with graduate level, showed less satisfaction. Suggestions to improve the services include having more doctors (70.0%, and offering exams in the same place of attendance (55.1%. CONCLUSIONS Patient satisfaction with the Tuberculosis Control Program was generally high, although lower among younger patients, those with university education and those on self-administered treatment. The study

  10. Phylogenomics and antimicrobial resistance of the leprosy bacillus Mycobacterium leprae.

    Science.gov (United States)

    Benjak, Andrej; Avanzi, Charlotte; Singh, Pushpendra; Loiseau, Chloé; Girma, Selfu; Busso, Philippe; Fontes, Amanda N Brum; Miyamoto, Yuji; Namisato, Masako; Bobosha, Kidist; Salgado, Claudio G; da Silva, Moisés B; Bouth, Raquel C; Frade, Marco A C; Filho, Fred Bernardes; Barreto, Josafá G; Nery, José A C; Bührer-Sékula, Samira; Lupien, Andréanne; Al-Samie, Abdul R; Al-Qubati, Yasin; Alkubati, Abdul S; Bretzel, Gisela; Vera-Cabrera, Lucio; Sakho, Fatoumata; Johnson, Christian R; Kodio, Mamoudou; Fomba, Abdoulaye; Sow, Samba O; Gado, Moussa; Konaté, Ousmane; Stefani, Mariane M A; Penna, Gerson O; Suffys, Philip N; Sarno, Euzenir Nunes; Moraes, Milton O; Rosa, Patricia S; Baptista, Ida M F Dias; Spencer, John S; Aseffa, Abraham; Matsuoka, Masanori; Kai, Masanori; Cole, Stewart T

    2018-01-24

    Leprosy is a chronic human disease caused by the yet-uncultured pathogen Mycobacterium leprae. Although readily curable with multidrug therapy (MDT), over 200,000 new cases are still reported annually. Here, we obtain M. leprae genome sequences from DNA extracted directly from patients' skin biopsies using a customized protocol. Comparative and phylogenetic analysis of 154 genomes from 25 countries provides insight into evolution and antimicrobial resistance, uncovering lineages and phylogeographic trends, with the most ancestral strains linked to the Far East. In addition to known MDT-resistance mutations, we detect other mutations associated with antibiotic resistance, and retrace a potential stepwise emergence of extensive drug resistance in the pre-MDT era. Some of the previously undescribed mutations occur in genes that are apparently subject to positive selection, and two of these (ribD, fadD9) are restricted to drug-resistant strains. Finally, nonsense mutations in the nth excision repair gene are associated with greater sequence diversity and drug resistance.

  11. Optimal traffic control in highway transportation networks using linear programming

    KAUST Repository

    Li, Yanning

    2014-06-01

    This article presents a framework for the optimal control of boundary flows on transportation networks. The state of the system is modeled by a first order scalar conservation law (Lighthill-Whitham-Richards PDE). Based on an equivalent formulation of the Hamilton-Jacobi PDE, the problem of controlling the state of the system on a network link in a finite horizon can be posed as a Linear Program. Assuming all intersections in the network are controllable, we show that the optimization approach can be extended to an arbitrary transportation network, preserving linear constraints. Unlike previously investigated transportation network control schemes, this framework leverages the intrinsic properties of the Halmilton-Jacobi equation, and does not require any discretization or boolean variables on the link. Hence this framework is very computational efficient and provides the globally optimal solution. The feasibility of this framework is illustrated by an on-ramp metering control example.

  12. Stochastic Control of Energy Efficient Buildings: A Semidefinite Programming Approach

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Xiao [ORNL; Dong, Jin [ORNL; Djouadi, Seddik M [ORNL; Nutaro, James J [ORNL; Kuruganti, Teja [ORNL

    2015-01-01

    The key goal in energy efficient buildings is to reduce energy consumption of Heating, Ventilation, and Air- Conditioning (HVAC) systems while maintaining a comfortable temperature and humidity in the building. This paper proposes a novel stochastic control approach for achieving joint performance and power control of HVAC. We employ a constrained Stochastic Linear Quadratic Control (cSLQC) by minimizing a quadratic cost function with a disturbance assumed to be Gaussian. The problem is formulated to minimize the expected cost subject to a linear constraint and a probabilistic constraint. By using cSLQC, the problem is reduced to a semidefinite optimization problem, where the optimal control can be computed efficiently by Semidefinite programming (SDP). Simulation results are provided to demonstrate the effectiveness and power efficiency by utilizing the proposed control approach.

  13. Evaluation of Acute Phase Reactants As Indicators of Activity in Leprosy

    Directory of Open Access Journals (Sweden)

    A P Jain

    1985-01-01

    Full Text Available Acute phase reactants i. e. ESR, C-reactive proteins, alpha 1 antitrypsin, complement (C3 and circulation immune complexes were evaluated in relation with the activity of the disease in leprosy. Levels of all the acute phase reactants were significantly raised during the active plase (LL and ENL, while these were normal during the arrested phase of the disease. Appearance of, circulating immune complexes also followed the same pattern. It is concluded that raised levels of ESR (C-reactive proteins, alpha-1 antitrypsin, complement (C3 and circulating immune complexes suggest active phase (LL ENL of the disease in leprosy.

  14. Tuberculoid leprosy and cytomegalovirus retinitis as immune restoration disease in a patient with AIDS.

    Science.gov (United States)

    Kumar, Shishir; Ghosh, Manab Kumar; Sarkar, Somenath; Mallik, Sudeshna; Biswas, Pradyot Narayan; Saha, Bibhuti

    2012-02-01

    Here we report a unique case of tuberculoid leprosy and cytomegalovirus retinitis in a 27-year-old female patient with AIDS, suggestive of highly active antiretroviral therapy (HAART)-induced immune restoration disease. After initiation of HAART, the patient presented with decreased visual acuity, hypoesthetic patch with local nerve thickening, and an increase in her CD4+ T cell count. On further investigations cytomegalovirus retinitis and tuberculoid leprosy were confirmed. To our knowledge no case with such a co-existence has previously been reported. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  15. Cyber Security Testing and Training Programs for Industrial Control Systems

    Energy Technology Data Exchange (ETDEWEB)

    Daniel Noyes

    2012-03-01

    Service providers rely on industrial control systems (ICS) to manage the flow of water at dams, open breakers on power grids, control ventilation and cooling in nuclear power plants, and more. In today's interconnected environment, this can present a serious cyber security challenge. To combat this growing challenge, government, private industry, and academia are working together to reduce cyber risks. The Idaho National Laboratory (INL) is a key contributor to the Department of Energy National SCADA Test Bed (NSTB) and the Department of Homeland Security (DHS) Control Systems Security Program (CSSP), both of which focus on improving the overall security posture of ICS in the national critical infrastructure. In support of the NSTB, INL hosts a dedicated SCADA testing facility which consists of multiple control systems supplied by leading national and international manufacturers. Within the test bed, INL researchers systematically examine control system components and work to identify vulnerabilities. In support of the CSSP, INL develops and conducts training courses which are designed to increase awareness and defensive capabilities for IT/Control System professionals. These trainings vary from web-based cyber security trainings for control systems engineers to more advanced hands-on training that culminates with a Red Team/ Blue Team exercise that is conducted within an actual control systems environment. INL also provides staffing and operational support to the DHS Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) Security Operations Center which responds to and analyzes control systems cyber incidents across the 18 US critical infrastructure sectors.

  16. Cyber Security Testing and Training Programs for Industrial Control Systems

    International Nuclear Information System (INIS)

    Noyes, Daniel

    2012-01-01

    Service providers rely on industrial control systems (ICS) to manage the flow of water at dams, open breakers on power grids, control ventilation and cooling in nuclear power plants, and more. In today's interconnected environment, this can present a serious cyber security challenge. To combat this growing challenge, government, private industry, and academia are working together to reduce cyber risks. The Idaho National Laboratory (INL) is a key contributor to the Department of Energy National SCADA Test Bed (NSTB) and the Department of Homeland Security (DHS) Control Systems Security Program (CSSP), both of which focus on improving the overall security posture of ICS in the national critical infrastructure. In support of the NSTB, INL hosts a dedicated SCADA testing facility which consists of multiple control systems supplied by leading national and international manufacturers. Within the test bed, INL researchers systematically examine control system components and work to identify vulnerabilities. In support of the CSSP, INL develops and conducts training courses which are designed to increase awareness and defensive capabilities for IT/Control System professionals. These trainings vary from web-based cyber security trainings for control systems engineers to more advanced hands-on training that culminates with a Red Team/ Blue Team exercise that is conducted within an actual control systems environment. INL also provides staffing and operational support to the DHS Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) Security Operations Center which responds to and analyzes control systems cyber incidents across the 18 US critical infrastructure sectors.

  17. Carboy Security Testing and Training Programs for Industrial Control Systems

    International Nuclear Information System (INIS)

    Noyes, Daniel

    2012-01-01

    Service providers rely on industrial control systems (ICS) to manage the flow of water at dams, open breakers on power grids, control ventilation and cooling in nuclear power plants, and more. In today's interconnected environment, this can present a serious cyber security challenge. To combat this growing challenge, government, private industry, and academia are working together to reduce cyber risks. The Idaho National Laboratory (INL) is a key contributor to the Department of Energy National SCADA Test Bed (NSTB) and the Department of Homeland Security (DHS) Control Systems Security Program (CSSP), both of which focus on improving the overall security posture of ICS in the national critical infrastructure. In support of the NSTB, INL hosts a dedicated SCADA testing facility which consists of multiple control systems supplied by leading national and international manufacturers. Within the test bed, INL researchers systematically examine control system components and work to identify vulnerabilities. In support of the CSSP, INL develops and conducts training courses which are designed to increase awareness and defensive capabilities for IT/Control System professionals. These training vary from web-based cyber security training for control systems engineers to more advanced hands-on training that culminates with a Red Team/Blue Team exercise that is conducted within an actual control systems environment. INL also provides staffing and operational support to the DHS Industrial Control Systems Cyber Emergency Response Team (ICS-CERT) Security Operations Center which responds to and analyzes control systems cyber incidents across the 18 US critical infrastructure sectors

  18. Neural dynamic programming applied to rotorcraft flight control and reconfiguration

    Science.gov (United States)

    Enns, Russell James

    This dissertation introduces a new rotorcraft flight control methodology based on a relatively new form of neural control, neural dynamic programming (NDP). NDP is an on-line learning control scheme that is in its infancy and has only been applied to simple systems, such as those possessing a single control and a handful of states. This dissertation builds on the existing NDP concept to provide a comprehensive control system framework that can perform well as a learning controller for more realistic and practical systems of higher dimension such as helicopters. To accommodate such complex systems, the dissertation introduces the concept of a trim network that is seamlessly integrated into the NDP control structure and is also trained using this structure. This is the first time that neural networks have been applied to the helicopter control problem as a direct form of control without using other controller methodologies to augment the neural controller and without using order reducing simplifications such as axes decoupling. The dissertation focuses on providing a viable alternative helicopter control system design approach rather than providing extensive comparisons among various available controllers. As such, results showing the system's ability to stabilize the helicopter and to perform command tracking, without explicit comparison to other methods, are presented. In this research, design robustness was addressed by performing simulations under various disturbance conditions. All designs were tested using FLYRT, a sophisticated, industrial-scale, nonlinear, validated model of the Apache helicopter. Though illustrated for helicopters, the NDP control system framework should be applicable to general purpose multi-input multi-output (MIMO) control. In addition, this dissertation tackles the helicopter reconfigurable flight control problem, finding control solutions when the aircraft, and in particular its control actuators, are damaged. Such solutions have

  19. Empowerment Program for People With Prediabetes: A Randomized Controlled Trial.

    Science.gov (United States)

    Chen, Mei-Fang; Hung, Shu-Ling; Chen, Shu-Lin

    2017-04-01

    Practicing a health-promoting lifestyle is believed to be effective for delaying or preventing the onset of diabetes. However, although empowerment interventions have proven effective for encouraging the adoption of a health-promoting lifestyle in people with diabetes, these interventions are rarely promoted to people with prediabetes. The aims of this study were to develop an empowerment program for people with prediabetes and to examine its efficacy in terms of the adoption of a health-promoting lifestyle and improvements in blood sugar, body mass index, and self-efficacy. A randomized controlled trial was conducted between May and December 2013. A convenience sample of people with a fasting blood sugar level of 100-125 mg/dl during the previous 3 months was recruited from the health examination center of a hospital in Kaohsiung, Taiwan. Participants were assigned to either the experimental group or the control group using block randomization with a block size of 8. The experimental group (n = 38) participated in a 4-month empowerment program (the ABC empowerment program), which encouraged participants to practice a health-promoting lifestyle in three phases: awareness raising, behavior building, and results checking. The control group (n = 40) received routine clinical care. Statistical analyses included descriptive statistics, independent t test, paired t test, and generalized estimated equations. After controlling for the differences at baseline and considering the interaction between group and time from baseline to 1 week and 3 months after completing the intervention, the generalized estimating equation showed significantly larger improvements in a health-promoting lifestyle, blood sugar, and self-efficacy in the experimental group than in the control group (p empowerment program was shown to have short-term, positive effects on behavioral, physical, and psychosocial outcomes in a Taiwan population with prediabetes. The results of this study provide a useful

  20. Discovery of a potential lead compound for treating leprosy with dapsone resistance mutation in M. leprae folP1.

    Science.gov (United States)

    Nisha, J; Ramanathan, K; Nawaz Khan, F; Dhanasekaran, D; Shanthi, V

    2016-06-21

    Dapsone resistance is a serious impediment to the implementation of the present leprosy control strategies. In the recent past, many studies have been undertaken to address the antibiotic activity and binding pattern of dapsone against both native and mutant (Pro55Leu) folP1. Yet, there is no well-developed structural basis for understanding drug action and there is dire need for new antibacterial therapies. In the present study, molecular simulation techniques were employed alongside experimental strategies to address and overcome the mechanism of dapsone resistance. In essence, we report the identification of small molecule compounds to effectively and specifically inhibit the growth of M. leprae through targeting dihydropteroate synthase, encoded by folP1 which is involved in folic acid synthesis. Initially, ADME and toxicity studies were employed to screen the lead compounds, using dapsone as standard drug. Subsequently, molecular docking was employed to understand the binding efficiency of dapsone and its lead compounds against folP1. Further, the activity of the screened lead molecule was studied by means of molecular dynamics simulation techniques. Furthermore, we synthesized 4-(2-fluorophenylsulfonyl)benzenamine, using (2-fluorophenyl)boronic acid and 4-aminobenzenesulfonyl chloride, and the compound structure was confirmed by (1)H NMR and (13)C NMR spectroscopic techniques. Most importantly, the antibacterial activity of the compound was also examined and compared against dapsone. Overall, the result from our analysis suggested that CID21480113 (4-(2-fluorophenylsulfonyl)benzenamine) could be developed into a promising lead compound and could be effective in treating dapsone resistant leprosy cases.

  1. Early detection of leprosy by examination of household contacts, determination of serum anti-PGL-1 antibodies and consanguinity

    Directory of Open Access Journals (Sweden)

    Renata Bazan-Furini

    2011-08-01

    Full Text Available A cross-sectional clinical trial in which the serum anti-phenolic glycolipid (anti-PGL-1 antibodies were analysed in household contacts (HHC of patients with leprosy as an adjunct early leprosy diagnostic marker was conducted. The families of 83 patients underwent clinical examination and serum anti-PGL1 measurement using enzyme-linked immunosorbent assay. Of 320 HHC, 98 were contacts of lepromatous leprosy (LL, 80 were contacts of borderline lepromatous (BL, 28 were contacts of borderline (BB leprosy, 54 were contacts of borderline tuberculoid (BT, 40 were contacts of tuberculoid (TT and 20 were contacts of indeterminate (I leprosy. Consanguinity with the patients was determined for 232 (72.5% HHC. Of those 232 contacts, 183 had linear consanguinity. Forty-nine HHC had collateral consanguinity. Fifty-eight contacts (18.1% tested positive for anti-PGL1 antibodies. The number of seropositive contacts based on the clinical forms of the index case was 17 (29.3% for LL, 15 (25.9% for BL, one (1.7% for BB, 14 (24.1% for BT, three (5.2% for TT and eight (13.7% for I. At the one year follow-up, two (3.4% of these seropositive contacts had developed BT leprosy. The results of the present study indicate that the serum anti-PGL-1 IgM antibody may be useful for evaluating antigen exposure and as a tool for an early leprosy diagnosis in HHC.

  2. A computer program for the algebraic determination of control coefficients in Metabolic Control Analysis.

    Science.gov (United States)

    Thomas, S; Fell, D A

    1993-06-01

    A computer program (MetaCon) is described for the evaluation of flux control, concentration control and branch-point distribution control coefficients of a metabolic pathway. Requiring only the reaction scheme as input, the program produces algebraic expressions for the control coefficients in terms of elasticity coefficients, metabolite concentrations and pathway fluxes. Any of these variables can be substituted by numeric or simple algebraic expressions; the expressions will then be automatically rearranged in terms of the remaining unknown variables. When all variables have been substituted, numeric values will be obtained for the control coefficients. The program is a computerized implementation of the matrix method for the determination of control coefficients. The features of MetaCon are compared with those of other programs available to workers in Metabolic Control Analysis. Potential benefits of, and methods of using, MetaCon are discussed. The mathematical background and validity of the matrix method rules are discussed, and the algorithm used by MetaCon is described. The matrix method is shown to be a specific case of a previously described general formalism for calculating control coefficients.

  3. Control system design and analysis using the INteractive Controls Analysis (INCA) program

    Science.gov (United States)

    Bauer, Frank H.; Downing, John P.

    1987-01-01

    The INteractive Controls Analysis (INCA) program was developed at the Goddard Space Flight Center to provide a user friendly efficient environment for the design and analysis of linear control systems. Since its inception, INCA has found extensive use in the design, development, and analysis of control systems for spacecraft, instruments, robotics, and pointing systems. Moreover, the results of the analytic tools imbedded in INCA have been flight proven with at least three currently orbiting spacecraft. This paper describes the INCA program and illustrates, using a flight proven example, how the package can perform complex design analyses with relative ease.

  4. Programs for control of an analog-signal switching network

    International Nuclear Information System (INIS)

    D'Ottavio, T.; Enriquez, R.; Katz, R.; Skelly, J.

    1989-01-01

    A suite of programs has been developed to control the network of analog-signal switching multiplexers in the AGS complex. The software is driven by a relational database which describes the architecture of the multiplexer tree and the set of available analog signals. Signals are routed through a three-layer multiplexer tree, to be made available at four consoles each with three 4-trace oscilloscopes. A menu-structured operator interface program is available at each console, to accept requests to route any available analog signal to any of that console's 12 oscilloscope traces. A common routing-server program provides automatic routing-server program provides automatic routing of requested signals through the layers of multiplexers, maintaining a reservation database to denote free and in-use trunks. Expansion of the analog signal system is easily accommodated in software by adding new signals, trunks, multiplexers, or consoles to the database. Programmatic control of the triggering signals for each of the oscilloscopes is also provided. 3 refs., 4 figs., 3 tabs

  5. Data Control Program to support the Quality Assurance System

    International Nuclear Information System (INIS)

    Yacobenco, A.; Varella, M.; Figuereido, W.; Passos, V.

    1998-01-01

    In order to give support the Quality Assurance System (QAS) in Odontological Radiology a software called Data Control Program (DCP) was developed. The aim of the DCP was to applied an uniform methodology during the inspections and for control of administrative and financial data. First, the DCP was developed using microsoft. The microcomputer configuration employs a Pentium 200 MHz processor, 64 MB of memory and 3,2 GB of free space in the hard disk. The DCP allows for the simultaneous use of several departments in the company providing the elaboration of safe and reliable system of information management in several areas and a fast and good performance in services

  6. The sheep blowfly genetic control program in Australia

    International Nuclear Information System (INIS)

    Foster, Geoffrey G.

    1989-01-01

    The blowfly Lucilia cuprina is the most important myiasis pet of sheep in Australia. Other species are associated with sheep myiasis, but L. cuprina is probably responsible for initiating more than 90% of infestations. Annual costs of production losses, prevention and treatment have been estimated at $149 millions in 1985. Prevention and treatment encompass both insecticidal applications to sheep and non-chemical management practices. In the absence of effective preventive measures, the sheep industry would be non-viable over much of Australia. Insecticide usage against L. cuprina has been marked by the appearance of widespread resistance to cyclodienes in 1956, the organophosphates in 1965, and carbamates in 1966. Resistance has not yet been reported against the triazine compounds introduced for blowfly control in 1981. The most effective non-chemical control measures are surgical (removal of skin from the breech in certain breeds of sheep, and tail-docking). They protect sheep by reducing favourable oviposition sites (dung and urine-stained wool). The spectre of insecticide resistance and the early success of the sterile insect technique (SIT) against screwworm fly in the U.S.A., led this Division to consider SIT and other autocidal methods in the 1960s. The L. cuprina genetics research program was established in 1966 and subsequently expanded in 1971. More recently, lobbying by animal welfare groups against surgical blowfly control practices, as well as increasing consumer awareness of insecticide residues in animal products, have accelerated the search for alternatives to chemical control. When SIT was first considered for L. cuprina control in 1960, little was known about the population dynamics of L. cuprina. There were insufficient ecological data to evaluate the prospects of alternative strategies such as suppression or containment. The number of flies which would have to be released in a SIT program was unknown, as were the costs. Assuming that the cost of

  7. Monsanto Mound Laboratory tritium waste control technology development program

    International Nuclear Information System (INIS)

    Bixel, J.C.; Kershner, C.J.; Rhinehammer, T.B.

    1975-01-01

    Over the past four years, implementation of tritium waste control programs has resulted in a 30-fold reduction in the gaseous tritium effluents from Mound Laboratory. However, to reduce tritium waste levels to the ''as low as practicable'' guideline poses problems that are beyond ready solution with state-of-the-art tritium control technology. To meet this advanced technology need, a tritium waste control technology program was initiated. Although the initial thrust of the work under this program was oriented toward development of gaseous effluent treatment systems, its natural evolution has been toward the liquid waste problem. It is thought that, of all the possible approaches to disposal of tritiated liquid wastes, recovery offers the greatest advantages. End products of the recovery processes would be water detritiated to a level below the Radioactivity Concentration Guide (RCG) or detritiated to a level that would permit safe recycle in a closed loop operation and enriched tritium. The detritiated water effluent could be either recycled in a closed loop operation such as in a fuel reprocessing plant or safely released to the biosphere, and the recovered tritium could be recycled for use in fusion reactor studies or other applications

  8. Monsanto/Mound Laboratory tritium waste control technology development program

    International Nuclear Information System (INIS)

    Bixel, J.C.; Kershner, C.J.; Rhinehammer, T.B.

    1975-01-01

    Over the past four years, implementation of tritium waste control programs has resulted in a 30-fold reduction in the gaseous tritium effluents from Mound Laboratory. However, to reduce tritium waste levels to the ''as low as practicable'' guideline poses problems that are beyond ready solution with state-of-the-art tritium control technology. To meet this advanced technology need, a tritium waste control technology program was initiated. Although the initial thrust of the work under this program was oriented toward development of gaseous effluent treatment systems, its natural evolution has been toward the liquid waste problem. We contend that, of all the possible approaches to disposal of tritiated liquid wastes, recovery offers the greatest advantages. End products of the recovery processes would be: (1) water detritiated to a level below the Radioactivity Concentration Guide or detritiated to a level that would permit safe recycle in a closed loop operation and, (2) enriched tritium. The detritiated water effluent could be either recycled in a closed loop operation such as in a fuel reprocessing plant or safely released to the biosphere, and the recovered tritium could be recycled for use in fusion reactor studies or other applications

  9. The influence of assistive technology on occupational performance and satisfaction of leprosy patients with grade 2 disabilities

    Directory of Open Access Journals (Sweden)

    Lucas da Silva Muniz

    Full Text Available Abstract INTRODUCTION: We aimed to investigate the feasibility of assistive technology (AT devices to improve leprosy patients' occupational performances and satisfaction. METHODS: This is a pretest-posttest design study. The Canadian Occupational Performance Measure was used to assess the occupational performance and satisfaction of five leprosy participants with grade 2 disabilities before and after ten 45-minute interventions using assistive technology devices. RESULTS: The data showed a statistically significant 7-point average improvement (p<0.05 in participants' post-intervention performance and satisfaction scores. CONCLUSIONS: Assistive technology devices may be useful therapeutic tools to enhance autonomy/independence and satisfaction of leprosy patients with grade 2 disabilities.

  10. Clinic-epidemiological evaluation of ulcers in patients with leprosy sequelae and the effect of low level laser therapy on wound healing: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Barreto Josafá G

    2010-08-01

    Full Text Available Abstract Background Mycobacterium leprae is the only pathogenic bacteria able to infect peripheral nerves. Neural impairment results in a set of sensitive, motor and autonomic disturbances, with ulcers originating primarily on the hands and feet. The study objectives were to analyze the clinic-epidemiological characteristics of patients attended at one specialized dressing service from a leprosy-endemic region of the Brazilian Amazon and to evaluate the effect of low level laser therapy (LLLT on wound healing of these patients. Methods Clinic-epidemiological evaluation of patients with leprosy sequelae was performed at the reference unit in sanitary dermatology of the state of Pará in Brazil. We conducted anamnesis, identification of the regions affected by the lesions and measurement of ulcer depth and surface area. After that, we performed a randomized clinical trial. Fifty-one patients with ulcers related to leprosy were evaluated, twenty-five of them were randomly assigned to a low level laser therapy group or a control group. Patients were treated 3 times per week for 12 weeks. Outcome measures were ulcer surface area, ulcer depth and the pressure ulcer scale for healing score (PUSH. Results Ninety-seven ulcers were identified, with a mean (SD duration of 97.6 (111.7 months, surface area of 7.3 (11.5 cm2, and depth of 6.0 (6.2 mm. Statistical analysis of the data determined that there were no significant differences in the variables analyzed before and after treatment with low level laser therapy. Conclusions Ulcers in patients with leprosy remain a major source of economic and social losses, even many years after they have been cured of M. leprae infection. Our results indicate that it is necessary to develop new and more effective therapeutic tools, as low level laser therapy did not demonstrate any additional benefits to ulcer healing with the parameters used in this study. Trial Registration The trial was registered at Clinical

  11. AUTOMATION OF PLC PROGRAMMING WHEN IMPLEMENTING ALGORITHMS OF GUARANTEEING CONTROL

    Directory of Open Access Journals (Sweden)

    M. V. Levinskyi

    2015-05-01

    Full Text Available During developing programs for programmable logic controllers (PLCs the concept of model-oriented design is increasingly used. In particular, usage of Simulink PLC Coder is giving the opportunity to get SCL program codefrom Simulink model which contains certain dynamic elements. Then, for example, this SCL code can be transformed to functional blocks of the Simatic S7-300 (VIPA 300 PLC. This significantly reduces the timerequired to develop code in the language of SCL and reduces requirements for specialists’ qualification when developing control systems. In this article we provide an example of PLC programming automation whenimplementing algorithms of guaranteeing control (AGC. For certain types of technological processes it is typical to contain monotonically increasing function of the effectiveness with fixed one-way restriction in regulations. Forexample, in the grinders, presses, extruders the load current of the drive is stabilized using the change of feed. Energy efficiency of these plants will increase with increasing of the set point (SP to the controller of the drive loadcurrent stabilization loop. However, an increase in SP increases the probability of triggering appropriate protection, for example, as a result of random changes in the properties of raw materials. Therefore, to avoid this accident, thepower of driving motors is often unreasonably overrated. And in this case they are used with currents equal to the half of rated.Systems of guaranteeing control (SGC are used to solve the contradiction between the need to improvethe efficiency and increasing probability of an accident.

  12. Single nucleotide polymorphism-based molecular typing of M. leprae from multicase families of leprosy patients and their surroundings to understand the transmission of leprosy.

    Science.gov (United States)

    Turankar, R P; Lavania, M; Chaitanya, V S; Sengupta, U; Darlong, J; Darlong, F; Siva Sai, K S R; Jadhav, R S

    2014-03-01

    The exact mode of transmission of leprosy is not clearly understood; however, many studies have demonstrated active transmission of leprosy around a source case. Families of five active leprosy cases and their household contacts were chosen from a high endemic area in Purulia. Fifty-two soil samples were also collected from different areas of their houses. DNA was extracted from slit-skin smears (SSS) and soil samples and the Mycobacterium leprae-specific RLEP (129 bp) region was amplified using PCR. Molecular typing of M. leprae was performed for all RLEP PCR-positive samples by single nucleotide polymorphism (SNP) typing and confirmation by DNA sequencing. SSS of these five patients and six out of the total 28 contacts were PCR positive for RLEP whereas 17 soil samples out of 52 showed the presence of M. leprae DNA. SNP typing of M. leprae from all RLEP PCR-positive subjects (patients and smear-positive contacts) and 10 soil samples showed the SNP type 1 genotype. M. leprae DNA from the five leprosy patients and the six contacts was further subtyped and the D subtype was noted in all patients and contacts, except for one contact where the C subtype was identified. Typing followed by subtyping of M. leprae clearly revealed that either the contacts were infected by the patients or both patients and contacts had the same source of infection. It also revealed that the type of M. leprae in the soil in the inhabited areas where patients resided was also of the same type as that found in patients. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  13. Object oriented programming techniques applied to device access and control

    International Nuclear Information System (INIS)

    Goetz, A.; Klotz, W.D.; Meyer, J.

    1992-01-01

    In this paper a model, called the device server model, has been presented for solving the problem of device access and control faced by all control systems. Object Oriented Programming techniques were used to achieve a powerful yet flexible solution. The model provides a solution to the problem which hides device dependancies. It defines a software framework which has to be respected by implementors of device classes - this is very useful for developing groupware. The decision to implement remote access in the root class means that device servers can be easily integrated in a distributed control system. A lot of the advantages and features of the device server model are due to the adoption of OOP techniques. The main conclusion that can be drawn from this paper is that 1. the device access and control problem is adapted to being solved with OOP techniques, 2. OOP techniques offer a distinct advantage over traditional programming techniques for solving the device access problem. (J.P.N.)

  14. A 29-Year-Old Male with Borderline Lepromatous Leprosy

    Directory of Open Access Journals (Sweden)

    Lubna Khondker

    2013-07-01

    Full Text Available Leprosy (Hansen’s disease is a chronic granulomatous infectious disease that primarily affects the peripheral nerves, skin, upper respiratory tract mucosa, eyes and certain other tissues. It is diagnosable and curable if recognized early and treated adequately. A twenty nine-year-old male from Jessore, Bangladesh reported in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh with the complaints of multiple erythematous, large, raised and circumscribed lesions with loss of sensations on different parts of the body, especially distal portions of all four limbs for last eight months. Subsequently he developed ulcers on the anesthetic fingers due to smoking and few ulcerative lesions on both feet. Skin examination revealed multiple erythematous, large nodular lesions on both sides of the cheek and forehead, multiple erythematous, indurated, large plaques with raised margin and central clearing on the trunk, waist and all four limbs, few satellite lesions around the large plaques on the trunk, few hypopigmented patches and plaques on buttock and lower limbs, multiple painless ulcers on dorsal surface of fingers of both hands, both lateral malleoluses and right sole. On examination of peripheral nerves, left great auricular nerve, both ulnar nerves and both common peroneal nerves were moderately enlarged and tender. Slit skin smear for AFB (modified Z-N stain was done and revealed that there were large number of acid and alcohol-fast bacilli arranged in straight and curved parallel bundles with globular masses (cigar-bundle appearance, morphologically resembling Mycobacterium leprae. Skin biopsy for histopathological examination revealed extensive infiltration of macrophages in the dermis, separated from epidermis by narrow grenz zone, with destruction of skin adnexa. Few foci of poorly defined granuloma in dermis were also noted. The patient was managed with rifampicin, clofazimine, dapsone, prednisolone and omeprazole.

  15. Cost-effectiveness of interventions to prevent disability in leprosy: A systematic review

    NARCIS (Netherlands)

    N.H.J. van Veen (Natasja); P. McNamee (McNamee); J.H. Richardus (Jan Hendrik); W.C.S. Smith (Cairns)

    2009-01-01

    textabstractBackground: Prevention of disability (POD) is one of the key objectives of leprosy programmes. Recently, coverage and access have been identified as the priority issues in POD. Assessing the cost-effectiveness of POD interventions is highly relevant to understanding the barriers and

  16. Role of PGL-I antibody detection in the diagnosis of pure neural leprosy

    NARCIS (Netherlands)

    Jardim, Marcia R.; Antunes, Sergio L. G.; Simons, Brian; Wildenbeest, Joanne G.; Nery, José Augusto C.; Illarramendi, Ximena; Moraes, Milton O.; Martinez, Alejandra N.; Oskam, Linda; Faber, William R.; Sarno, Euzenir N.; Sampaio, Elizabeth P.; Bührer-Sékula, Samira

    2005-01-01

    Pure neural leprosy (PNL) is difficult to diagnose because skin lesions and acid-fast bacilli (AFB) in slit smears are absent. At present, the gold standard for PNL diagnosis is the histopathological examination of a peripheral nerve biopsy. Even so, detection of bacteria is difficult and

  17. 13 Assessment of Social Welfare Services of Sufferers of Leprosy in ...

    African Journals Online (AJOL)

    Nekky Umera

    intended social welfare services and practicable social welfare practices. Keywords: focus group discussion, Social welfare, sufferers of. Leprosy. Introduction. Dyrough (1995:27) defined social welfare as;. The system of social services and institutions, designed to aid individuals and groups to attain satisfying standards of ...

  18. Evaluation of oral and periodontal status of leprosy patients in Dindigul district

    Directory of Open Access Journals (Sweden)

    S A Jacob Raja

    2016-01-01

    Full Text Available Aim: After the introduction of the multidrug therapy, the incidence of leprosy is decreasing every year. However, periodontal complaints are commonly seen in these patients due to compromised immunity and impaired oral hygiene. The aim of the present study is to assess the oral and periodontal status of the leprosy patients in Dindigul district. Materials and Methods: The study was conducted on 62 patients treated in a leprosy center at Dindigul district. Among these, 22 (35.5% were female patients and 40 were male patients (64.5%. Age ranges between 40 and 70 with the mean age being 52. Facial changes, periodontal status, dental caries, attrition, tooth loss, plaque index (Silness and Loe, and calculus component of oral hygiene index-simplified were assessed. Results: Majority of the patients presented with loss of eyebrows and eyelashes, saddle nose, ocular involvement, and leonine facies. Gingival recession (54.8% was a predominant finding followed by tooth loss (69.5%, mobility (60.86%, attrition (56%, chronic pulpitis (34.7%, and dental caries (26%. Most of the patients had severe periodontitis. Conclusions: Compromised immunity and altered autonomy pave way for many dental complaints such as periodontitis and deposits in tooth with poor oral hygiene. Awareness about the oral health problems and reinforcement of oral hygiene should be insisted to the leprosy patients to prevent further morbidity.

  19. Dealing with Stigma: Experiences of Persons Affected by Disabilities and Leprosy

    Directory of Open Access Journals (Sweden)

    Mimi Lusli

    2015-01-01

    Full Text Available Persons affected by leprosy or by disabilities face forms of stigma that have an impact on their lives. This study seeks to establish whether their experiences of stigma are similar, with a view to enabling the two groups of people to learn from each other. Accounts of experiences of the impact of stigma were obtained using in-depth interviews and focus group discussion with people affected by leprosy and by disabilities not related to leprosy. The analysis shows that there are a lot of similarities in impact of stigma in terms of emotions, thoughts, behaviour, and relationships between the two groups. The main difference is that those affected by leprosy tended to frame their situation in medical terms, while those living with disabilities described their situation from a more social perspective. In conclusion, the similarities offer opportunities for interventions and the positive attitudes and behaviours can be modelled in the sense that both groups can learn and benefit. Research that tackles different aspects of stigmatization faced by both groups could lead to inclusive initiatives that help individuals to come to terms with the stigma and to advocate against exclusion and discrimination.

  20. From genome-based in silico predictions to ex vivo verification of leprosy diagnosis

    NARCIS (Netherlands)

    Geluk, Annemieke; Spencer, John S.; Bobosha, Kidist; Pessolani, Maria C. V.; Pereira, Geraldo M. B.; Banu, Sayera; Honoré, Nadine; Reece, Stephen T.; MacDonald, Murdo; Sapkota, Bishwa Raj; Ranjit, Chaman; Franken, Kees L. M. C.; Zewdie, Martha; Aseffa, Abraham; Hussain, Rabia; Stefani, Mariane M.; Cho, Sang-Nae; Oskam, Linda; Brennan, Patrick J.; Dockrell, Hazel M.

    2009-01-01

    The detection of hundreds of thousands of new cases of leprosy every year suggests that transmission of Mycobacterium leprae infection still continues. Unfortunately, tools for identification of asymptomatic disease and/or early-stage M. leprae infection (likely sources of transmission) are lacking.

  1. Cultural validation of a new instrument to measure leprosy-related stigma: the SARI Stigma Scale

    NARCIS (Netherlands)

    Dadun,; Peters, Ruth M. H.; Van Brakel, Wim H.; Lusli, Mimi; Damayanti, Rita; Irwanto, A.; Bunders- Aelen, J.G.F.

    Background: There is a need for comprehensive, valid and reliable instruments to assess leprosy-related stigma. This paper presents the process of the cross-cultural validation of an instrument in Cirebon District, Indonesia initiated by the Stigma Assessment and Reduction of Impact (SARI) project.

  2. Dealing with Stigma: Experiences of Persons Affected by Disabilities and Leprosy

    Science.gov (United States)

    Zweekhorst, Marjolein B. M.; Miranda-Galarza, Beatriz; Peters, Ruth M. H.; Cummings, Sarah; Seda, Francisia S. S. E.; Bunders, Joske F. G.; Irwanto

    2015-01-01

    Persons affected by leprosy or by disabilities face forms of stigma that have an impact on their lives. This study seeks to establish whether their experiences of stigma are similar, with a view to enabling the two groups of people to learn from each other. Accounts of experiences of the impact of stigma were obtained using in-depth interviews and focus group discussion with people affected by leprosy and by disabilities not related to leprosy. The analysis shows that there are a lot of similarities in impact of stigma in terms of emotions, thoughts, behaviour, and relationships between the two groups. The main difference is that those affected by leprosy tended to frame their situation in medical terms, while those living with disabilities described their situation from a more social perspective. In conclusion, the similarities offer opportunities for interventions and the positive attitudes and behaviours can be modelled in the sense that both groups can learn and benefit. Research that tackles different aspects of stigmatization faced by both groups could lead to inclusive initiatives that help individuals to come to terms with the stigma and to advocate against exclusion and discrimination. PMID:25961008

  3. Case of Diffuse Lepromatous Leprosy Associated with “Mycobacterium lepromatosis” ▿

    OpenAIRE

    Vera-Cabrera, Lucio; Escalante-Fuentes, Wendy G.; Gomez-Flores, Minerva; Ocampo-Candiani, Jorge; Busso, Philippe; Singh, Pushpendra; Cole, Stewart T.

    2011-01-01

    An 86-year-old female patient from northeast Mexico presented with diffuse lepromatous leprosy (DLL). Sequence analysis of four genes (rrs, rpoB, sigA, and hsp65) from the skin biopsy specimen identified “Mycobacterium lepromatosis.” This is the first independent confirmation of a case of DLL due to M. lepromatosis.

  4. Serum anti-phenolic glycolipid-1 IgA correlates to IgM isotype in leprosy patients: a possible candidate for seroepidemiological surveys?

    Science.gov (United States)

    de Macedo, Alexandre C; Guimarães, Juliana A; Rodrigues, Raphael O; Araújo, Thiago D V; Tavares, Clodis M; Cabral, Paula B; de Moraes-Pinto, Maria Isabel; Nagao-Dias, Aparecida T

    2018-03-01

    The aim of this study was to compare serum anti-phenolic glycolipid-1 IgA, IgG, and IgM levels in leprosy patients and controls. Analysis of anti-PGL-1 IgA, IgG, or IgM in serum samples from multibacillary (MB, n=32) and paucibacillary (PB, n=22) leprosy patients, and in non-endemic controls (n=17), using an indirect enzyme-linked immunosorbent assay. A strong correlation between serum IgM and IgA isotypes was found (r=.745, PVPN) predictive values were estimated for each isotype. For IgA, the VPP and VPN were, respectively, 100.0% (87.0%-100.0%; 95% confidence interval) and 38.7% (24.4%-54.5%); for IgG, 100% (87.0%-100.0%) and 28.8% (17.8%-42.1%), respectively; and for IgM, 95.2% (83.8%-99.4%) and 51.7% (32.5%-70.6%), respectively. Despite the limiting factors, anti-PGL1 IgA correlates to IgM levels and it could be considered as a possible laboratorial tool to be also used, for instance, in serological follow-up studies. © 2017 Wiley Periodicals, Inc.

  5. Diagnosis and medical treatment of neuropathic pain in leprosy.

    Science.gov (United States)

    Arco, Rogerio Del; Nardi, Susilene Maria Tonelli; Bassi, Thiago Gasperini; Paschoal, Vania Del Arco

    2016-08-08

    to identify the difficulties in diagnosing and treating neuropathic pain caused by leprosy and to understand the main characteristics of this situation. 85 patients were treated in outpatient units with reference to leprosy and the accompanying pain. We used a questionnaire known as the Douleur Neuropathic 4 test and we conducted detailed neurological exams. As a result, 42 patients were excluded from the study for not having proved their pain. Out of the 37 patients that experienced pain, 22 (59.5%) had neuropathic pain (or a mixture of this pain and their existing pain) and of these 90.8% considered this pain to be moderate or severe. 81.8% of the sample suffered with this pain for more than 6 months. Only 12 (54.5%) of the patients had been diagnosed with neuropathic pain and in almost half of these cases, this pain had not been diagnosed. With reference to medical treatment (n=12) for neuropathic pain, 5 (41.6%) responded that they became better. For the other 7 (58.4%) there were no changes in relation to the pain or in some cases the pain worsened in comparison to their previous state. Statistical analysis comparing improvements in relation to the pain amongst the patients that were treated (n=12) and those that were not, showed significant differences (value p=0.020). we noted difficulties in diagnosing neuropathic pain for leprosy in that almost half of the patients that were studied had not had their pain diagnosed. We attributed this to some factors such as the non-adoption of the appropriate protocols which led to inadequate diagnosis and treatment that overlooked the true picture. identificar as dificuldades em diagnosticar e tratar a dor neuropática causada pela hanseníase, bem como determinar as características principais dessa situação. examinaram-se 85 pacientes tratados no ambulatório de referência para hanseníase e referiam dor. Aplicou-se questionário, o teste Douleur Neuropathic 4, e criterioso exame neurológico pelo qual exclu

  6. National control and eradication program of bovine tuberculosis in Chile.

    Science.gov (United States)

    Max, Vanessa; Paredes, Luis; Rivera, Alejandro; Ternicier, Claudio

    2011-07-05

    There have been reports of the presence of bovine tuberculosis (TB) in Chile for more than 100 years. Several prevalence studies have revealed that there is a wide spectrum of disease across the country with certain geographic areas where the disease is endemic through to other geographic areas where infection is sporadic and at very low prevalence. In 2009, this information was used to divide Chile into different geographic zones based on prevalence rates. This will enable the correct actions to be undertaken to reduce the prevalence of TB. Thus the northern part of Chile which has a medium to high prevalence of TB will be categorized as a control zone. In contrast, the southern part of Chile which has a high proportion of the bovine population, has a low prevalence of TB and will be classified as an eradication zone (Paredes, 2008). Although there have been several past attempts to create a national control and eradication program in Chile, none has been successful. A national program is proposed, and outlined in this paper. Progress toward program initiation in 2009 has been difficult, mostly because of the global economic crisis, difficulties in the milk and meat industry, and social and political issues. Copyright © 2011 Elsevier B.V. All rights reserved.

  7. Maintaining quality control in a nontraditional nuclear technology degree program

    International Nuclear Information System (INIS)

    DeSain, G.W.

    1989-01-01

    Regents College, created by the Board of Regents of the University of The State on New York in 1971, has been offering, since January 1985, AS and BS degrees in nuclear technology. The impetus for establishing the nuclear technology degrees came from nuclear utility management and had to do with the US Nuclear Regulatory Commission proposed rule regarding degreed operators on shift. There are a variety of ways to earn credits in Regents College degree programs: (1) college courses taken for degree-level credit from regionally accredited colleges; (2) courses sponsored by business, industry, or government that have been evaluated and recommended for credit by the New York National or American Council on Education (ACE's) Program on Noncollegiate Sponsored Instruction (PONSI); (3) military education that has been evaluated by ACE PONSI; (4) approved college-proficiency examinations; and (5) special assessment: an individualized examination of college-level knowledge gained from experience or independent study. Nuclear technology students primarily use college course work, evaluated military education, and proficiency examinations to complete degree programs. However, an increasing number of utilities are having training programs PONSI evaluated, resulting in an increased use of these courses in the nuclear technology degrees. Quality control is a function of several factors described in the paper

  8. Adaptive dynamic programming with applications in optimal control

    CERN Document Server

    Liu, Derong; Wang, Ding; Yang, Xiong; Li, Hongliang

    2017-01-01

    This book covers the most recent developments in adaptive dynamic programming (ADP). The text begins with a thorough background review of ADP making sure that readers are sufficiently familiar with the fundamentals. In the core of the book, the authors address first discrete- and then continuous-time systems. Coverage of discrete-time systems starts with a more general form of value iteration to demonstrate its convergence, optimality, and stability with complete and thorough theoretical analysis. A more realistic form of value iteration is studied where value function approximations are assumed to have finite errors. Adaptive Dynamic Programming also details another avenue of the ADP approach: policy iteration. Both basic and generalized forms of policy-iteration-based ADP are studied with complete and thorough theoretical analysis in terms of convergence, optimality, stability, and error bounds. Among continuous-time systems, the control of affine and nonaffine nonlinear systems is studied using the ADP app...

  9. The CERN PS/SL Controls Java Application Programming Interface

    International Nuclear Information System (INIS)

    I. Deloose; J. Cuperus; P. Charrue; F. DiMaio; K. Kostro; M. Vanden Eynden; W. Watson

    1999-01-01

    The PS/SL Convergence Project was launched in March 1998. Its objective is to deliver a common control as infrastructure for the CERN accelerators by year 2001. In the framework of this convergence activity, a project was launched to develop a Java Application Programming Interface (API) between programs written in the Java language and the PS and SL accelerator equipment. This Java API was specified and developed in collaboration with TJNAF. It is based on the Java CDEV [1] package that has been extended in order to end up with a CERN/TJNAF common product. It implements a detailed model composed of devices organized in named classes that provide a property-based interface. It supports data subscription and introspection facilities. The device model is presented and the capabilities of the API are described with syntax examples. The software architecture is also described

  10. The stigma and prejudice of leprosy: influence on the human condition

    Directory of Open Access Journals (Sweden)

    Cléa Adas Saliba Garbin

    2015-04-01

    Full Text Available INTRODUCTION: To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. METHODS: The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT, Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. RESULTS: The results revealed that the study population consisted predominantly of males (55.3% with an income between 1 and 3 times the minimum wage (67%. The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7% and the duration of the treatment (28.7%. A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. CONCLUSIONS: Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation.

  11. Experimental Infection of Rhodnius prolixus (Hemiptera, Triatominae with Mycobacterium leprae Indicates Potential for Leprosy Transmission.

    Directory of Open Access Journals (Sweden)

    Arthur da Silva Neumann

    Full Text Available Leprosy is a chronic dermato-neurological disease caused by infection with Mycobacterium leprae. In 2013 almost 200,000 new cases of leprosy were detected around the world. Since the first symptoms take from years to decades to appear, the total number of asymptomatic patients is impossible to predict. Although leprosy is one of the oldest records of human disease, the mechanisms involved with its transmission and epidemiology are still not completely understood. In the present work, we experimentally investigated the hypothesis that the mosquitoes Aedes aegypti and Culex quinquefasciatus and the hemiptera Rhodnius prolixus act as leprosy vectors. By means of real-time PCR quantification of M. leprae 16SrRNA, we found that M. leprae remained viable inside the digestive tract of Rhodnius prolixus for 20 days after oral infection. In contrast, in the gut of both mosquito species tested, we were not able to detect M. leprae RNA after a similar period of time. Inside the kissing bug Rhodnius prolixus digestive tract, M. leprae was initially restricted to the anterior midgut, but gradually moved towards the hindgut, in a time course reminiscent of the life cycle of Trypanosoma cruzi, a well-known pathogen transmitted by this insect. The maintenance of M. leprae infectivity inside the digestive tract of this kissing bug is further supported by successful mice footpad inoculation with feces collected 20 days after infection. We conclude that Rhodnius prolixus defecate infective M. leprae, justifying the evaluation of the presence of M. leprae among sylvatic and domestic kissing bugs in countries endemic for leprosy.

  12. Assessment of the sensory and physical limitations imposed by leprosy in a Brazilian Amazon Population

    Directory of Open Access Journals (Sweden)

    Cintia Yolette Urbano Pauxis Aben-Athar

    Full Text Available Abstract INTRODUCTION Leprosy often results in sensory and physical limitations. This study aimed to evaluate these limitations using a quantitative approach in leprosy patients in Belém (Pará, Brazil. METHODS This epidemiological, cross-sectional study measured the sensory impairment of smell and taste through the use of a questionnaire and evaluated activity limitations of daily life imposed by leprosy through the Screening of Activity Limitation and Safety Awareness (SALSA Scale. Data were collected from 84 patients and associations between the degree of disability and clinical and epidemiological characteristics were assessed. RESULTS The majority of patients were men (64.3%, married (52.4%, age 31-40 years old (26.2%, had primary education (50%, and were independent laborers (36.9%. The multibacillary operational classification (81%, borderline clinical form (57.1%, and 0 degrees of physical disability (41.7% were predominant. SALSA scores ranged from 17 to 59 points, and being without limitations was predominant (53.6%. The risk awareness score ranged from 0 to 8, with a score of 0 (no awareness of risk being the most common (56%. Evaluation of smell and taste sensory sensitivities revealed that 70.2% did not experience these sensory changes. Patients with leprosy reactions were 7 times more likely to develop activity limitations, and those who had physical disabilities were approximately four times more likely to develop a clinical picture of activity limitations. CONCLUSIONS Most patients showed no sensory changes, but patients with leprosy reactions were significantly more likely to develop activity limitations. Finally, further studies should be performed, assessing a higher number of patients to confirm the present results.

  13. The stigma and prejudice of leprosy: influence on the human condition.

    Science.gov (United States)

    Garbin, Cléa Adas Saliba; Garbin, Artênio José Ísper; Carloni, Maria Emília Oliveira Gomes; Rovida, Tânia Adas Saliba; Martins, Ronald Jefferson

    2015-01-01

    To analyze the knowledge, feelings and perceptions involving patients affected by leprosy, as a better understanding of these factors may be useful to decrease the stigma and prejudice associated with the condition. The study cohort consisted of 94 patients who underwent treatment for leprosy at the Health Units in the City of Cuiabá, Mato Grosso (MT), Brazil. The study questionnaire included items to collect information on socio-demographic data, knowledge about the disease, stigma, prejudice, self-esteem and quality of life of leprosy patients. Bivariate analyses were used to assess the data based on the chi-square test with a 5% significance threshold. The results revealed that the study population consisted predominantly of males (55.3%) with an income between 1 and 3 times the minimum wage (67%). The survey respondents reported that the most significant difficulties related to the treatment were the side effects (44.7%) and the duration of the treatment (28.7%). A total of 72.3% of the subjects were knowledgeable about the disease, of whom 26.6% had the leprosy reaction. Stigma and prejudice were cited by 93.6% of the participants. Based on the responses, 40.4% of patients reported being depressed and sad, and 69.1% of the subjects encountered problems at work after being diagnosed. A total of 45.7% of the patients rated their quality of life between bad and very bad. Our results suggest that leprosy causes suffering in patients beyond pain and discomfort and greatly influences social participation.

  14. Controlled Optimal Design Program for the Logit Dose Response Model

    Directory of Open Access Journals (Sweden)

    Jiaqiao Hu

    2010-10-01

    Full Text Available The assessment of dose-response is an integral component of the drug development process. Parallel dose-response studies are conducted, customarily, in preclinical and phase 1, 2 clinical trials for this purpose. Practical constraints on dose range, dose levels and dose proportions are intrinsic issues in the design of dose response studies because of drug toxicity, efficacy, FDA regulations, protocol requirements, clinical trial logistics, and marketing issues. We provide a free on-line software package called Controlled Optimal Design 2.0 for generating controlled optimal designs that can incorporate prior information and multiple objectives, and meet multiple practical constraints at the same time. Researchers can either run the web-based design program or download its stand-alone version to construct the desired multiple-objective controlled Bayesian optimal designs. Because researchers often adopt ad-hoc design schemes such as the equal allocation rules without knowing how efficient such designs would be for the design problem, the program also evaluates the efficiency of user-supplied designs.

  15. Brazilian clinical trial of uniform multidrug therapy for leprosy patients: the correlation between clinical disease types and adverse effects

    Directory of Open Access Journals (Sweden)

    Heitor de Sá Gonçalves

    2012-12-01

    Full Text Available This study sought to verify the correlation between leprosy types and the adverse effects of treatment drugs. This quantitative, prospective, nested study was developed at the Dona Libânia Dermatology Centre in Fortaleza, Brazil. Data were collected from November 2007-November 2008. During this period, 818 leprosy patients were diagnosed and began treatment. Forty patients with tuberculoid leprosy (TT were selected. Twenty patients followed a standard therapy of dapsone and rifampicin and 20 were administered dapsone, rifampicin and clofazimine (U-MDT. Twenty patients with borderline lepromatous (BL and lepromatous leprosy (LL were also selected and treated with U-MDT. All of the subjects received six doses. With the exception of haemolytic anaemia, there was a low incidence of adverse effects in all the groups. We did not observe any differences in the incidence of haemolytic anaemia or other side effects across groups of patients with TT, BL or LL treated with U-MDT.

  16. Retrospective histopathological classification of 1,108 skin biopsies from patients clinically suspected of having leprosy from Bahia, Northeast Brazil

    Directory of Open Access Journals (Sweden)

    Barbosa Júnior Aryon de Almeida

    1998-01-01

    Full Text Available We report a retrospective histopathological classification carried out under laboratory conditions by the method of Ridley & Jopling of 1,108 skin biopsies from patients clinically suspected of having leprosy from Bahia, Northeast Brazil.

  17. Structural mode significance using INCA. [Interactive Controls Analysis computer program

    Science.gov (United States)

    Bauer, Frank H.; Downing, John P.; Thorpe, Christopher J.

    1990-01-01

    Structural finite element models are often too large to be used in the design and analysis of control systems. Model reduction techniques must be applied to reduce the structural model to manageable size. In the past, engineers either performed the model order reduction by hand or used distinct computer programs to retrieve the data, to perform the significance analysis and to reduce the order of the model. To expedite this process, the latest version of INCA has been expanded to include an interactive graphical structural mode significance and model order reduction capability.

  18. CR mammography: Design and implementation of a quality control program

    Energy Technology Data Exchange (ETDEWEB)

    Moreno-Ramirez, A.; Brandan, M. E.; Villasenor-Navarro, Y.; Galvan, H. A.; Ruiz-Trejo, C. [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, DF 04510 (Mexico); Departamento de Radiodiagnostico, Instituto Nacional de Cancerologia, DF 14080 (Mexico); Instituto de Fisica, Universidad Nacional Autonoma de Mexico, DF 04510 (Mexico)

    2012-10-23

    Despite the recent acquisition of significant quantities of computed radiography CR equipment for mammography, Mexican regulations do not specify the performance requirements for digital systems such as those of CR type. The design of a quality control program QCP specific for CR mammography systems was thus considered relevant. International protocols were taken as reference to define tests, procedures and acceptance criteria. The designed QCP was applied in three CR mammography facilities. Important deficiencies in spatial resolution, noise, image receptor homogeneity, artifacts and breast thickness compensation were detected.

  19. qPCR detection of Mycobacterium leprae in biopsies and slit skin smear of different leprosy clinical forms

    OpenAIRE

    Michelle de Campos Soriani Azevedo; Natália Mortari Ramuno; Luciana Raquel Vincenzi Fachin; Mônica Tassa; Patrícia Sammarco Rosa; Andrea de Faria Fernandes Belone; Suzana Madeira Diório; Cleverson Teixeira Soares; Gustavo Pompermaier Garlet; Ana Paula Favaro Trombone

    2017-01-01

    Abstract Leprosy, whose etiological agent is Mycobacterium leprae, is a chronic infectious disease that mainly affects the skin and peripheral nervous system. The diagnosis of leprosy is based on clinical evaluation, whereas histopathological analysis and bacilloscopy are complementary diagnostic tools. Quantitative PCR (qPCR), a current useful tool for diagnosis of infectious diseases, has been used to detect several pathogens including Mycobacterium leprae. The validation of this technique ...

  20. The influence of assistive technology on occupational performance and satisfaction of leprosy patients with grade 2 disabilities.

    Science.gov (United States)

    Muniz, Lucas da Silva; Amaral, Irmara Géssica Santos; Dias, Thiago da Silva; Rodrigues, Jorge Lopes

    2016-01-01

    We aimed to investigate the feasibility of assistive technology (AT) devices to improve leprosy patients' occupational performances and satisfaction. This is a pretest-posttest design study. The Canadian Occupational Performance Measure was used to assess the occupational performance and satisfaction of five leprosy participants with grade 2 disabilities before and after ten 45-minute interventions using assistive technology devices. The data showed a statistically significant 7-point average improvement (pgrade 2 disabilities.

  1. Effects of an anger management and stress control program on smoking cessation: a randomized controlled trial.

    Science.gov (United States)

    Yalcin, Bektas Murat; Unal, Mustafa; Pirdal, Hasan; Karahan, Tevfik Fikret

    2014-01-01

    The purpose of this study was to investigate the effects of a cognitive behavioral therapy-oriented anger management and stress control program on smokers' quit rates. Of 2348 smokers, 350 were randomly allocated into study and control groups (n = 175 each). An individualized therapy cessation technique was selected for each participant (combination of behavioral counseling, nicotine replacement therapy, and/or pharmacotherapy). The participants in the control group attended a standard quit program, whereas the study group also received an additional 5-session (90 minutes each) cognitive behavioral therapy-oriented program aimed at improving their anger and stress coping skills. At the beginning of the study, both groups were asked to complete the Trait Anger Scale (TAS) of the State and Trait Anger Scale and the Self-Confident (SCS) and Hopeless (HS) subscales of the Stress Coping Styles Inventory; pretest smoking status of both groups and their coping skills were compared with each other as soon as the program ended (post-test results) and after 3 and 6 months (first and second follow-up tests). Although there was no difference between pretest scores on the TAS (P = .234), SCS (P = .130), and HS (P = .148) subscales, post-test results indicate that the study groups' TAS and HS scores decreased and SCS scores increased (P .05). The study group had a better quit level after 6 months compared with the control group (44% vs 27.4%; P smoking. © Copyright 2014 by the American Board of Family Medicine.

  2. CONTROL: the run control program used on the WA62 VAX data acquisition system at CERN

    International Nuclear Information System (INIS)

    Hand, R.P.

    1980-11-01

    The criteria are described which have been used in the design of CONTROL, a program in the WA62 VAX Native mode data acquisition system which serves the triple purpose of driving a status display, an operator's console and a message reporter. (U.K.)

  3. Controlled sample program publication No. 1: characterization of rock samples

    International Nuclear Information System (INIS)

    Ames, L.L.

    1978-10-01

    A description is presented of the methodology used and the geologic parameters measured on several rocks which are being used in round-robin laboratory and nuclide adsorption methodology experiments. Presently investigators from various laboratories are determining nuclide distribution coefficients utilizing numerous experimental techniques. Unfortunately, it appears that often the resultant data are dependent not only on the type of groundwater and rock utilized, but also on the experimentor or method used. The Controlled Sample Program is a WISAP (Waste Isolation Safety Assessment Program) attempt to resolve the apparent method and dependencies and to identify individual experimenter's bias. The rock samples characterized in an interlaboratory Kd methodology comparison program include Westerly granite, Argillaceous shale, Oolitic limestone, Sentinel Gap basalt, Conasauga shale, Climax Stock granite, anhydrite, Magenta dolomite and Culebra dolomite. Techniques used in the characterization include whole rock chemical analysis, X-ray diffraction, optical examination, electron microprobe elemental mapping, and chemical analysis of specific mineral phases. Surface areas were determined by the B.E.T. and ethylene glycol sorption methods. Cation exchange capacities were determined with 85 Sr, but were of questionable value for the high calcium rocks. A quantitative mineralogy was also estimated for each rock. Characteristics which have the potential of strongly affecting radionuclide Kd values such as the presence of sulfides, water-soluble, pH-buffering carbonates, glass, and ferrous iron were listed for each rock sample

  4. [Computer program controlled perimetry, its advantages and disadvantages].

    Science.gov (United States)

    Herbolzheimer, W G

    1986-10-01

    Following a short historical introduction and a description of basic methods of perimetry, computerized perimetry is described (taking the Octopus computerized perimeter as an example). The hardware-software concept and the three parts of the automatic perimeter, i.e., the controller, the measuring section, and the program section, are described. The technique of threshold determination, the programs (including the new Octopus programs), and the modes of representation of the results are explained. It is shown how one tries top take subjective criteria of the patient, such as attention, intelligence, and ability to concentrate into account during the measurements. The advantages and disadvantages of computerized perimetry are pointed out. It is emphasized that on average the range of scatter of measurements made with the automatic perimeter is smaller than when traditional manual methods are employed. In addition to the accuracy (scatter), the reproducibility (correlation) of the results is also better. Pathologic visual field defects are detected in greater detail and earlier by the automatic static perimeter than by manual perimetry. This applies in particular to early stages of retrobulbar neuritis and glaucoma.

  5. Trace contaminant control simulation computer program, version 8.1

    Science.gov (United States)

    Perry, J. L.

    1994-01-01

    The Trace Contaminant Control Simulation computer program is a tool for assessing the performance of various process technologies for removing trace chemical contamination from a spacecraft cabin atmosphere. Included in the simulation are chemical and physical adsorption by activated charcoal, chemical adsorption by lithium hydroxide, absorption by humidity condensate, and low- and high-temperature catalytic oxidation. Means are provided for simulating regenerable as well as nonregenerable systems. The program provides an overall mass balance of chemical contaminants in a spacecraft cabin given specified generation rates. Removal rates are based on device flow rates specified by the user and calculated removal efficiencies based on cabin concentration and removal technology experimental data. Versions 1.0 through 8.0 are documented in NASA TM-108409. TM-108409 also contains a source file listing for version 8.0. Changes to version 8.0 are documented in this technical memorandum and a source file listing for the modified version, version 8.1, is provided. Detailed descriptions for the computer program subprograms are extracted from TM-108409 and modified as necessary to reflect version 8.1. Version 8.1 supersedes version 8.0. Information on a separate user's guide is available from the author.

  6. Tuberculosis control program in the municipal context: performance evaluation

    Directory of Open Access Journals (Sweden)

    Tiemi Arakawa

    Full Text Available ABSTRACT OBJECTIVE The objective of this study is to evaluate the performance of the Tuberculosis Control Program in municipalities of the State of São Paulo. METHODS This is a program evaluation research, with ecological design, which uses three non-hierarchical groups of the municipalities of the State of São Paulo according to their performance in relation to operational indicators. We have selected 195 municipalities with at least five new cases of tuberculosis notified in the Notification System of the State of São Paulo and with 20,000 inhabitants or more in 2010. The multiple correspondence analysis was used to identify the association between the groups of different performances, the epidemiological and demographic characteristics, and the characteristics of the health systems of the municipalities. RESULTS The group with the worst performance showed the highest rates of abandonment (average [avg] = 10.4, standard deviation [sd] = 9.4 and the lowest rates of supervision of Directly Observed Treatment (avg = 6.1, sd = 12.9, and it was associated with low incidence of tuberculosis, high tuberculosis and HIV, small population, high coverage of the Family Health Strategy/Program of Community Health Agents, and being located on the countryside. The group with the best performance presented the highest cure rate (avg = 83.7, sd = 10.5 and the highest rate of cases in Directly Observed Treatment (avg = 83.0, sd = 12.7; the group of regular performance showed regular results for outcome (avg cure = 79.8, sd = 13.2; abandonment avg = 9.5, sd = 8.3 and supervision of the Directly Observed Treatment (avg = 42.8, sd = 18.8. Large population, low coverage of the Family Health Strategy/Program of Community Health Agents, high incidence of tuberculosis and AIDS, and being located on the coast and in metropolitan areas were associated with these groups. CONCLUSIONS The findings highlight the importance of the Directly Observed Treatment in relation

  7. Neuropathic pain and psychological morbidity in patients with treated leprosy: a cross-sectional prevalence study in Mumbai.

    Directory of Open Access Journals (Sweden)

    Estrella Lasry-Levy

    Full Text Available BACKGROUND: Neuropathic pain has been little studied in leprosy. We assessed the prevalence and clinical characteristics of neuropathic pain and the validity of the Douleur Neuropathique 4 questionnaire as a screening tool for neuropathic pain in patients with treated leprosy. The association of neuropathic pain with psychological morbidity was also evaluated. METHODOLOGY/PRINCIPAL FINDINGS: Adult patients who had completed multi-drug therapy for leprosy were recruited from several Bombay Leprosy Project clinics. Clinical neurological examination, assessment of leprosy affected skin and nerves and pain evaluation were performed for all patients. Patients completed the Douleur Neuropathique 4 and the 12-item General Health Questionnaire to identify neuropathic pain and psychological morbidity. CONCLUSIONS/SIGNIFICANCE: One hundred and one patients were recruited, and 22 (21.8% had neuropathic pain. The main sensory symptoms were numbness (86.4%, tingling (68.2%, hypoesthesia to touch (81.2% and pinprick (72.7%. Neuropathic pain was associated with nerve enlargement and tenderness, painful skin lesions and with psychological morbidity. The Douleur Neuropathique 4 had a sensitivity of 100% and specificity of 92% in diagnosing neuropathic pain. The Douleur Neuropathique 4 is a simple tool for the screening of neuropathic pain in leprosy patients. Psychological morbidity was detected in 15% of the patients and 41% of the patients with neuropathic pain had psychological morbidity.

  8. DCS-Neural-Network Program for Aircraft Control and Testing

    Science.gov (United States)

    Jorgensen, Charles C.

    2006-01-01

    A computer program implements a dynamic-cell-structure (DCS) artificial neural network that can perform such tasks as learning selected aerodynamic characteristics of an airplane from wind-tunnel test data and computing real-time stability and control derivatives of the airplane for use in feedback linearized control. A DCS neural network is one of several types of neural networks that can incorporate additional nodes in order to rapidly learn increasingly complex relationships between inputs and outputs. In the DCS neural network implemented by the present program, the insertion of nodes is based on accumulated error. A competitive Hebbian learning rule (a supervised-learning rule in which connection weights are adjusted to minimize differences between actual and desired outputs for training examples) is used. A Kohonen-style learning rule (derived from a relatively simple training algorithm, implements a Delaunay triangulation layout of neurons) is used to adjust node positions during training. Neighborhood topology determines which nodes are used to estimate new values. The network learns, starting with two nodes, and adds new nodes sequentially in locations chosen to maximize reductions in global error. At any given time during learning, the error becomes homogeneously distributed over all nodes.

  9. Real Time Speed Control of DC Motor by Programming the Fuzzy Controller in C Language

    Directory of Open Access Journals (Sweden)

    Abdelelah K. M.

    2017-12-01

    Full Text Available The fuzzy controller is one of the intelligent soft computing methods that realize a human being hierarchy sense and expert by building the program that realized it . In this work real time implementation of a fuzzy controller is realized by programming the industrial computer in c++ language. The performed fuzzy controller has two inputs and one output. The inputs are the speed error and change in error with controller output as PWM. The applied program architecture uses the matrix representation and subroutines for data entering the linguistic memberships for both error and change in error and performing rule-base in the inference mechanism using fuzzy logic . The output of the defuzification is pulse width modulation to the chopper drive circuit. The result shows good a fulfillment of the soft computing of the controller and with fast response and the effect of load as a disturbance on the shaft of the motor has been rejected quickly.

  10. PLC and DTAM Software Programs for Pumping Instrumentation and Control Skid P

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This document describe the software programs for the Programmable Logic Controller and the Datable Access Module for Pumping Instrumentation and Control skid ''P''. The Appendices contains copies of the printouts of these software programs

  11. PLC/DTAM Software Programs for Pumping Instrumentation and Control Skid ''L''

    International Nuclear Information System (INIS)

    KOCH, M.R.

    2000-01-01

    This document describes the software programs for the Programmable Logic Controller and the Data Table Access Module for Pumping Instrumentation and Control skid ''L''. The Appendices contains copies of the printouts of these software programs

  12. [Family planning programs and birth control in the third world].

    Science.gov (United States)

    Wohlschlagl, H

    1991-01-01

    The population explosion has been abating since the 2nd half of the 1960s. The birth rate of the 3rd World dropped from 45/1000 during 1950-55 to 31/1000 during 1985-90. From the 1st half of the 1960s to the 1st half of the 1980s the total fertility of such countries dropped from 6.1 to 4.2 children/woman. In Taiwan, Singapore, Hong Kong, South Korea, and Malaysia living standards improved as a result of industrialization, and fertility decreased significantly. In Sri Lanka, China, North Vietnam, and Thailand the drop of fertility is explained by cultural and religious factors. In 1982 about 78% of the population of developing countries lived in 39 states that followed an official policy aimed at reducing the population. Another 16% lived in countries supporting the concept of a desired family size. However, World Bank data showed that in the mid-1980s in 27 developing countries no state family planning (FP) programs existed. India adopted an official FP program in 1952, Pakistan followed suit in 1960, South Korea in 1961, and China in 1962. In Latin America a split policy manifested itself: in Brazil birth control was rejected, only Colombia had a FP policy. In 1986 the governments of 68 of 131 developing countries representing 3.1 billion people considered the number of children per woman too high. 31 of these countries followed concrete population control policies. On the other hand, in 1986 24 countries of Africa with 40% of the continent's population took no measures to influence population growth. In Latin America and the Caribbean 18 of 33 countries were idle, except for Mexico that had a massive state FP program. These programs also improve maternal and child health with birth spacing of at least 2 years, and the prevention of pregnancies of too young women or those over 40. The evaluation of rapidly spreading FP programs in the 1970s was carried out by the World Fertility Survey in 41 countries. The impact of FP programs was more substantial than

  13. A Fully Automated Diabetes Prevention Program, Alive-PD: Program Design and Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Block, Gladys; Azar, Kristen Mj; Block, Torin J; Romanelli, Robert J; Carpenter, Heather; Hopkins, Donald; Palaniappan, Latha; Block, Clifford H

    2015-01-21

    In the United States, 86 million adults have pre-diabetes. Evidence-based interventions that are both cost effective and widely scalable are needed to prevent diabetes. Our goal was to develop a fully automated diabetes prevention program and determine its effectiveness in a randomized controlled trial. Subjects with verified pre-diabetes were recruited to participate in a trial of the effectiveness of Alive-PD, a newly developed, 1-year, fully automated behavior change program delivered by email and Web. The program involves weekly tailored goal-setting, team-based and individual challenges, gamification, and other opportunities for interaction. An accompanying mobile phone app supports goal-setting and activity planning. For the trial, participants were randomized by computer algorithm to start the program immediately or after a 6-month delay. The primary outcome measures are change in HbA1c and fasting glucose from baseline to 6 months. The secondary outcome measures are change in HbA1c, glucose, lipids, body mass index (BMI), weight, waist circumference, and blood pressure at 3, 6, 9, and 12 months. Randomization and delivery of the intervention are independent of clinic staff, who are blinded to treatment assignment. Outcomes will be evaluated for the intention-to-treat and per-protocol populations. A total of 340 subjects with pre-diabetes were randomized to the intervention (n=164) or delayed-entry control group (n=176). Baseline characteristics were as follows: mean age 55 (SD 8.9); mean BMI 31.1 (SD 4.3); male 68.5%; mean fasting glucose 109.9 (SD 8.4) mg/dL; and mean HbA1c 5.6 (SD 0.3)%. Data collection and analysis are in progress. We hypothesize that participants in the intervention group will achieve statistically significant reductions in fasting glucose and HbA1c as compared to the control group at 6 months post baseline. The randomized trial will provide rigorous evidence regarding the efficacy of this Web- and Internet-based program in reducing or

  14. Programming a real-time operating system for satellite control applications Satellite Control Applications

    International Nuclear Information System (INIS)

    Omer, M.; Anjum, O.; Suddle, M.R.

    2004-01-01

    With the realization of ideas like formation flights and multi-body space vehicles the demands on an attitude control system have become increasingly complex. Even in its most simplified form, the control system for a typical geostationary satellite has to run various supervisory functions along with determination and control algorithms side by side. Within each algorithm it has to employ multiple actuation and sensing mechanisms and service real time interrupts, for example, in the case of actuator saturation and sensor data fusion. This entails the idea of thread scheduling and program synchronization, tasks specifically meant for a real time OS. This paper explores the embedding of attitude determination and control loop within the framework of a real time operating system provided for TI's DSP C6xxx series. The paper details out the much functionality provided within the scaleable real time kernel and the analysis and configuration tools available, It goes on to describe a layered implementation stack associated with a typical control for Geo Stationary satellites. An application for control is then presented in which state of the art analysis tools are employed to view program threads, synchronization semaphores, hardware interrupts and data exchange pipes operating in real time. (author)

  15. Rice Tolerance to Saflufenacil in Clomazone Weed Control Program

    Directory of Open Access Journals (Sweden)

    E. R. Camargo

    2011-01-01

    Full Text Available This research was conducted to evaluate (1 rice tolerance to saflufenacil applied preemergence (PRE and postemergence (POST and (2 the combination of saflufenacil and clomazone in light-textured soils. No injury from PRE application of saflufenacil was observed in 2009, and minimal injury for saflufenacil alone was observed in 2010. Injury as high as 68% was observed with combinations of 505 g ha−1 of clomazone applied PRE and 50 g ha−1 of saflufenacil applied POST in 2009 early evaluations. No interaction between clomazone and POST saflufenacil rates was observed in 2010. Rice injury intensified with increasing rates of saflufenacil applied POST. However, rice recovered with time for herbicide treatments applied PRE and POST in both years. Consequently, rice yield was not affected by any of the saflufenacil rates applied either PRE or POST in a clomazone weed control program.

  16. Cryogenic instrumentation needs in the controlled thermonuclear research program

    Energy Technology Data Exchange (ETDEWEB)

    Walstrom, P.L.

    1976-01-01

    The magnet development effort for the controlled thermonuclear research program will require extensive testing of superconducting coils at various sizes from small-scale models to full-size prototypes. Extensive use of diagnostic instrumentation will be required and to make detailed comparisons of predicted and actual performance in magnet tests and to monitor the test facility for incipient failure modes. At later stages of the program, cryogenic instrumentation will be required to monitor magnet system performance in fusion power reactors. Measured quantities may include temperature, strain, deflection, coil resistance, helium coolant pressure and flow, current, voltages, etc. The test environment, which includes high magnetic fields (up to 8-10 T) and low temperature, makes many commercial measuring devices inoperative or at least inaccurate. In order to ensure reliable measurements, careful screening of commercial devices for performance in the test environment will be required. A survey of potentially applicable instrumentation is presented along with available information on operation in the test environment based on experimental data or on analysis of the physical characteristics of the device. Areas where further development work is needed are delineated.

  17. SOCIAL PARTICIPATION OF DIABETES AND EX-LEPROSY PATIENTS IN THE NETHERLANDS AND PATIENT PREFERENCE FOR COMBINED SELF-CARE GROUPS

    Directory of Open Access Journals (Sweden)

    Henry John Christiaan De Vries

    2014-08-01

    Full Text Available Introduction: Earlier we showed that neuropathic complications limit social participation of ex-leprosy patients, even in a non-endemic leprosy setting like the Netherlands. Self-care groups for ex-leprosy patients can strengthen self-worth of participants, prevent further handicap, and enable the exchange of coping strategies. For non-endemic leprosy settings with a very low rate of leprosy patients a self-care group exclusively for (exleprosy patients is not likely to be feasible. A combined group with patients facing comparable morbidity would be more efficient than disease specific self-care groups. Here, we studied the comparability in social constraints of diabetic patients and ex-leprosy patients. Moreover, we investigated if combined self-care groups for ex-leprosy patients and diabetic patients would be desirable and acceptable for possible participants.Methods: Social participation was studied based on in-depth interviews and Participation Scale information collected from 41 diabetic patients and compared with the data of 31 ex-leprosy patients from a prior study. Moreover, we made an inventory of potential strengths and limitations and attitudes towards combined self-care groups for diabetic patients with neuropathy.Results: The following themes emerged among diabetic patients: disease confrontation, dependency, conflict with partner or relatives, feelings of inferiority, stigma, abandoning social activities, fear of the future, lack of information and hiding the disease. These themes were very similar to those voiced by the previously interviewed ex-leprosy patients. The latter more often mentioned stigma and disease ignorance among Dutch health care workers. Whereas ex-leprosy patients perceived stigma on multiple fronts, diabetic patients only mentioned feeling inferior. Diabetic patients experienced some form of participation restriction in 39% of the cases as opposed to 71% of the ex-leprosy patients. Diabetic patients did

  18. [Review of WHO Expert Committee on Leprosy 8th report, --comparison to 7th report].

    Science.gov (United States)

    Kitajima, Shinichi; En, Junichiro; Kitajima, Shiori; Barua, Sumana; Goto, Masamichi

    2014-03-01

    In 2012 the WHO Expert Committee on Leprosy published its 8th report, 14 years after the publication of its 7th report in 1998. This report, the first since the leprosy reduction goal was met in 2000, highlights key points such as improvements in the quality of various services available to patients and the efforts of individuals and societies, in addition to medical progress in diagnosis and treatment. This review will mainly describe the changes made since the 7th report. Some of the main modifications are the deletion of single lesion paucibacillary type, elongated treatment of patients with high bacterial indices, the introduction of promising new drugs, and a shift from reducing the statistical number of patients to a new target for disability prevention.

  19. A Case of Fluoroquinolone-Resistant Leprosy Discovered after 9 Years of Misdiagnosis

    Directory of Open Access Journals (Sweden)

    Onivola Raharolahy

    2016-01-01

    Full Text Available We report a case of misdiagnosed leprosy in a 21-year-old Malagasy male, who, improperly treated, developed secondary mycobacterial resistance to fluoroquinolone. The patient contracted the infection 9 years prior to the current consultation, displaying on the right thigh a single papulonodular lesion, which progressively spread to the lower leg, back, and face. Initial administration of ciprofloxacin and prednisolone led to temporary and fluctuating improvement. Subsequent long-term self-medication with ciprofloxacin and corticosteroid did not heal the foul and nonhealing ulcers on the legs and under the right sole. Histopathological findings were compatible with lepromatous leprosy. Skin biopsy was positive for acid-fast bacilli and PCR assay confirmed the presence of a fluoroquinolone-resistant strain of Mycobacterium leprae (gyrA A91V. After 6 months of standard regimen with rifampicin, clofazimine, and dapsone, clinical outcome significantly improved. Clinical characteristics and possible epidemiological implications are discussed.

  20. [Chaulmoogra oil as scientific knowledge: the construction of a treatment for leprosy].

    Science.gov (United States)

    dos Santos, Fernando Sergio Dumas; de Souza, Letícia Pumar Alves; Siani, Antonio Carlos

    2008-01-01

    The article investigates how knowledge of medicinal plants and related treatment practices are assimilated and transformed. Taking as its focus the use of chaulmoogra oil to treat leprosy, it examines how information on this plant was incorporated and transformed into scientifically validated knowledge when 'Brazilian chaulmoogra' came onto the scene. Pointing to the addition of chaulmoogra byproducts to the Instituto Oswaldo Cruz's production agenda in the 1920s, the study establishes links between productive processes and relates these to the period's scientific context. From the late nineteenth century until the 1940s, chaulmoogra oil was the great hope in efforts to cure leprosy. During this period, chaulmoogric treatment earned a place as scientific knowledge thanks to research studies conducted in laboratories throughout the Western world.