Pesquisa de hanseníase em doadores de sangue

Abstract

Hansen’s disease (HD) is an infectious disease with active transmission in endemic areas such as Brazil, which accounted for over 90% of the new HD in the Americas in 2021, and the second highest in the global scale. Clinically is characterized by the appearance of nerve or skin lesions with altered sensitivity, that in advanced cases, can cause deformities and physical disabilities. Its transmission occurs mainly through Mycobacterium leprae, through respiratory droplets of sick people, and has a prolonged incubation period. The diagnosis of leprosy is clinical, with multidrug treatment PQT (polychemotherapy) being crucial to avoid the chain of disease transmission. Suspected cases should be attended by a qualified professional in basic health units or active case finding campaigns. Although leprosy patient is considered definitively unfit for blood donation process, according to Consolidation regulation nº 5, of October 3, 2017, leprosy investigation occurs only through a clinical interview, without laboratory evaluation. At Hemocenter from Pará, 500 donors were selected for the study and blood was collected for serological investigation of anti-PGL-I antibodies. Of the selected donors, 4% (20/500) had positive serological results greater than or equal to 0,750 optical density among only eight agreed to be clinically examined and underwent other laboratory tests: bacilloscopy and qPCR. Among donors with clinical evaluation, more than half were diagnosed with leprosy, 62.5% (5/8), with the following cases: one individual with the primarily neural clinical form, three with borderline-tuberculoid, one lepromatous. of peripheral blood, the presence of the bacillus in two individuals was confirmed, suggesting a possible route of transmission of the disease. We emphasize that the prevalence of subclinical leprosy infection due to its etiological agent among the study population is very high, but compatible with the hidden prevalence already recorded in the state of Pará.