02657nas a2200385   4500000000100000008004100001260001300042653001000055653001100065653002200076653002600098653001100124653001400135653002500149653002500174653002500199653000900224653001400233653001500247653001700262653001700279100001400296700001500310700002100325700001300346700001500359700001500374700001600389245008900405856004100494300001200535490000700547520170300554022001402257       1993                            d  c1993 Jun10aAdult10aFemale10aFollow-Up Studies10aHistory, 20th Century10aHumans10aIncidence10aLeprosy, lepromatous10aLeprosy, Tuberculoid10aLongitudinal studies10aMale10aPolynesia10aRegistries10aRisk Factors10aTuberculosis1 aGlaziou P1 aCartel J L1 aMoulia-Pelat J P1 aNgoc L N1 aChanteau S1 aPlichart R1 aGrosset J H00aTuberculosis in leprosy patients detected between 1902 and 1991 in French Polynesia.  uhttp://ila.ilsl.br/pdfs/v61n2a03.pdf  a199-2040 v613 a<p>From 1902 onward, notification and follow up of leprosy patients has been systematic in French Polynesia. Since 1960, a tuberculosis control program and a register has also been implemented. From 1902 to 1959, 673 cases of leprosy were detected [346 multibacillary (MB), 138 paucibacillary (PB), and 179 unclassified due to the loss of medical files by the time of classification which was done during the 1980s]. Of these 673 cases, 89 (13.2%) died from tuberculosis, giving a mean annual death rate of tuberculosis in leprosy patients of 232 per 100,000. Mortality from tuberculosis in leprosy patients detected between 1901 and 1930 was 20.7%, and decreased to 8.04% in patients detected from 1931 to 1959. In total, it was estimated that 26.4% of the leprosy cases had developed tuberculosis. From 1960 to 1991, 350 new cases of leprosy were detected (141 MB, 209 PB). Of them, 12 (3.4%) developed tuberculosis (7 before detection of leprosy, 5 after detection of leprosy). The dramatic decrease of the proportion of leprosy patients who developed tuberculosis between the periods 1902-1959 (26.4%) and 1960-1991 (3.4%) might be related to the important decline of the tuberculosis situation since 1960. From 1902 to 1959, mortality from tuberculosis occurred significantly more frequently in MB patients (13%) than in PB patients [4%, relative risk (RR) = 3.21, p = 0.003]. From 1960 to 1991, the incidence of tuberculosis seemed more frequent in MB patients (RR = 2.96, p = 0.07) whatever the sequence of detection of the two diseases. Our study suggests that lepromatous patients could share factors of susceptibility to mycobacterial diseases with patients developing tuberculosis.</p>
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