01986nas a2200181   4500000000100000008004100001100001300042700001200055700001500067700001200082700001600094245014400110856008700254300001300341490000700354520142900361022001401790       2016                            d1 aPenna ML1 aPenna G1 aIglesias P1 aNatal S1 aRodrigues L00aAnti-PGL-1 Positivity as a Risk Marker for the Development of Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis.  uhttp://journals.plos.org/plosntds/article?id=info:doi/10.1371/journal.pntd.0004703  ae00047030 v103 a<p><strong>BACKGROUND: </strong>There is no point of care diagnostic test for infection with M. Leprae or for leprosy, although ELISA anti PGL-1 has been considered and sometimes used as a means to identify infection.</p>

<p><strong>METHODS: </strong>A systematic review of all cohort studies, which classified healthy leprosy contacts, at entry, according to anti-PGL1 positivity, and had at least one year follow up. The outcome was clinical diagnosis of leprosy by an experienced physician. The meta-analysis used a fixed model to estimated OR for the association of PGL-1 positivity and clinical leprosy. A fixed model also estimated the sensibility of PGL-1 positivity and positive predictive value.</p>

<p><strong>RESULTS: </strong>Contacts who were anti PGL-1 positive at baseline were 3 times as likely to develop leprosy; the proportion of cases of leprosy that were PGL-1 positive at baseline varied but was always under 50%.</p>

<p><strong>CONCLUSIONS: </strong>Although there is a clear and consistent association between positivity to anti PGL-1 and development of leprosy in healthy contacts, selection of contacts for prophylaxis based on anti PGL1 response would miss more than half future leprosy cases. Should chemoprophylaxis of controls be incorporated into leprosy control programmes, PGL1 appears not to be a useful test in the decision of which contacts should receive chemoprophylaxis.</p>
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