03111nas a2200325   4500000000100000008004100001653001200042653002200054653002000076653001100096100001600107700001100123700001300134700001800147700001500165700001500180700001300195700001500208700001700223700001400240700001400254700001400268700001300282245010100295856009800396300001300494490000700507520225700514022001402771       2019                            d10aleprosy10aRural communities10aWild armadillos10aBrazil1 aStefani MMA1 aRosa P1 aCosta MB1 aSchetinni APM1 aManhães I1 aPontes MAA1 aCosta PS1 aFachin LRV1 aBatista IMFD1 aVirmond M1 aPereira E1 aPenna MLF1 aPenna GO00aLeprosy survey among rural communities and wild armadillos from Amazonas state, Northern Brazil.  uhttps://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0209491&type=printable  ae02094910 v143 a<p>There is evidence that in southern US, leprosy is a zoonosis infecting wild Dasypus novemcinctus armadillos but the extent of this finding is unknown. This ecological study investigated leprosy in rural communities and in wild armadillos from the Brazilian Amazon. The study area was the Mamiá Lake of Coari municipality, Amazonas State, Northern region, a hyper endemic leprosy area where residents live on subsistence farming, fishing and armadillo hunting and its meat intake are frequent. The leprosy survey was conducted in sixteen communities by a visiting team of specialists. Local partakers provided wild armadillos to investigate M. leprae infection. Volunteers had complete dermato-neurological examination by a dermatologist with expertise in leprosy diagnosis, suspect skin lesions were biopsied for histopathology (Hematoxylin-eosin/HE, Fite-Faraco/FF staining); slit skin smears were collected. Armadillos' tissue fragments (skins, spleens, livers, lymph nodes, adrenal glands, others) were prepared for histopathology (HE/FF) and for M. leprae repetitive element-RLEP-qPCR. Among 176 volunteers, six new indeterminate leprosy cases were identified (incidence = 3.4%). Suspect skin sections and slit skin smears were negative for bacilli. Twelve wild D. novemcinctus were investigated (48 specimens/96 slides) and histopathological features of M. leprae infection were not found, except for one skin presenting unspecific inflammatory infiltrate suggestive of indeterminate leprosy. Possible traumatic neuroma, granuloma with epithelioid and Langhans cells, foreign-body granuloma were also identified. Granulomatous/non-granulomatous dermatitides were periodic-acid-Schiff/PAS negative for fungus. M. leprae-RLEP-qPCR was negative in all armadillos' tissues; no bacillus was found in histopathology. Our survey in rural communities confirmed the high endemicity for leprosy while one armadillo was compatible with paucibacillary M. leprae infection. At least in the highly endemic rural area of Coari, in the Brazilian Amazon region where infectious sources from untreated multibacillary leprosy are abundant, M. leprae infected armadillos may not represent a major source of infection nor a significant public health concern.</p>
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