NI ERRADICADA, NI OLVIDADA: LEPRA, UNA ENFERMEDAD TROPICAL ABANDONADA, PERO VIGENTE

Mónica Pachar-Flores; Jacqueline Levy

Enviado octubre 30, 2024

Publicado 2026-02-02

Artículos de Investigación

Vol. 34 Núm. 2 (2021): Revista Médico Científica

NI ERRADICADA, NI OLVIDADA: LEPRA, UNA ENFERMEDAD TROPICAL ABANDONADA, PERO VIGENTE

Mónica Pachar-Flores⁺⁻
Jacqueline Levy⁺⁻

PDF

Citación:

DOI: ND

Publicado: 2026-02-02

Derechos de autor 2024 Revista médico científica

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Resumen

RESUMEN:

La lepra es una enfermedad crónica granulomatosa causada por M. leprae y M. lepromatosis, que afecta la piel y los nervios periféricos. Además de los humanos, también infecta al Dasypus novemcinctus (armadillo de nueve bandas) y a otros mamíferos, resaltando su potencial zoonótico y su relación antroponótica.

Es una enfermedad tropical desatendida que afecta a millones de personas en el mundo y de la que aún existen reportes de casos en Panamá. Su erradicación no ha sido posible a pesar de las campañas internacionales de eliminación. Además, aún persisten interrogantes sobre la dinámica de transmisión y el rol de los reservorios naturales en la persistencia de esta enfermedad.

Se ha avanzado poco en técnicas y enfoques diagnósticos; el tratamiento consiste en poliquimioterapia con varios antibióticos que actúan en distintos niveles del Mycobacterium. Aunque se han mejorado los esquemas de tratamiento, la tasa de curación no alcanza el 100% y existen reportes sobre la aparición de resistencia antimicrobiana ante ciertos componentes de estos esquemas.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

BIBLIOGRAFÍA:
Ryan E, Hill D, Solomon T, Aronson N. Endy T. Hunter's Tropical Medicine and Emerging Infectious Diseases. 10th.
ed. USA: Elsevier; 2020.
Leprosy [Internet]. World Health Organization. 2019 [citado 14 marzo 2020]. Disponible en:
https://www.who.int/news-room/fact-sheets/detail/leprosy
Singh P, Benjak A, Schuenemann V, Herbig A, Avanzi C, Busso P, et al. Insight into the evolution and origin of
leprosy bacilli from the genome sequence of Mycobacterium lepromatosis. Proc. Natl. Acad. Sci. U. S. A. 2015;112(14):4459–4464.
Microbiology of M. leprae [Internet]. Leprosy elimination program. World Health Organization. [citado el 14 de marzo 2020] Disponible en: https://www.who.int/lep/microbiology/en/
Scollard D, Adams L, Guillis T, Krahenbuhl J, Truman R, Williams D. The Continuing Challenges of Leprosy. Clin Microbiol Rev. 2006;19(2):338–381.
Ng V, Zanazzi G, Timpl R, Talts J, Salzer J, Brennan B, et al. Role of the cell wall phenolic glycolipid-1 in the peripheral nerve predilection of Mycobacterium leprae. Cell. 2000;103:511–524.
Sandord C, Pottinger P, Jong E. Leprosy en: The Travel and Tropical Medicine Manual. 5.ª ed. Oxford: Elsevier; 2016.
Cole S, Eiglmeier K, Parkhill J, James K, Thomson J, Wheeler P, et al. Massive gene decay in the leprosy bacillus. Nature. 2001; 409(6823):1007–1011.
9. Truman R, Sharma R, Pena M, Stryjewska B, Figarola J, Scollard D. Mycobacterium leprae, the cause of leprosy. Microbiol Today. [Internet] 2014 [citado 14 marzo 2020]. Disponible en: https://microbiologysociety.org/publication/past-issues/mycobacteria/article/mycobacterium-leprae-the-cause-of-leprosy.html
Santos A, Suffys P, Vanderborght P, Moraes M, Vieira L, Cabello P, et al. Role of tumor necrosis factor-alpha and
interleukin-10 promoter gene polymorphisms in leprosy. J Infect Dis. 2002;186(11):1687-91.
Mira M, Alcaïs A, Van Thuc N, Moraes M, Di Flumeri C, Hong V, et al. Susceptibility to leprosy is associated with PARK2 and PACRG. Nature. 2004;427:636–640.
Marne R, Prakash C. Leprosy: An Overview of Pathophysiology. Interdiscip Perspect Infect Dis. 2012; 2012:1-6
Shepard C. Acid-fast bacilli in nasal excretions in leprosy, and results of inoculation of mice. Am J Epidemiol. 1960;71 (2):147–157.
Domozych R, Kim E, Hart S, Greenwald J. Increasing incidence of leprosy and transmission from armadillos in Central Florida: A case series. J. Am. Acad. Dermatol. 2016;2(3):189–192.
Da Silva M, Portela J, Li W, Jackson M, Gonzalez-Juarrero M, Hidalgo A, et al. Evidence of zoonotic leprosy in Pará, Brazilian Amazon, and risks associated with human contact or consumption of armadillos. PLOS Negl Trop Dis. 2018;12(6):e0006532.
Ploemacher T, Faber W, Menke H, Rutten V, Pieters T Reservoirs and transmission routes of leprosy; A systematic review. PLoS Negl Trop Dis. 2020;14(4): e0008276.
Aslam S, Peraza J, Mekaiel A, Castro M, Casanas B. Major risk factors for leprosy in a non-endemic area of the United States: A case series. IDCases. 2019;17:e00557.
Moreira I, Moreno E, Sotolongo A, Rivera A, Carballea Y. Enfoque de los factores de riesgo de la lepra con las determinantes sociales de la salud. Rev Cubana Hig Epidemiol. 2014;52(1):4-14.
Kerr-Pontes L, Barreto M, Evangelista C, Rodrigues L, Heukelbach J, Feldmeier H. Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case–control study. Int. J. Epidemiol. 2006;35(4):994–1000.
Smith W, van Brakel W, Gillis T, Saunderson P, Richardus J. The Missing Millions: A Threat to the Elimination of Leprosy. PLoS Negl Trop Dis. 2015;9(4): e0003658.
Normas de Vigilancia epidemiológica de la Lepra en Panamá [internet]. Ministerio de Salud de Panamá. 2017 [citado el 10 de mayo 2020]. Disponible en: http://www.minsa.gob.pa/sites/default/files/publicacion-general/normas_de_vigilancia_de_lepra.pdf
Harley R. Ocular leprosy in Panama, a study of 150 cases. Am J Ophthalmol.1946;29(3):295-316.
Neglected Tropical diseases data: Leprosy [internet]. World Health Organization. 2019 [Citado el 10 de mayo 2020]. Disponible en: https://apps.who.int/neglected_diseases/ntddata/leprosy/leprosy.html
Van Hoang M, Van Bui D, Phung T. Clinical Characteristics and Treatment of Leprosy. Curr Trop Med Rep. 2016;3(4):138–143.
Vargas-Ocampo F. Diffuse leprosy of Lucio and Latapí: a histologic study. Lepr Rev.2007;78(3):248–260.
Guía para el abordaje integral de los pacientes con lepra.[Internet] Ministerio de Salud de Panamá. 2019.
[Accesado el 19 de mayo 2020] Disponible en: http://gacetas.procuraduria-admon.gob.pa/28786_2019.pdf
Penna M, Penna G, Iglesias P, Natal S, Rodrigues L. Anti-PGL-1 Positivity as a Risk Marker for the Development of
Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis. PLoS Negl Trop Dis. 2016;10(5): e0004703.
Cardoso L, Boamorte D, Aparecida E, Cândido A, Benevides S. Leprosy: prevalence and factors associated with seropositivity for anti-NDO-LID antibodies in children under 15 years of age. An Bras Dermatol. 2019;94(4):405-10.
Jian L, Xiujian S, Yuangang Y, Yan X, Lianchao Y, Duthie M, et al. Evaluation of antibody detection against the NDO-BSA, LID-1 and NDO-LID antigens as confirmatory tests to support the diagnosis of leprosy in Yunnan province,
southwest China. Trans. R. Soc. Trop. Med. Hyg. 2020;114(3):193–199.
Espinosa O, Benevides S, Longhi F, Boamorte D, Ignotti E. Accuracy of Enzyme-Linked Immunosorbent Assays
(ELISAs) in Detecting Antibodies against Mycobacterium leprae in Leprosy Patients: A Systematic Review and Meta-Analysis. Can J Infect Dis Med Microbiol. 2018. 2018:1-11
Manta F, Barbieri R, Moreira S, Santos P, Nery J, Duppre N. Quantitative PCR for leprosy diagnosis and monitoring in household contacts: A follow-up study, 2011–2018. Sci Rep. 2019;9:1-8.
Botero-Jaramillo, N, Padilla-Pinzón LT, Beltrán-Serrano MA, Ossa-Trujillo RH. Tratamiento de la enfermedad de Hansen en Colombia: medicalización y control de la enfermedad a lo largo del siglo XX. Rev. Fac. Nac. Salud
Pública. 2017;35(3): 358-368.
Eichelman K, González-González S, Salas-Alanis JC, Ocampo-Candiani J. Lepra: puesta al día. Definición, patogénesis, clasificación, diagnóstico y tratamiento. Actas Dermosifiliogr. 2013;104(7):554-563.
Lazo-Porras M, Prutsky G, Barrionuevo P, Tapia C, Ugarte-Gil C, et al. World Health Organization (WHO) antibiotic
regimen against other regimens for the treatment of leprosy: a systematic review and meta-analysis. BMC Infect Dis. 2020;20:1-14
Prakash N, Lavania M, Singh I, Nashi S, Preethish V, Vengalil S. Evidence for Mycobacterium leprae Drug Resistance in a Large Cohort of Leprous Neuropathy Patients from India. Am J Trop Med Hyg. 2020;102(3):547-552.
Ponnaiya J, Chaitanya D, Ebenezer A. Evaluation of anti-bacterial activity of Rifapentine, Clarithromycin, Minocycline, Moxifloxacin, Ofloxacin and their combinations in Murine Model of Rifampicin Resistant Leprosy. Indian J Lepr. 2016;88(3):147-58.
Cambau E, Perani E, Guillemin I, Jamet P, Ji B. Multidrug resistance to dapsone, rifampicin, and ofloxacin in Mycobacterium leprae. Lancet. 1997;349(9045):103-4.
Leprosy. En: Jacson M, Kimberlin D, Long S, Brady M. Red Book Informe 2015 del Comite sobre Enfermedades Infecciosas. 30 ed. United States: American Academy of Pediatrics; 2015. P. 506-510.
Chemotherapy of leprosy: report of a WHO study group [meeting held in Geneva from 1 to 5 November 1993]
[Internet]. 1994. World Health Organization. [Citado el 5 de abril 2020]. Disponible en: https://apps.who.int/iris/handle/10665/39877
Vieira J, Riveira J, Martins A, da Silva J, Salgado C. Methemoglobinemia and dapsone levels in patients with leprosy. Braz J Infect Dis. 2010;14:319-21.
Ji B, Jamet P, Perani E, Bobin P, Grosset J. Powerful bactericidal activities of clarithromycin and minocycline
against Mycobacterium leprae in lepromatous leprosy. J Infect Dis. 1993;168(1):188-90.
Ji B, Perani E, Petinom C, N'Deli L, Grosset J. Clinical trial of ofloxacin alone and in combination with dapsone plus clofazimine for treatment of lepromatous leprosy. Antimicrob Agents Chemother. 1994;38(4):662-667.
Gelber R, Fukuda K, Byrd S, Murray L, Siu P, Tsang M, et al. A clinical trial of minocycline in lepromatous leprosy. BMJ. 1992;304(6819):91-92.
Demet N, Akkus A, Kaynak E. An Update on the Epidemiology, Diagnosis and Treatment of Leprosy. En: Ribòn W. Hansen's Disease - The Forgotten and Neglected. [Internet] London: IntechOpen. 2019. Disponible en: https://www.intechopen.com/books/hansen-s-disease-the-forgotten-and-neglected-disease/an-update-on-the-
epidemiology-diagnosis-and-treatment-of-leprosy
Nunzi E, Massone C.Treatment and Prophylaxis. Leprosy: a practical guide. London: Springer. 2012.
WHO Expert Committee on leprosy: eighth report [Internet]. 2012 [Citado el 12 de abril 2020]. World Health
Organization. Disponible en: https://apps.who.int/iris/handle/10665/75151
Hoyos-Gómez C, Cardona-Castro N. Reacciones leprosas. Rev CES Med. 2016;30(2):200-209.
Franco-Paredes C, Jacob JT, Stryjewska B, Yoder L. Two Patients with Leprosy and the Sudden Appearance of
Inflammation in the Skin and New Sensory Loss. PLoS Negl Trop Dis. 2009;3(9):e425.
Programa nacional de detección y control de la enfermedad de Hansen [Internet]. Ministerio de Salud de
Panamá. 2002. [Citado el 10 de mayo 2020] Disponible en: https://pesquisa.bvsalud.org/portal/resource/es/lil-
Richardus J, Nicholls P, Croft R, Withington S, Smith W. Incidence of acute nerve function impairment and
reactions in leprosy: a prospective cohort analysis after 5 years of follow-up. Int J Epidemiol. 2004;33(2):337-43.
Setia M, Steinmaus C, Ho C, Rutherford G. The role of BCG in prevention of leprosy: a meta-analysis. Lancet Infect Dis. 2006;6(3):162?170.
Duthie M, Pena M, Ebenezer G, Gillis T, Sharma R, Cunningham K, et al. LepVax, a defined subunit vaccine that provides effective pre-exposure and post-exposure prophylaxis of M. leprae infection. PCJ Vaccines. 2018;3:1-
Rao P. Global leprosy strategy 2016-2020: Issues and concerns. Indian J Dermatol Venereol Leprol. 2017;83:4-6
Global Leprosy Strategy 2016-2020: Accelerating Towards a Leprosy-free World [Internet]. WHO. 2016 [Citado el 15 de mayo 2020] Disponible en: https://apps.who.int/iris/bitstream/handle/10665/208824/9789290225096_en.pdf

Palabras clave

PDF

Resumen visto - 16 veces
PDF descargado - 1

Licencia

Content Top

[1] BIBLIOGRAFÍA:

[2] Ryan E, Hill D, Solomon T, Aronson N. Endy T. Hunter's Tropical Medicine and Emerging Infectious Diseases. 10th.

[3] ed. USA: Elsevier; 2020.

[4] Leprosy [Internet]. World Health Organization. 2019 [citado 14 marzo 2020]. Disponible en:

[5] https://www.who.int/news-room/fact-sheets/detail/leprosy

[6] Singh P, Benjak A, Schuenemann V, Herbig A, Avanzi C, Busso P, et al. Insight into the evolution and origin of

[7] leprosy bacilli from the genome sequence of Mycobacterium lepromatosis. Proc. Natl. Acad. Sci. U. S. A. 2015;112(14):4459–4464.

[8] Microbiology of M. leprae [Internet]. Leprosy elimination program. World Health Organization. [citado el 14 de marzo 2020] Disponible en: https://www.who.int/lep/microbiology/en/

[9] Scollard D, Adams L, Guillis T, Krahenbuhl J, Truman R, Williams D. The Continuing Challenges of Leprosy. Clin Microbiol Rev. 2006;19(2):338–381.

[10] Ng V, Zanazzi G, Timpl R, Talts J, Salzer J, Brennan B, et al. Role of the cell wall phenolic glycolipid-1 in the peripheral nerve predilection of Mycobacterium leprae. Cell. 2000;103:511–524.

[11] Sandord C, Pottinger P, Jong E. Leprosy en: The Travel and Tropical Medicine Manual. 5.ª ed. Oxford: Elsevier; 2016.

[12] Cole S, Eiglmeier K, Parkhill J, James K, Thomson J, Wheeler P, et al. Massive gene decay in the leprosy bacillus. Nature. 2001; 409(6823):1007–1011.

[13] 9. Truman R, Sharma R, Pena M, Stryjewska B, Figarola J, Scollard D. Mycobacterium leprae, the cause of leprosy. Microbiol Today. [Internet] 2014 [citado 14 marzo 2020]. Disponible en: https://microbiologysociety.org/publication/past-issues/mycobacteria/article/mycobacterium-leprae-the-cause-of-leprosy.html

[14] Santos A, Suffys P, Vanderborght P, Moraes M, Vieira L, Cabello P, et al. Role of tumor necrosis factor-alpha and

[15] interleukin-10 promoter gene polymorphisms in leprosy. J Infect Dis. 2002;186(11):1687-91.

[16] Mira M, Alcaïs A, Van Thuc N, Moraes M, Di Flumeri C, Hong V, et al. Susceptibility to leprosy is associated with PARK2 and PACRG. Nature. 2004;427:636–640.

[17] Marne R, Prakash C. Leprosy: An Overview of Pathophysiology. Interdiscip Perspect Infect Dis. 2012; 2012:1-6

[18] Shepard C. Acid-fast bacilli in nasal excretions in leprosy, and results of inoculation of mice. Am J Epidemiol. 1960;71 (2):147–157.

[19] Domozych R, Kim E, Hart S, Greenwald J. Increasing incidence of leprosy and transmission from armadillos in Central Florida: A case series. J. Am. Acad. Dermatol. 2016;2(3):189–192.

[20] Da Silva M, Portela J, Li W, Jackson M, Gonzalez-Juarrero M, Hidalgo A, et al. Evidence of zoonotic leprosy in Pará, Brazilian Amazon, and risks associated with human contact or consumption of armadillos. PLOS Negl Trop Dis. 2018;12(6):e0006532.

[21] Ploemacher T, Faber W, Menke H, Rutten V, Pieters T Reservoirs and transmission routes of leprosy; A systematic review. PLoS Negl Trop Dis. 2020;14(4): e0008276.

[22] Aslam S, Peraza J, Mekaiel A, Castro M, Casanas B. Major risk factors for leprosy in a non-endemic area of the United States: A case series. IDCases. 2019;17:e00557.

[23] Moreira I, Moreno E, Sotolongo A, Rivera A, Carballea Y. Enfoque de los factores de riesgo de la lepra con las determinantes sociales de la salud. Rev Cubana Hig Epidemiol. 2014;52(1):4-14.

[24] Kerr-Pontes L, Barreto M, Evangelista C, Rodrigues L, Heukelbach J, Feldmeier H. Socioeconomic, environmental, and behavioural risk factors for leprosy in North-east Brazil: results of a case–control study. Int. J. Epidemiol. 2006;35(4):994–1000.

[25] Smith W, van Brakel W, Gillis T, Saunderson P, Richardus J. The Missing Millions: A Threat to the Elimination of Leprosy. PLoS Negl Trop Dis. 2015;9(4): e0003658.

[26] Normas de Vigilancia epidemiológica de la Lepra en Panamá [internet]. Ministerio de Salud de Panamá. 2017 [citado el 10 de mayo 2020]. Disponible en: http://www.minsa.gob.pa/sites/default/files/publicacion-general/normas_de_vigilancia_de_lepra.pdf

[27] Harley R. Ocular leprosy in Panama, a study of 150 cases. Am J Ophthalmol.1946;29(3):295-316.

[28] Neglected Tropical diseases data: Leprosy [internet]. World Health Organization. 2019 [Citado el 10 de mayo 2020]. Disponible en: https://apps.who.int/neglected_diseases/ntddata/leprosy/leprosy.html

[29] Van Hoang M, Van Bui D, Phung T. Clinical Characteristics and Treatment of Leprosy. Curr Trop Med Rep. 2016;3(4):138–143.

[30] Vargas-Ocampo F. Diffuse leprosy of Lucio and Latapí: a histologic study. Lepr Rev.2007;78(3):248–260.

[31] Guía para el abordaje integral de los pacientes con lepra.[Internet] Ministerio de Salud de Panamá. 2019.

[32] [Accesado el 19 de mayo 2020] Disponible en: http://gacetas.procuraduria-admon.gob.pa/28786_2019.pdf

[33] Penna M, Penna G, Iglesias P, Natal S, Rodrigues L. Anti-PGL-1 Positivity as a Risk Marker for the Development of

[34] Leprosy among Contacts of Leprosy Cases: Systematic Review and Meta-analysis. PLoS Negl Trop Dis. 2016;10(5): e0004703.

[35] Cardoso L, Boamorte D, Aparecida E, Cândido A, Benevides S. Leprosy: prevalence and factors associated with seropositivity for anti-NDO-LID antibodies in children under 15 years of age. An Bras Dermatol. 2019;94(4):405-10.

[36] Jian L, Xiujian S, Yuangang Y, Yan X, Lianchao Y, Duthie M, et al. Evaluation of antibody detection against the NDO-BSA, LID-1 and NDO-LID antigens as confirmatory tests to support the diagnosis of leprosy in Yunnan province,

[37] southwest China. Trans. R. Soc. Trop. Med. Hyg. 2020;114(3):193–199.

[38] Espinosa O, Benevides S, Longhi F, Boamorte D, Ignotti E. Accuracy of Enzyme-Linked Immunosorbent Assays

[39] (ELISAs) in Detecting Antibodies against Mycobacterium leprae in Leprosy Patients: A Systematic Review and Meta-Analysis. Can J Infect Dis Med Microbiol. 2018. 2018:1-11

[40] Manta F, Barbieri R, Moreira S, Santos P, Nery J, Duppre N. Quantitative PCR for leprosy diagnosis and monitoring in household contacts: A follow-up study, 2011–2018. Sci Rep. 2019;9:1-8.

[41] Botero-Jaramillo, N, Padilla-Pinzón LT, Beltrán-Serrano MA, Ossa-Trujillo RH. Tratamiento de la enfermedad de Hansen en Colombia: medicalización y control de la enfermedad a lo largo del siglo XX. Rev. Fac. Nac. Salud

[42] Pública. 2017;35(3): 358-368.

[43] Eichelman K, González-González S, Salas-Alanis JC, Ocampo-Candiani J. Lepra: puesta al día. Definición, patogénesis, clasificación, diagnóstico y tratamiento. Actas Dermosifiliogr. 2013;104(7):554-563.

[44] Lazo-Porras M, Prutsky G, Barrionuevo P, Tapia C, Ugarte-Gil C, et al. World Health Organization (WHO) antibiotic

[45] regimen against other regimens for the treatment of leprosy: a systematic review and meta-analysis. BMC Infect Dis. 2020;20:1-14

[46] Prakash N, Lavania M, Singh I, Nashi S, Preethish V, Vengalil S. Evidence for Mycobacterium leprae Drug Resistance in a Large Cohort of Leprous Neuropathy Patients from India. Am J Trop Med Hyg. 2020;102(3):547-552.

[47] Ponnaiya J, Chaitanya D, Ebenezer A. Evaluation of anti-bacterial activity of Rifapentine, Clarithromycin, Minocycline, Moxifloxacin, Ofloxacin and their combinations in Murine Model of Rifampicin Resistant Leprosy. Indian J Lepr. 2016;88(3):147-58.

[48] Cambau E, Perani E, Guillemin I, Jamet P, Ji B. Multidrug resistance to dapsone, rifampicin, and ofloxacin in Mycobacterium leprae. Lancet. 1997;349(9045):103-4.

[49] Leprosy. En: Jacson M, Kimberlin D, Long S, Brady M. Red Book Informe 2015 del Comite sobre Enfermedades Infecciosas. 30 ed. United States: American Academy of Pediatrics; 2015. P. 506-510.

[50] Chemotherapy of leprosy: report of a WHO study group [meeting held in Geneva from 1 to 5 November 1993]

[51] [Internet]. 1994. World Health Organization. [Citado el 5 de abril 2020]. Disponible en: https://apps.who.int/iris/handle/10665/39877

[52] Vieira J, Riveira J, Martins A, da Silva J, Salgado C. Methemoglobinemia and dapsone levels in patients with leprosy. Braz J Infect Dis. 2010;14:319-21.

[53] Ji B, Jamet P, Perani E, Bobin P, Grosset J. Powerful bactericidal activities of clarithromycin and minocycline

[54] against Mycobacterium leprae in lepromatous leprosy. J Infect Dis. 1993;168(1):188-90.

[55] Ji B, Perani E, Petinom C, N'Deli L, Grosset J. Clinical trial of ofloxacin alone and in combination with dapsone plus clofazimine for treatment of lepromatous leprosy. Antimicrob Agents Chemother. 1994;38(4):662-667.

[56] Gelber R, Fukuda K, Byrd S, Murray L, Siu P, Tsang M, et al. A clinical trial of minocycline in lepromatous leprosy. BMJ. 1992;304(6819):91-92.

[57] Demet N, Akkus A, Kaynak E. An Update on the Epidemiology, Diagnosis and Treatment of Leprosy. En: Ribòn W. Hansen's Disease - The Forgotten and Neglected. [Internet] London: IntechOpen. 2019. Disponible en: https://www.intechopen.com/books/hansen-s-disease-the-forgotten-and-neglected-disease/an-update-on-the-

[58] epidemiology-diagnosis-and-treatment-of-leprosy

[59] Nunzi E, Massone C.Treatment and Prophylaxis. Leprosy: a practical guide. London: Springer. 2012.

[60] WHO Expert Committee on leprosy: eighth report [Internet]. 2012 [Citado el 12 de abril 2020]. World Health

[61] Organization. Disponible en: https://apps.who.int/iris/handle/10665/75151

[62] Hoyos-Gómez C, Cardona-Castro N. Reacciones leprosas. Rev CES Med. 2016;30(2):200-209.

[63] Franco-Paredes C, Jacob JT, Stryjewska B, Yoder L. Two Patients with Leprosy and the Sudden Appearance of

[64] Inflammation in the Skin and New Sensory Loss. PLoS Negl Trop Dis. 2009;3(9):e425.

[65] Programa nacional de detección y control de la enfermedad de Hansen [Internet]. Ministerio de Salud de

[66] Panamá. 2002. [Citado el 10 de mayo 2020] Disponible en: https://pesquisa.bvsalud.org/portal/resource/es/lil-

[67] Richardus J, Nicholls P, Croft R, Withington S, Smith W. Incidence of acute nerve function impairment and

[68] reactions in leprosy: a prospective cohort analysis after 5 years of follow-up. Int J Epidemiol. 2004;33(2):337-43.

[69] Setia M, Steinmaus C, Ho C, Rutherford G. The role of BCG in prevention of leprosy: a meta-analysis. Lancet Infect Dis. 2006;6(3):162?170.

[70] Duthie M, Pena M, Ebenezer G, Gillis T, Sharma R, Cunningham K, et al. LepVax, a defined subunit vaccine that provides effective pre-exposure and post-exposure prophylaxis of M. leprae infection. PCJ Vaccines. 2018;3:1-

[71] Rao P. Global leprosy strategy 2016-2020: Issues and concerns. Indian J Dermatol Venereol Leprol. 2017;83:4-6

[72] Global Leprosy Strategy 2016-2020: Accelerating Towards a Leprosy-free World [Internet]. WHO. 2016 [Citado el 15 de mayo 2020] Disponible en: https://apps.who.int/iris/bitstream/handle/10665/208824/9789290225096_en.pdf

Imagen de portada

Resumen

Descargas

Citas

Palabras clave

Licencia