Estudo da diversidade genética do MycobacteriUm leprae em pacientes com hanseníase no município de Rondonópolis (MT): uma contribuição para o melhor entendimento da sua transmissão

• Ano de defesa: 2013
• Autor(a) principal: Lamano, Leticia Rossignolli de [UNESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual Paulista (Unesp)
• Palavras-chave em Português: Mycobacterium leprae; Hanseniase - Epidemiologia; Epidemiologia molecular - Pesquisa; Saúde pública
• Link de acesso: http://hdl.handle.net/11449/131993; http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/06-10-2015/000850658.pdf

The municipality of Rondonópolis, in Mato Grosso is highly endemic for leprosy despite the existence of qualified services for diagnosis and monitoring of cases and the implementation of multidrug therapy. To address this paradox, a comprehensive molecular epidemiology study was initiated. Structured questionnaires including clinical, residential, demographic, and occupational details and skin samples for diagnosis and laboratory tests were collected for 260 patients diagnosed during the period of 2007-2010. Genotypes of Mycobacterium leprae were determined using STR analysis and SNP typing using DNA extracts from skin biopsies taken before starting treatment. GoogleMaps was used to localize patients. The patients ranging in age from 11 to 90 years included 137 males and 123 females. According to the classification of Ridley & Jopling observed a predominance of forms TT (39%) and BT (33%), followed by BB (19%), BL (5%), LL (3%) and I (1%). The city is primarily urban with 200,000 inhabitants and the patients could be assigned to 106 smaller units (villages). Neighborhoods of high endemicity encompassing adjoining villages could be detected. Of the 260 biopsy DNA samples analyzed across 17 STR loci, 15 loci were polymorphic (2-23 alleles), while the loci 6-3a and 21-3 were not. When we analyzed the genotypes of the SNP we observed that 77% (n = 200) were genotype 3: 16% (n = 41) genotype 4, 1.5% (n = 4) genotype 1 and 3, 8% (n = 10) 2 genotype. Two samples (0.76%) to differentiate genotype 1 and 2 the sequencing analysis was inconclusive and the other three samples (1.15%) did not amplification. Through phylogenetic analysis, we observed a particular population structure composed of some subgroups. Multiple STR strain types are found in each of the neighborhoods. Genetic diversity within and among the neighborhoods does not reveal a distinct population structure. Spatial clustering of patients is likely a consequence of socio-economic ...