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Prevalence of Mycobacterium leprae in armadillos in Brazil: A systematic review and meta-analysis.
PLOS Neglected Tropical Diseases ( IF 3.4 ) Pub Date : 2020-03-23 , DOI: 10.1371/journal.pntd.0008127
Patrícia Deps 1, 2 , João Marcelo Antunes 3 , Adalberto Rezende Santos 4 , Simon M Collin 5
Affiliation  

Understanding the prevalence of M. leprae infection in armadillos is important because of evidence from Brazil and other countries of an association between contact with armadillos and the development of Hansen's Disease (leprosy). Our aim was to characterize studies which have investigated natural M. leprae infection in wild armadillos in Brazil, and to quantify and explore variability in the reported prevalence of infection. We conducted a systematic review (PROSPERO CRD42019155277) of publications in MEDLINE, EMBASE, Global Health, Scopus, LILACS, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses e Dissertações de CAPES, and Biblioteca Virtual em Saúde up to 10/2019 using Mesh and text search terms (in English, Portuguese, Spanish, and French). The 10 included studies represented a total sample of 302 armadillos comprising 207 (69%) Dasypus novemcinctus, 67 (22%) Euphractus sexcinctus, 16 (5%) Priodontes maximus, 10 (3%) Cabassous unicinctus, and 2 (1%) Cabassous tatouay from 7 different states. Methods used included histopathology (4 studies), PGL-1 and LID-1 antigen detection (4 studies) and examination for clinical signs of disease (4 studies). Eight studies used PCR of which 7 targeted the RLEP repetitive element and 3 tested for inhibitory substances. M. leprae prevalence by PCR ranged from 0% (in 3 studies) to 100% in one study, with a summary estimate of 9.4% (95% CI 0.4% to 73.1%) and a predictive interval of 0-100%. The average prevalence is equivalent to 1 in 10 armadillos in Brazil being infected with M. leprae, but wide variation in sample estimates means that the prevalence in any similar study would be entirely unpredictable. We propose instead that future studies aim to investigate transmission and persistence of M. leprae within and between armadillo populations, meanwhile adopting the precautionary principle to protect human health and an endangered species in Brazil.

中文翻译:

巴西犰狳中麻风分枝杆菌的流行:系统评价和荟萃分析。

由于巴西和其他国家的证据表明,接触犰狳与汉森氏病(麻风病)之间存在关联,因此了解犰狳中麻风分枝杆菌感染的流行很重要。我们的目的是表征研究巴西野生犰狳中自然麻风分枝杆菌感染的研究,并量化和探索报道的感染率的变异性。我们对MEDLINE,EMBASE,Global Health,Scopus,LILACS,Biblioteca Digital Brasileira de Teses eDissertações,Catálogode Teses eDissertaçõesCAPES和Biblioteca Virtual emSaúde等出版物进行了系统审查(PROSPERO CRD42019155277),使用时间截至10/2019网格和文本搜索词(英语,葡萄牙语,西班牙语和法语)。纳入的10项研究代表了302只犰狳的总样本,其中包括207只(69%)新生达斯pu,67只(22%)六头熊,16只(5%)南美大嘴猴,10只(3%)Cabassous unicinctus和2只(1%)来自7个不同州的Cabassous tatouay。使用的方法包括组织病理学(4个研究),PGL-1和LID-1抗原检测(4个研究)以及检查疾病的临床体征(4个研究)。八项研究使用了PCR,其中7项针对RLEP重复元件,另外3项针对抑制性物质进行了测试。PCR检出的麻风杆菌的患病率为0%(在3个研究中)到100%,一项总结估计为9.4%(95%CI为0.4%至73.1%),预测间隔为0-100%。在巴西,平均患病率相当于十分之一的犰狳被麻风杆菌感染,但是样本估算值的巨大差异意味着任何类似研究中的患病率都是完全不可预测的。相反,我们建议未来的研究旨在调查犰狳种群内部和种群之间的传播和持久性,同时采用预防原则保护巴西的人类健康和濒危物种。
更新日期:2020-03-24
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