**Author details**

prevalence-based elimination program could not stopped the spreading. The meeting was held in Brazil in 2015 and the strategy was changed. A strategy based on incidence instead of prevalence was identified. Early diagnosis and prompt inclusion of all patients to treatment

Living in the same house with a leprosy person increases the risk of spreading by 2–10 fold. Most of the new cases constitute subclinical infection cases in contact and no diagnosed cases. For this reason, for eliminating leprosy, it is very important to detect new cases with effective contact monitoring. The development of diagnostic tests that can detect subclinical infection

In fact, BCG, which is tuberculosis specific, is the only vaccine used for leprosy protection. The level of protection, as well as the protection against leprosy is evidenced, varies between 20% and 90% in the literature. Protection level of the vaccine, when vaccinated in first decade, was higher in women and lower socioeconomic individuals [109]. With age, the level of protection decreases [110]. Although it has been shown that revaccination of leprosy patients and contacts with them have been shown to reinforce the protection, this approach is still not

Protection of post-contact chemoprophylaxis (PEP) has been shown in clinical trials in a range of 35–57% in patients with asymptomatic contact. Although it is not included in WHO's official recommendations, PEP evaluations rapidly continue with a single dose of rifampin (SDR). One study has shown that the protection of PEP with BCG combination is better in distant-contact individuals [112]. With the cooperation of Novartis agency and Netherlands Leprosy Relief (NLR), Leprosy Post-Exposure Prophylaxis (LPEP) program has been established. A large-scale study was started to investigate the applicability of the use of SDR as a PEP by the program and the impact on the number of new diagnosed cases. It is expected that

Permanent nerve damage is a part of the natural process of the disease, and the risk is also quite increased with leprosy reactions. Reducing the stigmatization of leprosy patients and providing mental well-being is possible by preventing nerve damage. Delay in recognition of leprosy and leprosy reactions, and therefore of delay in treatment is the most important factor on permanent nerve damage. Follow-ups should be done in leprosy centers whenever possible. It is important to ensure compliance with treatment and follow-up. Patients should be educated on issues such as care of existing wounds, proper shoe selection, self-examination of hands and feet. Another important point is that the leprosy does not come to mind because of the rare occurrence in some areas and the patients are followed up with false diagnoses. The implementation of information programs for healthcare professionals is also important

and separate exposure to and infection with *M. leprae* is very important [101, 108].

common and there is a need for studies evaluating efficacy [39, 111].

were aimed [30, 106, 107].

52 Hansen's Disease - The Forgotten and Neglected Disease

**12.1. Immunoprophylaxis/chemoprophylaxis**

the first data will be obtained in 2019 [113].

**12.2. Prevention of disability**

in this context [114–116].

Nebahat Demet Akpolat<sup>1</sup> \*, Ayse Akkus<sup>2</sup> and Emre Kaynak<sup>2</sup>


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**Chapter 4**

**Provisional chapter**

**Molecular and Biotechnological Approaches in the**

**Molecular and Biotechnological Approaches in the** 

Leprosy is a worldwide health problem, which needs the development of new and innovative strategies to be controlled. Early diagnosis of leprosy is an important contribution to reducing the incidence of the disease; thus, the development of biotechnology platforms, which include the mapping of antigens with potential to be used in immunodiagnostic and molecular methods for the detection of *Mycobacterium leprae*, is an important tool to confirm the clinical diagnostic. Molecular biology and biotechnological methods have been used to assist in the diagnosis of this disease, each one with its advantages and drawbacks. Enzyme-linked immunosorbent assay (ELISA) is the used method for leprosy diagnosis, and it allows the detection of infection-related antigens. Alternatively, due to their versatility to perform the same functions as the protein and non-protein natural antigens, mimetic peptides are considered an important tool. On the other hand, lateral flow assay (LFA) and optical and electrochemical biosensors are rapid and portable methods, capable of performing diagnosis in the field without sample preparation. This chapter presents such techniques, their uses in the diagnosis and detection of M. leprae, as well as the potential for the development of new techniques and strategies that

DOI: 10.5772/intechopen.75506

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

**Diagnosis of Leprosy**

**Diagnosis of Leprosy**

Mayara Ingrid Sousa Lima,

Mayara Ingrid Sousa Lima,

Jaqueline Diniz Pinho,

**Abstract**

Jaqueline Diniz Pinho,

Emilly Caroline dos Santos Moraes,

Emilly Caroline dos Santos Moraes,

Gustavo Henrique Corrêa Soares and Ítalo Vinícius Cantanhêde Santos

Gustavo Henrique Corrêa Soares and Ítalo Vinícius Cantanhêde Santos

http://dx.doi.org/10.5772/intechopen.75506

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

can help to control and understand mycobacteriosis.

**Keywords:** *Mycobacterium leprae*, immunoassays, molecular tests, biomarkers

#### **Molecular and Biotechnological Approaches in the Diagnosis of Leprosy Molecular and Biotechnological Approaches in the Diagnosis of Leprosy**

DOI: 10.5772/intechopen.75506

Mayara Ingrid Sousa Lima, Emilly Caroline dos Santos Moraes, Jaqueline Diniz Pinho, Gustavo Henrique Corrêa Soares and Ítalo Vinícius Cantanhêde Santos Mayara Ingrid Sousa Lima, Emilly Caroline dos Santos Moraes, Jaqueline Diniz Pinho, Gustavo Henrique Corrêa Soares and Ítalo Vinícius Cantanhêde Santos

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.75506

#### **Abstract**

Leprosy is a worldwide health problem, which needs the development of new and innovative strategies to be controlled. Early diagnosis of leprosy is an important contribution to reducing the incidence of the disease; thus, the development of biotechnology platforms, which include the mapping of antigens with potential to be used in immunodiagnostic and molecular methods for the detection of *Mycobacterium leprae*, is an important tool to confirm the clinical diagnostic. Molecular biology and biotechnological methods have been used to assist in the diagnosis of this disease, each one with its advantages and drawbacks. Enzyme-linked immunosorbent assay (ELISA) is the used method for leprosy diagnosis, and it allows the detection of infection-related antigens. Alternatively, due to their versatility to perform the same functions as the protein and non-protein natural antigens, mimetic peptides are considered an important tool. On the other hand, lateral flow assay (LFA) and optical and electrochemical biosensors are rapid and portable methods, capable of performing diagnosis in the field without sample preparation. This chapter presents such techniques, their uses in the diagnosis and detection of M. leprae, as well as the potential for the development of new techniques and strategies that can help to control and understand mycobacteriosis.

**Keywords:** *Mycobacterium leprae*, immunoassays, molecular tests, biomarkers

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
