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The ML Flow test as a point of care test for leprosy control programmes: potential effects on classification of leprosy patients
Samira Bührer-Sékula
  Samira Bührer-Sékula
Affiliation
KIT (Royal Tropical Institute), KIT Biomedical Research, Amsterdam, The Netherlands
Correspondence to: S. Bührer-Sékula (Tel: +31 20 5665449; Fax: +31 20 6971841; e-mail: samira@buhrer.net; l.oskam@kit.nl)
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a,*
Jan Visschedijk
  Jan Visschedijk
Affiliation
KIT (Royal Tropical Institute), KIT Biomedical Research, Amsterdam, The Netherlands
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a
Maria Aparecida F. Grossi
  Maria Aparecida F. Grossi
Affiliation
Secretaria de Estado da Saúde de Minas Gerais, Belo Horizonte, Brazil
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b
Krishna P. Dhakal
  Krishna P. Dhakal
Affiliation
Netherlands Leprosy Relief (NLR), Biratnagar, Nepal
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c
Abdullahi U. Namadi
  Abdullahi U. Namadi
Affiliation
Netherlands Leprosy Relief (NLR), Jos, Nigeria
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d
Paul R. Klatser
  Paul R. Klatser
Affiliation
KIT (Royal Tropical Institute), KIT Biomedical Research, Amsterdam, The Netherlands
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a
Linda Oskam
  Linda Oskam
Affiliation
KIT (Royal Tropical Institute), KIT Biomedical Research, Amsterdam, The Netherlands
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a
Objective

To evaluate the use of the ML Flow test as an additional, serological, tool for the classification of new leprosy patients.

 Design

In Brazil, Nepal and Nigeria, 2632 leprosy patients were classified by three methods: (1) as multibacillary (MB) or paucibacillary (PB) according to the number of skin lesions (WHO classification), (2) by slit skin smear examination, and (3) by serology using the ML Flow test detecting IgM antibodies to Mycobacterium leprae-specific phenolic glycolipid-I.

 Results

The proportion of MB leprosy patients was 39.5, 35.6 and 19.4% in Brazil, Nepal and Nigeria, respectively. The highest seropositivity in patients was observed in Nigeria (62.9%), followed by Brazil (50.8%) and Nepal (35.6%). ML Flow test results and smears were negative in 69.1 and 82.7% of PB patients, while smears were positive in 58.6MB patients in Brazil and 28.3% in Nepal. In MB patients, both smears and ML Flow tests were negative in 15.6% in Brazil and 38.3%, in Nepal. Testing all PB patients with the ML Flow test to prevent under-treatment would increase the MB group by 18, 11 and 46.2% for Brazil, Nepal and Nigeria, respectively. Using the ML Flow test as the sole criterion for classification would result in an increase of 11.3 and 43.5% of patients requiring treatment for MB leprosy in Brazil and Nigeria, respectively, and a decrease of 3.7% for Nepal.

 Conclusions

The ML Flow test could be used to strengthen classification, reduce the risk of under-treatment and minimize the need for slit skin smears.
Cite this article
Samira Bührer-Sékula, Jan Visschedijk, Maria Aparecida F. Grossi, Krishna P. Dhakal, Abdullahi U. Namadi, Paul R. Klatser, Linda Oskam;
The ML Flow test as a point of care test for leprosy control programmes: potential effects on classification of leprosy patients; Leprosy Review; 2007; 78; 1; 70-79; DOI: 10.47276/lr.78.1.70
home.article_information

DOI: 10.47276/lr.78.1.70

articleview.journal_title: Leprosy Review
articleview.publisher: British Leprosy Relief Association
articleview.publisher_location: Colchester, UK
articleview.article_date_pre accepted on 31 October 2006 and articleview.pub_on 01 March 2007
© Lepra 2007
LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
07-079
0305-7518/07/064053+10
10.47276/lr.78.1.70
Original Papers
The ML Flow test as a point of care test for leprosy control programmes: potential effects on classification of leprosy patients
Bührer-SékulaSamira
a
VisschedijkJan
a
GrossiMaria Aparecida F.
b
DhakalKrishna P.
c
NamadiAbdullahi U.
d
KlatserPaul R.
a
OskamLinda
a
a
KIT (Royal Tropical Institute), KIT Biomedical Research, Amsterdam, The Netherlands
b
Secretaria de Estado da Saúde de Minas Gerais, Belo Horizonte, Brazil
c
Netherlands Leprosy Relief (NLR), Biratnagar, Nepal
d
Netherlands Leprosy Relief (NLR), Jos, Nigeria
Correspondence to: S. Bührer-Sékula (Tel: +31 20 5665449; Fax: +31 20 6971841; e-mail: ; )
01032007
78
1
70
79
31102006
© Lepra
2007
Objective
To evaluate the use of the ML Flow test as an additional, serological, tool for the classification of new leprosy patients.
Design
In Brazil, Nepal and Nigeria, 2632 leprosy patients were classified by three methods: (1) as multibacillary (MB) or paucibacillary (PB) according to the number of skin lesions (WHO classification), (2) by slit skin smear examination, and (3) by serology using the ML Flow test detecting IgM antibodies to Mycobacterium leprae-specific phenolic glycolipid-I.
Results
The proportion of MB leprosy patients was 39.5, 35.6 and 19.4% in Brazil, Nepal and Nigeria, respectively. The highest seropositivity in patients was observed in Nigeria (62.9%), followed by Brazil (50.8%) and Nepal (35.6%). ML Flow test results and smears were negative in 69.1 and 82.7% of PB patients, while smears were positive in 58.6MB patients in Brazil and 28.3% in Nepal. In MB patients, both smears and ML Flow tests were negative in 15.6% in Brazil and 38.3%, in Nepal. Testing all PB patients with the ML Flow test to prevent under-treatment would increase the MB group by 18, 11 and 46.2% for Brazil, Nepal and Nigeria, respectively. Using the ML Flow test as the sole criterion for classification would result in an increase of 11.3 and 43.5% of patients requiring treatment for MB leprosy in Brazil and Nigeria, respectively, and a decrease of 3.7% for Nepal.
Conclusions
The ML Flow test could be used to strengthen classification, reduce the risk of under-treatment and minimize the need for slit skin smears.