Título:	Leprosy detection rate in patients under immunosuppression for the treatment of dermatological, rheumatological, and gastroenterological diseases : a systematic review of the literature and meta-analysis
Autor(es):	Barroso, Daniel Holanda Brandão, Jurema Guerrieri Andrade, Elaine Silva Nascimento Correia, Ana Clara Banhatto Aquino, Danielle Costa Chen, Ana Carolina Rios Vernal, Sebastian Araújo, Wildo Navegantes de Mota, Licia Maria Henrique da Sampaio, Raimunda Nonata Ribeiro Kurizky, Patricia Shu Gomes, Ciro Martins
ORCID:	http://orcid.org/0000-0003-4128-1593
Assunto:	Hanseníase Imunossupressão
Data de publicação:	2021
Editora:	BioMed Central
Referência:	BARROSO, Daniel Holanda et al. Leprosy detection rate in patients under immunosuppression for the treatment of dermatological, rheumatological, and gastroenterological diseases: a systematic review of the literature and meta-analysis. BMC Infectious Diseases, v. 21, 347, 2021. DOI: https://doi.org/10.1186/s12879-021-06041-7. Disponível em: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-021-06041-7. Acesso em: 26 jul. 2021.
Abstract:	Background: Recently developed immunosuppressive drugs, especially TNF antagonists, may enhance the risk of granulomatous infections, including leprosy. We aimed to evaluate the leprosy detection rate in patients under immunosuppression due to rheumatological, dermatological and gastroenterological diseases. Methods: We performed a systematic review of the literature by searching the PubMed, EMBASE, LILACS, Web of Science and Scielo databases through 2018. No date or language restrictions were applied. We included all articles that reported the occurrence of leprosy in patients under medication-induced immunosuppression. Results: The search strategy resulted in 15,103 articles; finally, 20 articles were included, with 4 reporting longitudinal designs. The detection rate of leprosy ranged from 0.13 to 116.18 per 100,000 patients/year in the USA and Brazil, respectively. In the meta-analysis, the detection rate of cases of leprosy per 100,000 immunosuppressed patients with rheumatic diseases was 84 (detection rate = 0.00084; 95% CI = 0.0000–0.00266; I2 = 0%, p = 0.55). Conclusion: Our analysis showed that leprosy was relatively frequently detected in medication-induced immunosuppressed patients suffering from rheumatological diseases, and further studies are needed. The lack of an active search for leprosy in the included articles precluded more precise conclusions. Trial registration: This review is registered in PROSPERO with the registry number CRD42018116275.
Unidade Acadêmica:	Faculdade de Medicina (FMD)
Licença:	© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/
DOI:	https://doi.org/10.1186/s12879-021-06041-7
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