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Limited data exist on leprosy screening strategies in incarcerated populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational, cross-sectional study was conducted at Baldomero Cavalcante Male Penitentiary in Macei\u00f3, Alagoas, Brazil. A total of 915 inmates were approached using the Leprosy Suspicion Questionnaire (LSQ) as an active case-finding tool. Neurodermatological examinations were performed on 260 participants, and serological testing for anti-PGL-I (IgM) and anti-Mce1A antibodies (IgA, IgM, IgG) was conducted on 244 plasma samples using indirect ELISA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 842\/915 returned questionnaires (92%), 240\/842 (28.5%) were positive in the LSQ. Clinical examination revealed 8 new leprosy cases among 260\/842 evaluated inmates with positive and negative LSQ, yielding an overall new case detection rate (NCDR) of 3.08%, which increased to 6.52% among symptomatic individuals. All diagnosed patients were classified as having multibacillary disease, with 100% presenting some grade of physical disability at diagnosis, and 75% LSQ were positive (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0249), while only 34.1% in the non-leprosy group. Anti-Mce1A IgM showed 37.7% seropositivity rate, and 19.9% for anti-PGL-I among clinically unaffected individuals. IgA (100%), IgM (37.5%), and IgG (25%) anti-Mce1A antibodies were positive in the leprosy group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The LSQ may be effective as a screening tool. The study confirms significant underdiagnosis of leprosy in prison populations and highlights that anti-Mce1A serology showed higher positivity among diagnosed cases than anti-PGL-I, particularly for the detection of early-stage and neural forms of the disease. These findings support enhanced active surveillance strategies in high-risk populations to achieve leprosy elimination goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10096-026-05578-2","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T07:27:21Z","timestamp":1783927641000},"page":"3205-3215","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hidden burden of leprosy in incarcerated populations in northeast Brazil: active case detection and serological assessment"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5321-1870","authenticated-orcid":false,"given":"Thatiane Silva","family":"de Lucena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3760-829X","authenticated-orcid":false,"given":"Lorena Covre","family":"Galani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9036-6594","authenticated-orcid":false,"given":"Luize Dianin","family":"Barbosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1033-0507","authenticated-orcid":false,"given":"Gabriela Ferreira","family":"Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-3751","authenticated-orcid":false,"given":"Jaci Maria","family":"Santana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7629-4963","authenticated-orcid":false,"given":"Filipe Rocha","family":"Lima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2700-5971","authenticated-orcid":false,"given":"Marco Andrey Cipriani","family":"Frade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"5578_CR1","unstructured":"Ministry of Health (Brazil). 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