{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:00:40Z","timestamp":1790848840622,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leprosy is a chronic infectious disease affecting the skin and peripheral nerves, potentially causing deformities and disabilities. Transmission occurs mainly via aerosols and nasal secretions, with persistent endemicity in countries such as Brazil, India and Indonesia. Systematic monitoring of contacts is a key strategy for early detection and disease control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate risk factors associated with time to disease onset among leprosy contacts and describe the temporal dynamics of disease development in a historical cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort of 600 contacts of newly diagnosed leprosy cases (2002\u20132022) was followed for up to 5\u2009years. Variables included age, Mitsuda test, anti\u2010PGL\u2010I IgM serology, qPCR in peripheral blood, BCG scar and type of contact. Disease\u2010free survival was estimated with Kaplan\u2013Meier curves and differences between groups were tested using the log\u2010rank test. Variables with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.20 were included in a multivariate Cox proportional hazards model, with stepwise removal until only variables with\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 remained.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During follow\u2010up, 123 contacts (20.5%) developed leprosy, with a higher incidence in the first 24\u2009months: 33.3% of cases occurred in the first year and 25.2% in the second year, followed by a relative stabilisation of new cases in subsequent years. Median survival time was 52\u2009months. In multivariate analysis, positive qPCR (HR\u2009=\u20093.67; 95% CI\u2009=\u20092.42\u20135.55) and positive anti\u2010PGL\u2010I IgM (HR\u2009=\u20095.48; 95% CI\u2009=\u20093.79\u20137.92) were independently associated with earlier disease onset. Other factors, including age, Mitsuda test, BCG scar and type of contact, were not significant after adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Contacts with positive biomarkers face a higher risk of developing leprosy within 5\u2009years. Understanding the temporal dynamics of disease onset supports targeted surveillance and timely intervention strategies, contributing to more effective leprosy control in endemic settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70174","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:01:39Z","timestamp":1780624899000},"page":"1338-1347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk Factors Associated With Time to Disease Onset Among Leprosy Contacts: A Cohort\u2010Based Survival Analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0787-5259","authenticated-orcid":false,"given":"Edilamar Silva","family":"de Alecrin","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade: Infectologia e Medicina Tropical Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"},{"name":"Funda\u00e7\u00e3o Hospitalar do Estado de Minas Gerais Hospital Eduardo de Menezes  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5211-411X","authenticated-orcid":false,"given":"Maria Auxiliadora Parreiras","family":"Martins","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade: Infectologia e Medicina Tropical Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"},{"name":"Departamento de Produtos Farmac\u00eauticos, Faculdade de Farm\u00e1cia Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dulcinea","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Centro de Refer\u00eancia Nacional em Dermatologia Sanit\u00e1ria e Hansen\u00edase, Hospital das Cl\u00ednicas Universidade Federal de Uberl\u00e2ndia (UFU\/EBSERH)  Uberl\u00e2ndia Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4614-7502","authenticated-orcid":false,"given":"Ana Laura Grossi","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade: Infectologia e Medicina Tropical Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Thereza","family":"Chaves","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade: Infectologia e Medicina Tropical Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9945-2714","authenticated-orcid":false,"given":"Maria Aparecida de Faria","family":"Grossi","sequence":"additional","affiliation":[{"name":"Secretaria de Estado de Sa\u00fade de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8777-5068","authenticated-orcid":false,"given":"Sandra","family":"Lyon","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias M\u00e9dicas CEMEPE  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4111-7451","authenticated-orcid":false,"given":"Fernando Henrique","family":"Pereira","sequence":"additional","affiliation":[{"name":"Pr\u00f3\u2010reitoria de Gradua\u00e7\u00e3o Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7199-8590","authenticated-orcid":false,"given":"Ilka Afonso","family":"Reis","sequence":"additional","affiliation":[{"name":"Departamento de Estat\u00edstica, Instituto de Ci\u00eancias Exatas Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4721-1767","authenticated-orcid":false,"given":"Manoel Ot\u00e1vio da Costa","family":"Rocha","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s\u2010Gradua\u00e7\u00e3o em Ci\u00eancias da Sa\u00fade: Infectologia e Medicina Tropical Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"},{"name":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina Universidade Federal de Minas Gerais  Belo Horizonte Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3284-1037","authenticated-orcid":false,"given":"Isabela Maria Bernardes","family":"Goulart","sequence":"additional","affiliation":[{"name":"Centro de Refer\u00eancia Nacional em Dermatologia Sanit\u00e1ria e Hansen\u00edase, Hospital das Cl\u00ednicas Universidade Federal de Uberl\u00e2ndia (UFU\/EBSERH)  Uberl\u00e2ndia Minas Gerais Brazil"},{"name":"Departamento de Cl\u00ednica M\u00e9dica, Faculdade de Medicina Universidade Federal de Uberl\u00e2ndia  Uberl\u00e2ndia Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008276"},{"key":"e_1_2_10_3_1","volume-title":"Global Leprosy (Hansen Disease) Update, 2024: Beyond Zero Cases\u2014What Elimination of Leprosy Really Means","author":"WHO","year":"2025"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)61340-X"},{"issue":"12","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0008917","article-title":"Leprosy in a Prison Population: A New Active Search Strategy and a Prospective Clinical Analysis","volume":"14","author":"Bernardes F.","year":"2020","journal-title":"PLoS Neglected Tropical Diseases"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.12362"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1590\/S0037-86822008000700012","article-title":"Seroprevalence of ML Flow Test in Leprosy Contacts From State of Minas Gerais, Brazil","volume":"41","author":"Andrade A. R. C.","year":"2008","journal-title":"Revista da Sociedade Brasileira de Medicina Tropical"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0100-879X2012007500073"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.imbio.2019.05.002"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.01811"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1476450"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205234"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.micinf.2022.104981"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(19)30260-8"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/0102-311X00130020"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006622"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1590\/1980-549720210039"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1678-9946202264055"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1590\/1806-9282.20220248"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.2147\/IDR.S361799"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001013"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2021.103379"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.841030"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/tmi.14020"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1590\/0102-311x00045321"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v5i0.18394"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.89.3.208"},{"issue":"4","key":"e_1_2_10_28_1","first-page":"712","article-title":"Social Relationships and Intimate Dimensions of Elderly Individuals Affected by Hansen's Disease","volume":"20","author":"Viana L. S.","year":"2015","journal-title":"Cogitare Enfermagem"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0003440"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-025-07362-6"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-019-1271-3"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0013584"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/traf110\/8277349"},{"key":"e_1_2_10_34_1","first-page":"31","volume-title":"Towards Zero Leprosy: Global Leprosy (Hansen's Disease) Strategy 2021\u20132030","author":"WHO","year":"2021"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-81643-4"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw570"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.82.4.389"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-018-3320-9"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12349"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.5.1991-1995.2003"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001711"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0245-2015"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000002337"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006494"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0285450"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2023.1143402"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2019.08.067"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(06)70412-1"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0013465"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.90.4.356"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2021.07.032"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2019.08.035"},{"key":"e_1_2_10_53_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/596316"},{"key":"e_1_2_10_54_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0365-05962010000300007"},{"issue":"9","key":"e_1_2_10_55_1","article-title":"Epidemiological Characteristics of Leprosy in Elderly Brazilians and Comparison With Other Age Groups (2016\u20102018)","volume":"36","author":"Napoleao Rocha M. C.","year":"2020","journal-title":"Cadernos De Saude Publica"},{"issue":"9","key":"e_1_2_10_56_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0007709","article-title":"Leprosy in Elderly People and the Profile of a Retrospective Cohort in an Endemic Region of the Brazilian Amazon","volume":"13","author":"De Sousa Oliveira J. S.","year":"2019","journal-title":"PLoS Neglected Tropical Diseases"},{"key":"e_1_2_10_57_1","doi-asserted-by":"publisher","DOI":"10.1590\/0037-8682-0245-2015"},{"key":"e_1_2_10_58_1","doi-asserted-by":"publisher","DOI":"10.1128\/CVI.00372-07"},{"key":"e_1_2_10_59_1","volume-title":"Protocolo Cl\u00ednico e Diretrizes Terap\u00eauticas da Hansen\u00edase\/Minist\u00e9rio da Sa\u00fade, Secretaria de Ci\u00eancia, Tecnologia, Inova\u00e7\u00e3o e Insumos Estrat\u00e9gicos em Sa\u00fade, Secretaria de Vigil\u00e2ncia em Sa\u00fade","author":"BRASIL","year":"2022"},{"key":"e_1_2_10_60_1","doi-asserted-by":"publisher","DOI":"10.1590\/S0037-86822008000700004"},{"key":"e_1_2_10_61_1","doi-asserted-by":"publisher","DOI":"10.1177\/15353702231209422"},{"key":"e_1_2_10_62_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006083"},{"key":"e_1_2_10_63_1","doi-asserted-by":"publisher","DOI":"10.47276\/lr.82.4.358"},{"key":"e_1_2_10_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-0955-3"},{"key":"e_1_2_10_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-025-05071-2"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70174","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.70174","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:32:55Z","timestamp":1790847175000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.70174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":64,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/tmi.70174"],"URL":"https:\/\/doi.org\/10.1111\/tmi.70174","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,4]]},"assertion":[{"value":"2025-12-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}