{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:40:58Z","timestamp":1767177658898,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012772","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000}}],"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T00:00:00Z","timestamp":1734566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Leprosy reactions being closely related to damage to peripheral nerves and physical disabilities associated with disease progression. Disabilities in childhood can have a devastating effect with impaired children\u2019s cognitive, emotional, social, and educational development. We followed up the progression of leprosy reactions in children identifying associated factors with the emergence and\/or worsening of nerve damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A prospective longitudinal cohort study was performed in patients under 15 years of age affected by leprosy reactions diagnosed at the Leprosy referral unit in the Amazon region of Brazil. The follow-up time was a cohort for 2 years from diagnosis. A clinical evaluation and the simplified neurological were performed at diagnosis and every 6 months, until the end of the follow-up period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Principal findings<\/jats:title>\n                    <jats:p>Of the 77 children monitored, 38 had reactions and were recruited. Only 23.7% (9\/38) of patients improved their initial neurological impairment and 42.1% (16\/38) had progression of the leprosy reaction with worsening of the initial nerve damage. Two or more reaction episodes, nerve damage and two or more nerves affected at diagnosis, isolated neuritis, silent neuritis and low educational level of caregiver had a significant association with the emergence and\/or worsening of neural damage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A high proportion of children had progression of the leprosy reaction with worsening neural damage. The absence of warning signs of inflammation, such as pain and exacerbation of skin lesions, appears to contribute to the worse prognosis of reactions. Early diagnosis, systematic monitoring especially of neural function, beyond the educate caregivers to recognize the reactional episode early and to helping with children\u2019s self-care are very important measures to minimize the emergence or worsening of neural damage resulting from leprosy reactions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0012772","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T13:54:58Z","timestamp":1734616498000},"page":"e0012772","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Progression of the leprosy reaction and nerve damage: A prospective cohort study in children with leprosy from the Brazilian Amazon"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9115-7270","authenticated-orcid":true,"given":"Sabrina Sampaio","family":"Bandeira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andressa Bocalon","family":"dos Anjos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla Avelar","family":"Pires","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juarez Antonio Sim\u00f5es","family":"Quaresma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,19]]},"reference":[{"issue":"78","key":"pntd.0012772.ref001","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1093\/bmb\/ldl010","article-title":"The clinical and immunological features of leprosy","volume":"77","author":"SL Walker","year":"2006","journal-title":"British Medical Bulletin"},{"issue":"1","key":"pntd.0012772.ref002","doi-asserted-by":"crossref","first-page":"108","DOI":"10.4269\/ajtmh.13-0221","article-title":"Risk Factors for Leprosy Reactions in Three Endemic Countries","volume":"92","author":"DM Scollard","year":"2015","journal-title":"Am. 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