{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T01:31:04Z","timestamp":1785893464940,"version":"3.56.0"},"reference-count":54,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,6]]},"abstract":"<jats:p>Leprosy reactions are immune-mediated complications occurring in up to 50% of patients. The immune consequences of helminth infections and micronutrient deficiencies suggest a potential role in type 1 reactions (T1R) or type 2 reactions (T2R). We conducted a case\u2013control study in Minas Gerais, Brazil, to evaluate whether comorbidities and other factors are associated with reactions in patients with multibacillary leprosy. Stool and serum were tested for helminth infections. Deficiencies of vitamin A, D, and iron were measured using serum retinol, 25-hydroxyvitamin D, and ferritin, respectively. Logistic regression models identified associations between reactions and helminth infections, micronutrient deficiencies, and other variables. Seventy-three patients were enrolled, 24 (33%) with T1R, 21 (29%) with T2R, 8 (15%) with mixed T1R\/T2R, and 20 (27%) without reactions. Evidence of helminth infections were found in 11 participants (15%) and included IgG4 reactivity against <jats:italic>Schistosoma mansoni<\/jats:italic>, <jats:italic>Strongyloides<\/jats:italic>, and <jats:italic>Ascaris<\/jats:italic> antigens. Thirty-eight (52%) had vitamin D deficiency, eight (11%) had vitamin A insufficiency, 21 (29%) had anemia, and one (1.4%) had iron deficiency. Multivariable logistic regression showed no statistically significant associations between helminth coinfections and total reactions (adjusted odds ratios [aOR]: 1.36, 95% CI: 0.22, 8.33), T1R (aOR: 0.85, 95% CI: 0.17, 4.17), or T2R (aOR: 2.41, 95% CI: 0.29, 20.0). Vitamin D deficiency and vitamin A insufficiency were also not statistically associated with reactions. However, vitamin deficiencies and helminth infections were prevalent in these patients, suggesting a potential role for additional treatment interventions. Studying reactions prospectively may further clarify the role of comorbidities in the clinical presentation of leprosy.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0502","type":"journal-article","created":{"date-parts":[[2019,9,23]],"date-time":"2019-09-23T07:01:13Z","timestamp":1569222073000},"page":"1058-1065","source":"Crossref","is-referenced-by-count":10,"title":["The Burden of Helminth Coinfections and Micronutrient Deficiencies in Patients with and without Leprosy Reactions: A Pilot Study in Minas Gerais, Brazil"],"prefix":"10.4269","volume":"101","author":[{"given":"Jessica K.","family":"Fairley","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Laura Grossi","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thelma","family":"de Filippis","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Aparecida","family":"de Faria Grossi","sequence":"additional","affiliation":[{"name":"Secretaria de Estado da Sa\u00fade de Minas Gerais, Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Pinheiro","family":"Chaves","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiza Navarro","family":"Caldeira","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Souza","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafaella Rodrigues","family":"Costa","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cavallieri","family":"Diniz","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina Soares","family":"Duarte","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Alberto","family":"Bomjardim P\u00f4rto","sequence":"additional","affiliation":[{"name":"Hospital Eduardo de Menezes, Funda\u00e7\u00e3o Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parminder S.","family":"Suchdev","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah Aparecida","family":"Negr\u00e3o-Corr\u00eaa","sequence":"additional","affiliation":[{"name":"Departamento de Parasitologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda","family":"do Carmo Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Departamento de Parasitologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Marcelo","family":"Peixoto Moreira","sequence":"additional","affiliation":[{"name":"Departamento de Parasitologia, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelino","family":"de Melo Freire J\u00fanior","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio S\u00e3o Marcos, Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana Costa","family":"Cerqueira","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio S\u00e3o Marcos, Belo Horizonte, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uriel","family":"Kitron","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences, Emory University, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Lyon","sequence":"additional","affiliation":[{"name":"Faculdade Sa\u00fade e Ecologia Humana (FASEH), Vespasiano, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Wkly Epidemiol Rec","first-page":"501","article-title":"Global leprosy update, 2016: accelerating reduction of disease burden","volume":"92","author":"World Health Organazation","year":"2017"},{"key":"b2","series-title":"Wkly Epidemiol Rec","first-page":"405","article-title":"Global leprosy update, 2015: time for action, accountability and inclusion","volume":"91","author":"World Health Organazation","year":"2015"},{"key":"b3","series-title":"Lancet Infect Dis","first-page":"464","article-title":"Leprosy now: epidemiology, progress, challenges, and research gaps","volume":"11","author":"Rodrigues","year":"2011"},{"key":"b4","series-title":"Clin Microbiol 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