Résumé :
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[BDSP. Notice produite par INIST-CNRS vHSR0x1g. Diffusion soumise à autorisation]. Background : Not every leprosy patient is equally effective in transmitting Mycobacterium leprae. We studied the spatial distribution of infection (using seropositivity as a marker) in the population to identify which disease characteristics of leprosy patients are important in transmission. Methods : Clinical data and blood samples for anti-Mycobacterium leprae ELISA were collected during a cross-sectional survey on five Indonesian islands highly endemic for leprosy. A geographic information system (GIS) was used to define contacts of patients. We investigated spatial clustering of patients and seropositive people and used logistic regression to determine risk factors for seropositivity. Results : Of the 3986 people examined for leprosy, 3271 gave blood. Seroprevalence varied between islands (1.7-8.7%) and correlated significantly with leprosy prevalence. Five clusters of patients and two clusters of seropositives were detected. In multivariate analysis, seropositivity significantly differed by leprosy status, age, sex, and island. Serological status of patients appeared to be the best discriminator of contact groups with higher seroprevalence : contacts of seropositive patients had an adjusted odds ratio (aOR) of 1.75 (95% CI 0.92-3.31). This increased seroprevalence was strongest for contact groups living
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