Mycobacterium leprae infection, Hansen’s disease, and helminth infections: A cross-sectional study in southeastern Brazil
11 affiliations
- 1Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
- 2Programa Multicêntrico de Bioquímica e Biologia Molecular/PMBqBM, Universidade Federal de Juiz De Fora-Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
- 3Department of Health Sciences, Universidade Vale do Rio Doce (UNIVALE), Governador Valadares, Minas Gerais, Brazil
- 4Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- 5Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States of America
- 6Department of Environmental Sciences, Emory University, Atlanta, Georgia, United States of America
- 7Department of Medicine, Division of Endocrinology, Metabolism and Lipids, Emory University School of Medicine, Atlanta, Georgia, United States of America
- 8Centro de Referência em Doenças Endêmicas e Programas Especiais, Governador Valadares, Minas Gerais, Brazil
- 9Unifenas Universidade, Belo Horizonte, Minas Gerais, Brazil
- 10Department of Biostatistics and Bioinformatics, Rollins School of Public health, Emory University, Atlanta, Georgia, United States of America
- 11Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
Abstract
Background: Neglected tropical diseases are often co-endemic in affected areas but how they interact is less clear, especially in the case of Hansen’s Disease (HD), commonly referred to as leprosy. Prior studies have demonstrated associations between helminths and HD, but our understanding of the epidemiology of these infections is limited. Our goal was to assess the prevalence and potential associations of Mycobacterium leprae infection and parasitic infections in a sample of community members in a highly endemic area for HD in Minas Gerais, Brazil. Methods: Adults and children ages 3 years and older were enrolled from communities in Governador Valadares, Minas Gerais, Brazil, and nearby municipalities. Questionnaires on demographics and infection history were administered. Serological reactivity against M. leprae, Schistosoma mansoni, and Strongyloides stercoralis was assessed by multiplexed bead assay (MBA). Descriptive, univariate, and multivariate statistics were performed to describe the outcomes and potential associations. Results: Of 1,311 participants, 72 (5.5%) reported a prior history of HD, 94 (7.2%) tested positive for anti-LID-1, 836 (63.8%) reported having one or more parasitic diseases in the past, 153 (11.7%) tested positive for antibodies to schistosoma egg antigen (SEA), and 69 (5.3%) for antibodies to the Strongyloides stercoralis antigen, NIE. Rural residence and anti-LID-1 showed a positive association (aOR 1.79, CI: 1.07- 3.38) as did rural residence and history of HD (aOR, 1.97, CI: 1.14 – 3.38). While not statistically significant, there was a positive association between anti-LID-1 and NIE antibodies (aOR 1.57, CI: 0.69-3.57), and a negative association between anti-LID-1 and SEA antibodies (aOR 0.79, CI: 0.38 - 1.61). Conclusion: We simultaneously measured seroreactivity among various pathogens. While we did not find that a history of HD and anti-LID-1 positivity were associated with seropositivity to NIE or SEA, our study found a high burden of several neglected tropical diseases (NTDs). There was also a strong association with rural residence and LID-1 positivity warranting investigation into the prevalence and epidemiology of M. leprae infection, as well as potential spatial and environmental risk factors. Author summary: Hansen’s disease, leprosy, continues to affect populations globally with Brazil reporting the second highest number of cases after India. Helminth infections are often co-endemic with HD and have been found to be associated with leprosy in prior research. Therefore, in order to better understand the epidemiology of Mycobacterium leprae infection and helminths in a hyperendemic area Brazil, we sought to describe the overlap of these neglected tropical diseases. We measured antibody reactivity to M. leprae, Schistosoma mansoni, and Strongyloides stercoralis in a sample of 1311 adults and children in eastern Minas Gerais, Brazil using a multiplexed beaded assay. In addition, we collected data on prior history of HD and parasitic infections. We found that 7% of the participants tested positive for IgGagainst the leprosy bacteria (anti-LID-1) and 6% had a prior history of HD. Schistosoma mansoni antibodies and Strongyloides stercoralis antibodies were present in 12% and 5% respectively and 2/3 of individuals self-reported a parasitic infection in the past. We did not find statistically significant associations between the different infections; however, the proportion of individuals who were either seropositive or who self-reported prior infections demonstrated a large burden of HD and other neglected tropical infections in these communities. In addition, rural residence was associated with HD, highlighting future area of study to home in on potential associated risk factors.
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BibTeX
@article{bass2026mycobacterium,
title = {{Mycobacterium leprae infection, Hansen’s disease, and helminth infections: A cross-sectional study in southeastern Brazil}},
author = {Audra Bass and Heloine Leite and Lorena B. P. Oliveira and Emma Nedell and Pedro Marçal and Julie A. Clennon and Jeffrey M. Collins and Thomas R. Ziegler and Erica Magueta Silva and Maisa P. Vieira and Marcos D. S. Pinheiro and Alexandre C. Branco and José A. Ferreira and Lance Waller and Lucia A. O. Fraga and Jessica K. Fairley},
journal = {PLOS Neglected Tropical Diseases},
year = {2026},
month = oct,
doi = {10.1371/journal.pntd.0013285},
url = {https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0013285},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Mycobacterium leprae infection, Hansen’s disease, and helminth infections: A cross-sectional study in southeastern Brazil
AU - Audra Bass
AU - Heloine Leite
AU - Lorena B. P. Oliveira
AU - Emma Nedell
AU - Pedro Marçal
AU - Julie A. Clennon
AU - Jeffrey M. Collins
AU - Thomas R. Ziegler
AU - Erica Magueta Silva
AU - Maisa P. Vieira
AU - Marcos D. S. Pinheiro
AU - Alexandre C. Branco
AU - José A. Ferreira
AU - Lance Waller
AU - Lucia A. O. Fraga
AU - Jessica K. Fairley
PY - 2026
DA - 2026/10/01
JO - PLOS Neglected Tropical Diseases
DO - 10.1371/journal.pntd.0013285
UR - https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0013285
AB - Background: Neglected tropical diseases are often co-endemic in affected areas but how they interact is less clear, especially in the case of Hansen’s Disease (HD), commonly referred to as leprosy. Prior studies have demonstrated associations between helminths and HD, but our understanding of the epidemiology of these infections is limited. Our goal was to assess the prevalence and potential associations of Mycobacterium leprae infection and parasitic infections in a sample of community members in a highly endemic area for HD in Minas Gerais, Brazil. Methods: Adults and children ages 3 years and older were enrolled from communities in Governador Valadares, Minas Gerais, Brazil, and nearby municipalities. Questionnaires on demographics and infection history were administered. Serological reactivity against M. leprae, Schistosoma mansoni, and Strongyloides stercoralis was assessed by multiplexed bead assay (MBA). Descriptive, univariate, and multivariate statistics were performed to describe the outcomes and potential associations. Results: Of 1,311 participants, 72 (5.5%) reported a prior history of HD, 94 (7.2%) tested positive for anti-LID-1, 836 (63.8%) reported having one or more parasitic diseases in the past, 153 (11.7%) tested positive for antibodies to schistosoma egg antigen (SEA), and 69 (5.3%) for antibodies to the Strongyloides stercoralis antigen, NIE. Rural residence and anti-LID-1 showed a positive association (aOR 1.79, CI: 1.07- 3.38) as did rural residence and history of HD (aOR, 1.97, CI: 1.14 – 3.38). While not statistically significant, there was a positive association between anti-LID-1 and NIE antibodies (aOR 1.57, CI: 0.69-3.57), and a negative association between anti-LID-1 and SEA antibodies (aOR 0.79, CI: 0.38 - 1.61). Conclusion: We simultaneously measured seroreactivity among various pathogens. While we did not find that a history of HD and anti-LID-1 positivity were associated with seropositivity to NIE or SEA, our study found a high burden of several neglected tropical diseases (NTDs). There was also a strong association with rural residence and LID-1 positivity warranting investigation into the prevalence and epidemiology of M. leprae infection, as well as potential spatial and environmental risk factors. Author summary: Hansen’s disease, leprosy, continues to affect populations globally with Brazil reporting the second highest number of cases after India. Helminth infections are often co-endemic with HD and have been found to be associated with leprosy in prior research. Therefore, in order to better understand the epidemiology of Mycobacterium leprae infection and helminths in a hyperendemic area Brazil, we sought to describe the overlap of these neglected tropical diseases. We measured antibody reactivity to M. leprae, Schistosoma mansoni, and Strongyloides stercoralis in a sample of 1311 adults and children in eastern Minas Gerais, Brazil using a multiplexed beaded assay. In addition, we collected data on prior history of HD and parasitic infections. We found that 7% of the participants tested positive for IgGagainst the leprosy bacteria (anti-LID-1) and 6% had a prior history of HD. Schistosoma mansoni antibodies and Strongyloides stercoralis antibodies were present in 12% and 5% respectively and 2/3 of individuals self-reported a parasitic infection in the past. We did not find statistically significant associations between the different infections; however, the proportion of individuals who were either seropositive or who self-reported prior infections demonstrated a large burden of HD and other neglected tropical infections in these communities. In addition, rural residence was associated with HD, highlighting future area of study to home in on potential associated risk factors.
SN - 1935-2735
ER -