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Polymerase Chain Reaction (PCR) as a Potential Point of Care Laboratory Test for Leprosy Diagnosis—A Systematic Review

1
LEPRA Society, Blue Peter Public Health and Research Centre, Cherlapally, Hyderabad 501301, Telangana, India
2
Formerly at LEPRA Society, Blue Peter Public Health and Research Centre, Cherlapally, Hyderabad 501301, Telangana, India
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2018, 3(4), 107; https://doi.org/10.3390/tropicalmed3040107
Received: 20 July 2018 / Revised: 19 September 2018 / Accepted: 23 September 2018 / Published: 1 October 2018
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Abstract

Leprosy is an infectious disease caused by Mycobacterium leprae and mainly affects skin, peripheral nerves, and eyes. Suitable tools for providing bacteriological evidence of leprosy are needed for early case detection and appropriate therapeutic management. Ideally these tools are applicable at all health care levels for the effective control of leprosy. This paper presents a systematic review analysis in order to investigate the performance of polymerase chain reaction (PCR) vis-à-vis slit skin smears (SSS) in various clinical settings and its potential usefulness as a routine lab test for leprosy diagnosis. Records of published journal articles were identified through PubMed database search. Twenty-seven articles were included for the analysis. The evidence from this review analysis suggests that PCR on skin biopsy is the ideal diagnostic test. Nevertheless, PCR on SSS samples also seems to be useful with its practical value for application, even at primary care levels. The review findings also indicated the necessity for improving the sensitivity of PCR and further research on specificity in ruling out other clinical conditions that may mimic leprosy. The M. leprae-specific repetitive element (RLEP) was the most frequently-used marker although its variable performance across the clinical sites and samples are a matter of concern. Undertaking further research studies with large sample numbers and uniform protocols studied simultaneously across multiple clinical sites is recommended to address these issues. View Full-Text
Keywords: leprosy; leprosy diagnosis; PCR; slit skin smears; point of care test; skin biopsy; early diagnosis leprosy; leprosy diagnosis; PCR; slit skin smears; point of care test; skin biopsy; early diagnosis
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Tatipally, S.; Srikantam, A.; Kasetty, S. Polymerase Chain Reaction (PCR) as a Potential Point of Care Laboratory Test for Leprosy Diagnosis—A Systematic Review. Trop. Med. Infect. Dis. 2018, 3, 107.

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