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PAGES: 805-811 DOI: 10.1590/0074-02760170117 Full paper
Natural environmental water sources in endemic regions of northeastern Brazil are potential reservoirs of viable Mycobacterium leprae

Maria Luisa Bezerra de Macedo Arraes1, Maísa Viana de Holanda1, Luana Nepomuceno Gondim Costa Lima2, José Antônio Beltrão Sabadia3, Cynthia Romariz Duarte3, Rosa Livia Freitas Almeida4, Carl Kendall5, Ligia Regina Sansigolo Kerr6, Cristiane Cunha Frota1+

1Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Patologia e Medicina Legal, Fortaleza, CE, Brasil
2Instituto Evandro Chagas, Seção de Bacteriologia e Micologia, Belém, PA, Brasil
3Universidade Federal do Ceará, Departamento de Geologia, Fortaleza, CE, Brasil
4Universidade de Fortaleza, Programa de Pós-Graduação em Saúde Coletiva, Fortaleza, CE, Brasil
5Tulane University, School of Public Health and Tropical Medicine, Department of Global Community Health and Behavioral Sciences, New Orleans, LA, USA
6Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Saúde Comunitária, Fortaleza, CE, Brasil


BACKGROUND The detection of live Mycobacterium leprae in soil and animals other than humans suggests that the environment plays a role in the transmission of leprosy.

OBJECTIVE The objective of this study was to investigate the presence of viable M. leprae in natural water sources used by the local population in five municipalities in the state of Ceará, northeastern Brazil.

METHODS Samples were collected from 30 different sources. Viable bacilli were identified by reverse transcriptase polymerase chain reaction (PCR) of the M. leprae gyrA gene and sequencing of the PCR products. Physicochemical properties of each water source were also assessed.

FINDINGS M. leprae gyrA mRNA was found in 23 (76.7%) of the water sources. No association was found between depth of the water and sample positivity, nor was there any association between the type of water used by the population and sample positivity. An association between viable M. leprae and temperature and pH was found. Georeferencing showed a relation between the residences of leprosy cases and water source containing the bacterium.

MAIN CONCLUSIONS The finding of viable M. leprae in natural water sources associated with human contact suggests that the environment plays an important role in maintaining endemic leprosy in the study region.

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Financial support: CNPq (CT-HIDRO/CT-SAÚDE/CNPq 45/2008 - Water and Public Health, 577028/2008-1).
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Received 23 March 2017
Accepted 30 June 2017