Efficiency of the sensitive mapping score for the diagnosis and follow-up of leprosy: a functional cure ranking?

• Grant number: 25/07919-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2025
• End date: July 31, 2026
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Marco Andrey Cipriani Frade
• Grantee: João Vitor da Silva Sabino
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Leprosy is a chronic infectious disease caused by Mycobacterium leprae andM. lepromatosis, characterized by progressive peripheral nerve involvement andrecognized as the leading infectious cause of peripheral neuropathy worldwide. TheWorld Health Organization (WHO) classifies leprosy as a neglected tropical disease,with a high burden in countries such as India, Brazil, and Indonesia. Diagnosis relieson cardinal signs, including hypoesthesia or anesthesia in skin lesions, thickenedperipheral nerves, and positive slit-skin smear microscopy in multibacillary cases.However, early detection remains challenging, particularly in initial forms, due to thelow accuracy of available diagnostic methods.Leprosy neuropathy results from both direct invasion of peripheral nerves by M.leprae and an exacerbated inflammatory response, leading to progressive sensory andmotor deficits. Neuro-sensory assessment plays a crucial role in early diagnosis andclinical monitoring, with Semmes-Weinstein monofilament esthesiometry emerging asa promising method. Despite therapeutic advancements, the WHO defines leprosycure based on the completion of multidrug therapy, regardless of neurologicalrecovery. This approach limits post-treatment functional assessment and contributesto irreversible disabilities.The absence of standardized techniques, such as graphical and photographicsensory mapping of lesions, represents a critical gap in the literature. This study aimsto validate the efficacy of a standardized sensory mapping score using SemmesWeinstein monofilaments as a quantitative tool for diagnosis, clinical follow-up, anddefinition of cure criteria in leprosy.The implementation of this scoring system may enhance diagnosticreproducibility across different healthcare centers, refine discharge criteria, andredefine parameters for neurological rehabilitation, aligning with global strategies forleprosy control. (AU)