Use of the ML-Flow test as a tool in classifying and treating leprosy

Abstract

Background: The treatment of leprosy is defined by the classification of patients as paucibacillary (PB) or multibacillary (MB). The WHO (World Health Organization) classifies patients according to the number of lesions, but Ridley-Jopling (R & J) also uses complementary exams, which are difficult to use outside reference services. In 2003, a test called ML-Flow, an alternative to Elisa serology, was developed to help classify patients as PB or MB and decide about their treatment.

Objectives: To assess the agreement between the ML-Flow test and slit skin smears, already largely used for MB detection, and to observe the efficacy of the ML-Flow test in the field.

Material and methods: A retrospective study evaluating the medical records of 55 patients who had not undergone previous treatment, diagnosed as PB or MB according to R & J and subjected to slit skin smears and the ML- Flow test.

Results: In MB patients, slit skin smears were positive in 80% of the cases, the ML-flow was positive in 82.5%. Among PB patients, the ML-Flow was positive in 37.5% and slit skin smears were negative in 100% of the cases. The agreement between skin smear and ML-Flow results was 87.5%, with a kappa value of 0.59, p <0.001.

Conclusion: No laboratory test is 100% sensitive and specific for the correct classification of all forms of leprosy. The ML-Flow test is faster, easier to use, and less invasive than slit skin smears and therefore may be useful when making therapeutic decisions in areas of difficult access to reference services.