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Leprosy classification methods: a comparative study in a referral center in Brazil
Ismael Alves Rodrigues Júnior1, Letícia Trivellato Gresta1, Maria de Lourdes Meirelles Noviello1
1Pathology Department, Universidade Federal de Minas Gerais, Campus da Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Bloco C3/251, 6627 Antônio Carlos Av, Pampulha, Belo Horizonte 31.270-010, Brazil.
Summary
The World Health Organization (WHO) operational classification for leprosy is simpler and agrees better with clinical assessments than other methods. However, the Ridley and Jopling classification shows less agreement between clinical and histopathological findings, especially for borderline forms.
Area of Science:
- Dermatology
- Infectious Diseases
- Public Health
Background:
- Leprosy classification methods have evolved since the 1930s.
- Accurate classification is crucial for effective leprosy management and treatment.
Purpose of the Study:
- To compare the World Health Organization (WHO) operational classification with other leprosy classification systems.
- To evaluate the agreement between clinical and histopathological components of the Ridley and Jopling classification.
Main Methods:
- Comparative analysis of WHO operational classification, Ridley and Jopling, Madrid, and Number of Body Areas Affected (NBAA) classifications.
- Assessment of clinical-histopathological correlation within the Ridley and Jopling system.
Main Results:
- The WHO operational classification demonstrated 77.6% agreement (kappa = 0.53) with the Ridley and Jopling classification.
- The WHO classification tended to overestimate multibacillary leprosy cases.
- Highest agreement was observed between the WHO classification and the NBAA method.
- Perfect agreement between clinical and histopathological Ridley and Jopling criteria occurred in 46.9% of patients.
Conclusions:
- The WHO operational classification is a simple and effective method, showing better agreement than purely clinical alternatives.
- Discrepancies between clinical and histopathological Ridley and Jopling classifications were noted, particularly in borderline forms, suggesting potential improvements in histopathological criteria.
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