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Abstract：
Understanding the prevalence of M. leprae infection in armadillos is important because of evidence from Brazil and other countries of an association between contact with armadillos and the development of Hansen\'s Disease (leprosy). Our aim was to characterize studies which have investigated natural M. leprae infection in wild armadillos in Brazil, and to quantify and explore variability in the reported prevalence of infection. We conducted a systematic review (PROSPERO CRD42019155277) of publications in MEDLINE, EMBASE, Global Health, Scopus, LILACS, Biblioteca Digital Brasileira de Teses e Dissertações, Catálogo de Teses e Dissertações de CAPES, and Biblioteca Virtual em Saúde up to 10/2019 using Mesh and text search terms (in English, Portuguese, Spanish, and French). The 10 included studies represented a total sample of 302 armadillos comprising 207 (69%) Dasypus novemcinctus, 67 (22%) Euphractus sexcinctus, 16 (5%) Priodontes maximus, 10 (3%) Cabassous unicinctus, and 2 (1%) Cabassous tatouay from 7 different states. Methods used included histopathology (4 studies), PGL-1 and LID-1 antigen detection (4 studies) and examination for clinical signs of disease (4 studies). Eight studies used PCR of which 7 targeted the RLEP repetitive element and 3 tested for inhibitory substances. M. leprae prevalence by PCR ranged from 0% (in 3 studies) to 100% in one study, with a summary estimate of 9.4% (95% CI 0.4% to 73.1%) and a predictive interval of 0-100%. The average prevalence is equivalent to 1 in 10 armadillos in Brazil being infected with M. leprae, but wide variation in sample estimates means that the prevalence in any similar study would be entirely unpredictable. We propose instead that future studies aim to investigate transmission and persistence of M. leprae within and between armadillo populations, meanwhile adopting the precautionary principle to protect human health and an endangered species in Brazil.
摘要：
由于来自巴西和其他国家的证据表明，与Armadillos接触与汉森病（麻风病）的发展之间存在关联，因此了解Armadillos中麻风分枝杆菌感染的患病率很重要。我们的目的是描述在巴西野生Armadillos中调查自然麻风分枝杆菌感染的研究，并量化和探索报告的感染率的变异性。我们对MEDLINE，EMBASE,全球卫生,Scopus,LILACS,巴西数字图书馆，CatálogodeTeseseDissertaçšesdeCAPES,和BibliotecaVirtualemSaúde使用网格和文本搜索词（英文，葡萄牙语,西班牙语,和法语）。纳入的10项研究代表了总共302个Armadillos样本，其中包括207个（69％）Dasypusnovemcinctus，67（22%）Euphractussexcintus，16只(5%)大鱼，10只(3%)甘蓝独角兽，和来自7个不同州的2个(1%)彻头彻尾。使用的方法包括组织病理学（4项研究），PGL-1和LID-1抗原检测(4项研究)和检查疾病的临床体征(4项研究)。8项研究使用PCR,其中7项靶向RLEP重复元件,3项测试抑制物质。通过PCR，麻风分枝杆菌的患病率范围从0％（在3项研究中）到100％，在一项研究中，汇总估计值为9.4％（95％CI为0.4％至73.1％），预测区间为0-100％。巴西的平均患病率相当于十分之一的Armadillos感染麻风分枝杆菌，但是样本估计的差异很大，这意味着任何类似研究中的患病率都是完全不可预测的。相反，我们建议未来的研究旨在研究麻风分枝杆菌在Armadillo种群内部和之间的传播和持久性，同时采取预防原则来保护人类健康和巴西的濒危物种。
