This is the first study reporting global data on AMR in leprosy. Rifampicin resistance emerged, stressing the need for expansion of surveillance. This is also a call for vigilance on the global use of antimicrobial agents, because ofloxacin resistance probably developed in relation to the general intake of antibiotics for other infections as it is not part of the multidrug combination used to treat leprosy.

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to monitor their own skin lesions. This study also demonstrates the higher risk of deformity and abnormality among nerves near inflamed skin lesions.

Background Diagnosis of leprosy currently requires individuals suspecting themselves to be affected to present for expert clinical exams. Clinic attendance can be impacted by a variety of logistical and psychological factors, but rapid diagnostic tests (RDT) could potentially be used as a screening tool to provide triaged referrals. Methods In 2015, 200 newly diagnosed, predominantly multibacillary (MB), leprosy patients attending Cebu Skin Clinic, Philippines, were interviewed with regard to their perception of how leprosy had impacted their lives and their level of acceptance of an immunologic, lateral flow-based RDT as a tool for leprosy control. Six hundred household contacts (HC) of some index cases were also asked to respond to a questionnaire. Each participant provided responses from multiple choice options and the same surveys were repeated on a regular basis to a sub-set of the cohort over the ensuing 4 years. Results At the time of diagnosis many patients (73.0%) and their HC (66.5%) reported that their lives had already been adversely affected by leprosy. RDT were perceived positively by both groups with the majority (87% patients and 71% HC) considering the tool as 'very important'. No patients, and only 0.8% HHC, considered that tests would be of no benefit. In general, patients preferred an extensive RDT monitoring schedule following their diagnosis and indicated a preference that testing be confined among HHC rather than being extended to their larger community. Annual follow-up of a sub-set of participants (131 patients and 170 HC) indicated a retained enthusiasm for testing and, importantly, a marked decrease in those that would not like testing among community contacts, with an increase from 58.5% to 89.4% indicating that they would like testing among their respective HC. Importantly, the perceived impact of leprosy on the lives of both patients and HC declined during the monitoring period that occurred concomitantly with a progressive increase in the number of HC stating that they would definitely submit to testing. Conclusion Our data demonstrate an enthusiasm for regular use of RDT among these particular patients and their HC.Due to their ease of use and point of care applicability