A strategy to halt leprosy transmission

Smith, Cairns; Noordeen, S. K.; Richardus, Jan Hendrik; Sansarricq, H; Cole, Stewart T.; Soares, Rosa Castalia França Ribeiro; Savioli, Lorenzo; Aerts, Ann; Aertsh, Ann; Baruaf, Sumana

doi:10.1016/s1473-3099(13)70365-7

Cited by 67 publications

(71 citation statements)

References 6 publications

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“…The Mycobacterium bovis BCG (bacillus Calmette-Guérin) vaccine used to prevent disseminated forms of tuberculosis has been reported to impart protection against HD in different populations (97). However, we believe that a key public health outcome, along with decreasing further transmission (98), is to focus control efforts on preventing HD-associated disability and to foster improvements in the quality of life for those affected by HD (99).…”

Section: Future Directionsmentioning

confidence: 99%

Leprosy in the 21st Century

2015

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SUMMARY Despite significant improvements in leprosy (Hansen's disease) treatment and outlook for patients since the introduction of multidrug therapy (MDT) 3 decades ago, the global incidence remains high, and patients often have long-term complications associated with the disease. In this article, we discuss recent findings related to genetics, susceptibility, and disease reservoirs and the implications of these findings for Hansen's disease control and health outcomes for patients. We describe the continued difficulties associated with treatment of inflammatory episodes known as “leprosy reactions,” which cause much of the disability associated with the disease and can affect people for many years after MDT is complete. We also discuss some of the contemporary challenges for physicians and patients, including international and internal migration of people affected by the disease. We suggest some important areas of focus for future Hansen's disease research.

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Section: Future Directionsmentioning

confidence: 99%

Leprosy in the 21st Century

2015

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“…However, to our knowledge there are no recent studies investigating these potential issues in Malawi. In addition to global efforts, individualised, national systems of detection, contact tracing and the provision of affordable treatments are needed to definitively eradicate leprosy in these settings [17]. …”

Section: Case Discussionmentioning

confidence: 99%

A case of leprosy in Malawi. Making the final push towards eradication: a clinical and public health perspective

Roe

May

2016

Infect Dis Poverty

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Statistically speaking, Malawi has achieved the World Health Organisation's target for the elimination of leprosy (<1 case per 10 000 people), yet the disease is still considered a leading cause of long term physical disability. In this case study the authors discuss the presentation of a 39-year-old gentleman to a district hospital in Malawi with multibacillary, lepromatous leprosy. The condition was initially managed in the community as an 'allergy' which suggests that local barriers currently hinder the detection of leprosy in this developing primary care system. Leprosy is a multi-system disease and this gentleman demonstrated evidence of lepromatous orchitis. Promoting an awareness of these systemic manifestations will increase the the detection of complications and circumvent long term morbidity. Efforts to optimise systems of detection, management and public and professional education are essential to drive eradication in these at-risk populations. At an international level, we must strive to fulfil the objectives outlined by the 'Enhanced Global Strategy for Further Reducing the Disease Burden due to Leprosy for 2011-2015'. At a national level, local research should delineate community factors that impede the eradication of leprosy. Developing new diagnostic and epidemiologic tools, more efficacious chemoprophylactic regimens and vaccination for endemic regions would facilitate these efforts.

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“…Leprosy is a highly treatable chronic bacterial NTD with multidrug therapy (MDT), which has a cure rate of about 98 % (Lockwood et al 2014). Therefore, early diagnosis and treatment of all patients is the mainstay of the elimination approach that will hopefully translate into a transmission-lowering strategy (Smith et al 2014). Proper treatment decreases bacterial burden and thus likely decreases transmissibility considerably, though the degree of transmission risk reduction remains unknown due to lack of exact knowledge of transmission mode and mechanism.…”

Section: Leprosy Is a Neglected Tropical Diseasementioning

confidence: 99%

“…In 2000, the World Health Organization (WHO) established the WHO Strategic Plan for Leprosy Elimination 2000-2005 focused on elimination at a national level, followed in 2005 by the Global Strategy for Further Reducing the Leprosy Burden and Sustaining Leprosy Control Activities 2006-2010 Push" strategy for elimination (Lockwood et al 2014;Smith et al 2014). The elimination goal was set to decrease prevalence below 1 case per 10,000 people.…”

Section: Epidemiology and Burden Of Disease Of Leprosy In The Americasmentioning

confidence: 99%