Innovative tools and approaches to end the transmission of Mycobacterium leprae

Abstract

Leprosy control has seen little innovation and only limited progress in the past decade. However, research on the disease has increased and important innovations are underway. Here, we comment on efforts to develop tools and approaches to detect leprosy and to stop the transmission of Mycobacterium leprae, the causative bacillus of the disease. The tracing and screening of contacts of known patients with leprosy promises to strengthen early diagnosis, while preventive chemotherapy will reduce the risk of contacts developing the disease by 50-60% within 2 years of administration. Until now, diagnosis has been mainly based on the presence of signs and symptoms, but efforts are underway to develop inexpensive, reliable, point-of-care tests to diagnose infection. Development of a leprosy-specific vaccine that boosts long-lasting T-cell responses is also a research objective. As for launching a programme to interrupt transmission, two interlinked tools-epidemiological modelling and the concept of an investment case-are being developed to explore the feasibility and costs of such a programme and its overall effect on individuals and society. We believe that sustained innovation is needed and that only a combination of tools and approaches holds promise to end M leprae transmission.

Persistência da hanseníase em redes de convívio domiciliar: sobreposição de casos e vulnerabilidade em regiões endêmicas no Brasil

“…Não foram identificados outros estudos que discutam, em particular, essas duas temáticas. Portanto, o desconhecimento da magnitude do problema da reação hansênica e a sua relação com a sobreposição de casos de hanseníase em RCD fortalecem a importância de se estabelecer novos mecanismos e indicadores de vigilância para o acompanhamento desses eventos no cotidiano dos serviços de saúde 32 .…”

Counting Down the 2020 Goals for 9 Neglected Tropical Diseases: What Have We Learned From Quantitative Analysis and Transmission Modeling?

“…Leprosy, a directly transmitted bacterial infection, was one of the first NTDs to have global targets for elimination as a public health problem, leading to large declines, although these have stabilized in the last decade [29][30][31]. Leprosy exemplifies the problem with surveillance for a disease in which cases are identified if both the infected individuals seek care and the appropriate care is available for them and mathematical modeling provides methods for estimating the pool of undiagnosed infections [32].…”

Application of molecular tools to elucidate the microbiota of seafood

“…; Steinmann et al . ). Thus, in both cases, applying molecular biology tools allows for their taxonomic classification, for the evaluation of their pathogenic potential and serve as a diagnostic method (Bergholz et al .…”

“…These may not yet have been identified because they exhibit few indicative diagnostic characteristics through culture morphology (Kom arek et al 2014;Sciuto and Moro 2015), attenuated growth capacity or unclear growth requirements in culture, making them difficult to identify by traditional methodology (Youssef et al 2014;Sciuto and Moro 2015). In addition, they may not be able to be cultivated, thus known as viable, but not cultivable, which is either a transitory state for some bacteria in response to the environment stress, such as the Vibrio genus (Griffitt et al, 2011;Zhong et al 2016;Chahorm and Prakitchaiwattana 2018) or a stable state, as occurs in Mycobacterium leprae and Treponema pallidum (Petricha et al 2015;Ruiz-Fuentesa et al 2015;Gogarten et al 2016;Steinmann et al 2017). Thus, in both cases, applying molecular biology tools allows for their taxonomic classification, for the evaluation of their pathogenic potential and serve as a diagnostic method (Bergholz et al 2014;Das et al 2014;Kergourlay et al 2015;Sciuto and Moro 2015;King et al 2017).…”