A single dose of rifampicin to prevent leprosy: qualitative analysis of perceptions of persons affected, contacts, community members and health professionals towards chemoprophylaxis and the impact on their attitudes in India, Nepal and Indonesia

Peters, Ruth; Mieras, Liesbeth; Subedi, Madhusudan; Apte, Hemant; Koesbardiati, Toetik; Banstola, Nand Lal; Das, Shweta; Brakel, Wim H. van

doi:10.47276/lr.89.4.335

Cited by 11 publications

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“…Integral parts of the LPEP programme were side studies to establish feasibility, 38 effect on perceptions of leprosy and acceptability of the intervention, 39,40 and health system and health economic parameters in different contexts. 34,41 Role of the funding source Novartis Foundation and International Federation of Anti-Leprosy Association partners provided technical input in the design phase of the LPEP programme and ensured overall programme coordination.…”

Section: Methodsmentioning

confidence: 99%

Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

Richardus

Tiwari

Barth‐Jaeggi

et al. 2021

The Lancet Global Health

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Background Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities.Methods The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil,

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Section: Methodsmentioning

confidence: 99%

Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

Richardus

Tiwari

Barth‐Jaeggi

et al. 2021

The Lancet Global Health

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“…An LPEP substudy in India, Indonesia, and Nepal assessed how the intervention changed the perception of main stakeholders regarding leprosy. 118 The LPEP program was perceived positively, though more research was recommended on providing accurate and understandable health information to contacts, and on approaches that do not require disclosure of the index patient. The LPEP program also had a positive effect on people’s knowledge regarding leprosy (Mieras et al, unpublished report).…”

Section: Resultsmentioning

confidence: 99%

“… 119 The results of this study aligned with the results of the main study and the perception study, illustrating that contact screening and SDR-PEP distribution in Dadra and Nagar Haveli, India, were well accepted by the stakeholders. 115 , 118 - 120 …”

Section: Resultsmentioning

confidence: 99%

<p>The State of Affairs in Post-Exposure Leprosy Prevention: A Descriptive Meta-Analysis on Immuno- and Chemo-Prophylaxis</p>

Schoenmakers

Mieras

Budiawan³

et al. 2020

RRTM

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Objective: Annually, over 200,000 people are diagnosed with leprosy, also called Hansen's disease. This number has been relatively stable over the past years. Progress has been made in the fields of chemoprophylaxis and immunoprophylaxis to prevent leprosy, with a primary focus on close contacts of patients. In this descriptive meta-analysis, we summarize the evidence and identify knowledge gaps regarding post-exposure prophylaxis against leprosy. Methods: A systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted by searching the medical scientific databases Cochrane, Embase, Pubmed/MEDLINE, Research Gate, Scopus and Web of Science on Jan. 22, 2020, using a combination of synonyms for index terms in four languages: "leprosy" and "population" or "contacts" and "prevention" or "prophylaxis." Subsequently, Infolep.org and Google Scholar were searched and the "snowball method" was used to retrieve other potentially relevant literature. The found articles were screened for eligibility using predetermined inclusion and exclusion criteria. Results: After deduplication, 1,515 articles were screened, and 125 articles were included in this descriptive meta-analysis. Immunoprophylaxis by bacillus Calmette-Guérin (BCG) vaccination is known to provide protection against leprosy. The protection it offers is higher in household contacts of leprosy patients compared with the general population and is seen to decline over time. Contact follow-up screening is important in the first period after BCG administration, as a substantial number of new leprosy patients presents three months postvaccination. Evidence for the benefit of re-vaccination is conflicting. The World Health Organization (WHO) included BCG in its Guidelines for the Diagnosis, Treatment and Prevention of Leprosy by stating that BCG at birth should be maintained in at least all leprosy high-burden regions. Literature shows that several vaccination interventions with other immunoprophylactic agents demonstrate similar or slightly less efficacy in leprosy risk reduction compared with BCG. However, most of these studies do not exclusively focus on post-exposure prophylaxis. Two vaccines are considered future candidates for leprosy prophylaxis: Mycobacterium indicus pranii (MiP) and LepVax. For chemoprophylaxis, trials were performed with dapsone/acedapsone, rifampicin, and ROM, a combination of rifampicin, ofloxacin, and minocycline. Single-dose rifampicin is favored as post-exposure prophylaxis, abbreviated as SDR-PEP. It demonstrated a protective effect of 57% in the first two years after administration to contacts of leprosy patients. It is inexpensive, and adverse events are rare. The risk of SDR-PEP inducing rifampicin resistance is considered negligible, but continuous monitoring in accordance with WHO policies should be encouraged. The integration of contact screening and SDR-PEP administration into different leprosy control programs was found to be feasible and well accep...

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“…These cut-offs were chosen arbitrarily, as no external criterion was available. The KAP measure has been used in several leprosy studies in Nepal, India, Indonesia and Brazil between 2012 and 2018 [8,[25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Changing perception and improving knowledge of leprosy: An intervention study in Uttar Pradesh, India

et al. 2021

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Introduction Since ancient times leprosy has had a negative perception, resulting in stigmatization. To improve the lives of persons affected by leprosy, these negative perceptions need to change. The aim of this study is to evaluate interventions to change perceptions and improve knowledge of leprosy. Methodology/Principal findings We conducted a pre-post intervention study in Fatehpur and Chandauli districts, Uttar Pradesh, India. Based on six steps of quality intervention development (6SQuID) two interventions were designed: (1) posters that provided information about leprosy and challenged misconceptions, and (2) meetings with persons affected by leprosy, community members and influential people in the community. The effect of the interventions was evaluated in a mixed-methods design; in-depth interviews, focus group discussions, and questionnaires containing a knowledge measure (KAP), two perception measures (EMIC-CSS, SDS) and an intervention evaluation tool. 1067 participants were included in Survey 1 and 843 in Survey 2. The interventions were effective in increasing knowledge of all participant groups, and in changing community and personal attitudes of close contacts and community members (changes of 19%, 24% and 13% on the maximum KAP, EMIC-CSS and SDS scores respectively, p<0.05). In Survey 1, 13% of participants had adequate knowledge of leprosy versus 53% in Survey 2. Responses showed stigmatizing community attitudes in 86% (Survey 1) and 61% (Survey 2) of participants and negative personal attitudes in 37% (Survey 1) and 19% (Survey 2). The number of posters seen was associated with KAP, EMIC-CSS and SDS scores in Survey 2 (p<0.001). In addition, during eight post-intervention focus group discussions and 48 interviews many participants indicated that the perception of leprosy in the community had changed. Conclusions/Significance Contextualized posters and community meetings were effective in changing the perception of leprosy and in increasing leprosy-related knowledge. We recommend studying the long-term effect of the interventions, also on behavior.

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A single dose of rifampicin to prevent leprosy: qualitative analysis of perceptions of persons affected, contacts, community members and health professionals towards chemoprophylaxis and the impact on their attitudes in India, Nepal and Indonesia

Cited by 11 publications

References 0 publications

Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

<p>The State of Affairs in Post-Exposure Leprosy Prevention: A Descriptive Meta-Analysis on Immuno- and Chemo-Prophylaxis</p>

Changing perception and improving knowledge of leprosy: An intervention study in Uttar Pradesh, India

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