Global practices in regard to implementation of preventive measures for leprosy

Gillini, Laura; Cooreman, Erwin; Wood, Tanya; Pemmaraju, V.R.R.; Saunderson, Paul

doi:10.1371/journal.pntd.0005399

Cited by 30 publications

(27 citation statements)

References 8 publications

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“…Studies point out that the second BCG vaccination increases protection against the disease, reaching a 95% decrease in the relative risk with the application of the second dose (18,20). Among the patients participating in the present study, only 7,1% had received two doses of the vaccine.…”

Section: Discussionmentioning

confidence: 59%

“…Brazil, together with Colombia, Peru and Australia, makes up the list of a few countries that use the application of a second dose of BCG vaccine in contacts of new cases of leprosy as a national prophylactic measure. Although not recommended by the World Health Organization (WHO), the application of this vaccination speci cally for leprosy prophylaxis is recognized by the WHO for its signi cant contribution to the decline in the incidence of the disease (5,18). The BCG vaccine induces the activation of T-cell clones that recognize speci c M. leprae epitopes, providing a protective effect against disease progression, including leading to negative PGL-I serological tests that were previously positive (4,19).…”

Section: Discussionmentioning

confidence: 99%

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Age, gender and BCG vaccination status as risk factors for Leprosy in endemic areas of northern Brazil.

Lima

Paz

Silvestre

et al. 2020

Preprint

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Background In 2018, 208.619 new cases of the leprosy were reported to the World Health Organization (WHO). Of these, 30.957 occurred in the Americas region and 28.660 (92.6% of the total in the Americas) were reported in Brazil. This study aimed to show the reality of the profile of a population in an endemic leprosy area in northern Brazil in relation to age, gender and BCG (bacilo Calmette-Guérin) vaccination status, through the collection of data in the field with evaluation of the study individuals, recruited by spontaneous demand.Methods 405 individuals participated in the study, being 100 multibacillary, 57 paucibacillary and 248 healthy contacts.Results A relationship was observed between the occurrence of the disease, as well as the multibacillary form with the largest age group. The male gender was associated with leprosy per se, with the multibacillary form and was the largest representative of the group that was not vaccinated once.Conclusion BCG vaccination was effective both in protecting against leprosy per se and in the multibacillary form. These results are limited by sample size, may not be conclusive and will need further confirmation in a larger cohort.

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Age, gender and BCG vaccination status as risk factors for Leprosy in endemic areas of northern Brazil.

Lima

Paz

Silvestre

et al. 2020

Preprint

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“…Além do exame dermatoneurológico, o Ministério da Saúde recomendada a imunoprofilaxia dos contatos com a vacina Bacillus Calmette-Guérin (BCG), no entanto, pouco se sabe sobre sua implementação (27) . Mais recentemente, iniciou-se uma discussão sobre a eficácia da quimioprofilaxia com uma dose de rifampicina (28)(29) .…”

Section: Discussionunclassified

Tendência da situação epidemiológica e operacional da hanseníase no estado de Minas Gerais (2008 - 2018)

Silva¹,

Lago²,

Costa³

et al. 2020

SaudColetiv (Barueri)

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Objetivo: Analisar a tendência da situação epidemiológica e operacional da hanseníase no estado de Minas Gerais, período 2008 a 2018. Método: Estudo ecológico de séries temporais. Foram utilizados os indicadores taxa de detecção anual de casos novos de hanseníase e proporção de contatos examinados de casos novos de hanseníase. Os dados foram extraídos do departamento de informática do Sistema Único de Saúde do Brasil, disponibilizadas pelo Ministério da Saúde por meio do acesso a sua página na internet. Utilizou-se análise linear generalizada de Prais-Winsten para análise de tendência. Resultados: Foram registrados 14.991 casos de hanseníase no período. O estado de Minas Gerais apresentou tendência decrescente (-6,74) para detecção geral e tendência crescente (3,38) para a proporção de contatos examinados. Conclusão: Apesar do comportamento favorável dos indicadores analisados, o estado ainda mantém média endemicidade para a doença e uma regular capacidade dos serviços em realizar a vigilância de contatos.

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“…PEP with SDR has been adopted as national policy in several countries with a very low leprosy burden, such as Cuba (since 2002), Morocco (since 2014) and Samoa (since 2015). PEP was implemented as a sub-national policy in recent years in Indonesia, Nepal and India [ 15 ]. Furthermore, the leprosy post-exposure prophylaxis (LPEP) programme is currently ongoing in eight countries: Tanzania, India, Nepal, Sri Lanka, Myanmar, Brazil, Cambodia and Indonesia.…”

Section: Introductionmentioning

confidence: 99%

An enhanced regimen as post-exposure chemoprophylaxis for leprosy: PEP++

et al. 2018

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The ongoing transmission of Mycobacterium (M.) leprae reflected in a very slow decline in leprosy incidence, forces us to be innovative and conduct cutting-edge research. Single dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for contacts of leprosy patients, reduces their risk to develop leprosy by 60%. This is a promising new preventive measure that can be integrated into routine leprosy control programmes, as is being demonstrated in the Leprosy Post-Exposure Programme that is currently ongoing in eight countries.The limited (60%) effectiveness of SDR is likely due to the fact that some contacts have a preclinical infection beyond the early stages for which SDR is not sufficient to prevent the development of clinical signs and symptoms of leprosy. An enhanced regimen, more potent against a higher load of leprosy bacteria, would increase the effectiveness of this preventive measure significantly.The Netherlands Leprosy Relief (NLR) is developing a multi-country study aiming to show that breaking the chain of transmission of M. leprae is possible, evidenced by a dramatic reduction in incidence. In this study the assessment of the effectiveness of an enhanced prophylactic regimen for leprosy is an important component. To define the so called PEP++ regimen for this intervention study, NLR convened an Expert Meeting that was attended by clinical leprologists, public health experts, pharmacologists, dermatologists and microbiologists.The Expert Meeting advised on combinations of available drugs, with known efficacy against leprosy, as well as on the duration of the intake, aiming at a risk reduction of 80–90%. To come to a conclusion the Expert Meeting considered the bactericidal, sterilising and bacteriostatic activity of the potential drugs. The criteria used to determine an optimal enhanced regimen were: effectiveness, safety, acceptability, availability, affordability, feasibility and not inducing drug resistance.The Expert Meeting concluded that the enhanced regimen for the PEP++ study should comprise three standard doses of rifampicin 600 mg (weight adjusted when given to children) plus moxifloxacin 400 mg given at four-weekly intervals. For children and for adults with contraindications for moxifloxacin, moxifloxacin should be replaced by clarithromycin 300 mg (weight adjusted).

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Global practices in regard to implementation of preventive measures for leprosy

Cited by 30 publications

References 8 publications

Age, gender and BCG vaccination status as risk factors for Leprosy in endemic areas of northern Brazil.

Age, gender and BCG vaccination status as risk factors for Leprosy in endemic areas of northern Brazil.

Tendência da situação epidemiológica e operacional da hanseníase no estado de Minas Gerais (2008 - 2018)

An enhanced regimen as post-exposure chemoprophylaxis for leprosy: PEP++

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Global practices in regard to implementation of preventive measures for leprosy

Cited by 30 publications

References 8 publications

Age, gender and BCG vaccination status as risk factors for Leprosy in endemic areas of northern Brazil.

Age, gender and BCG vaccination status as risk factors for Leprosy in endemic areas of northern Brazil.

Tendência da situação epidemiológica e operacional da hansení­ase no estado de Minas Gerais (2008 - 2018)

An enhanced regimen as post-exposure chemoprophylaxis for leprosy: PEP++

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Product

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Tendência da situação epidemiológica e operacional da hanseníase no estado de Minas Gerais (2008 - 2018)