Leprosy control in the Northern Territory

Lush, Douglas; Hargrave, John; Merianos, Angela

doi:10.1111/j.1467-842x.1998.tb01475.x

Cited by 9 publications

(7 citation statements)

References 7 publications

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“…From 1971, all newly diagnosed leprosy patients (and previously diagnosed MB patients) were given a three-month course of rifampicin daily in addition to DDS. Clofazimine was later added to existing treatment regimens, with MDT now used as the minimum treatment standard [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

Mycobacterium leprae transmission characteristics during the declining stages of leprosy incidence: A systematic review

et al. 2021

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Background Leprosy is an infectious disease caused by Mycobacterium leprae. As incidence begins to decline, the characteristics of new cases shifts away from those observed in highly endemic areas, revealing potentially important insights into possible ongoing sources of transmission. We aimed to investigate whether transmission is driven mainly by undiagnosed and untreated new leprosy cases in the community, or by incompletely treated or relapsing cases. Methodology/Principal findings A literature search of major electronic databases was conducted in January, 2020 with 134 articles retained out of a total 4318 records identified (PROSPERO ID: CRD42020178923). We presented quantitative data from leprosy case records with supporting evidence describing the decline in incidence across several contexts. BCG vaccination, active case finding, adherence to multidrug therapy and continued surveillance following treatment were the main strategies shared by countries who achieved a substantial reduction in incidence. From 3950 leprosy case records collected across 22 low endemic countries, 48.3% were suspected to be imported, originating from transmission outside of the country. Most cases were multibacillary (64.4%) and regularly confirmed through skin biopsy, with 122 cases of suspected relapse from previous leprosy treatment. Family history was reported in 18.7% of cases, while other suspected sources included travel to high endemic areas and direct contact with armadillos. None of the countries included in the analysis reported a distinct increase in leprosy incidence in recent years. Conclusions/Significance Together with socioeconomic improvement over time, several successful leprosy control programmes have been implemented in recent decades that led to a substantial decline in incidence. Most cases described in these contexts were multibacillary and numerous cases of suspected relapse were reported. Despite these observations, there was no indication that these cases led to a rise in new secondary cases, suggesting that they do not represent a large ongoing source of human-to-human transmission.

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Section: Resultsmentioning

confidence: 99%

Mycobacterium leprae transmission characteristics during the declining stages of leprosy incidence: A systematic review

et al. 2021

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Section: Bacterial and Fungal Ntdsmentioning

confidence: 99%

“…Among Aboriginal Australians in the early 1950s, the incidence of diagnosis of leprosy was 270 per 100,000, but had fallen to 4/100,000 in the Northern Territory by 1997 [78]. This decrease was attributed to widespread use of the BCG vaccine in Aboriginal populations since 1958 [78]. Buruli ulcer, another mycobacterial infection, is endemic in some specific locations in Southeastern Australia and Queensland, with focal outbreaks being reported [79], [80].…”

Section: Bacterial and Fungal Ntdsmentioning

confidence: 99%

Neglected Tropical Diseases of Oceania: Review of Their Prevalence, Distribution, and Opportunities for Control

et al. 2013

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Among Oceania's population of 35 million people, the greatest number living in poverty currently live in Papua New Guinea (PNG), Fiji, Vanuatu, and the Solomon Islands. These impoverished populations are at high risk for selected NTDs, including Necator americanus hookworm infection, strongyloidiasis, lymphatic filariasis (LF), balantidiasis, yaws, trachoma, leprosy, and scabies, in addition to outbreaks of dengue and other arboviral infections including Japanese encephalitis virus infection. PNG stands out for having the largest number of cases and highest prevalence for most of these NTDs. However, Australia's Aboriginal population also suffers from a range of significant NTDs. Through the Pacific Programme to Eliminate Lymphatic Filariasis, enormous strides have been made in eliminating LF in Oceania through programs of mass drug administration (MDA), although LF remains widespread in PNG. There are opportunities to scale up MDA for PNG's major NTDs, which could be accomplished through an integrated package that combines albendazole, ivermectin, diethylcarbamazine, and azithromycin, in a program of national control. Australia's Aboriginal population may benefit from appropriately integrated MDA into primary health care systems. Several emerging viral NTDs remain important threats to the region.

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“…We agree with Prociv that control of filariasis and malaria was achieved in Australia by mosquito control; our statement about the role of sustained public health programs refers to the control of leprosy 4 . With respect to the prospects for control of intestinal protozoa as well as helminths, a single‐dose regimen with broad‐spectrum activity would be ideal.…”

mentioning

confidence: 54%