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

Area of Science:

• Infectious Diseases
• Public Health
• Tropical Medicine

Background:

• Innovative strategies are crucial for effective leprosy control, aiming to reduce disease incidence and transmission of Mycobacterium leprae.
• Early detection, contact tracing, and chemoprophylaxis are key interventions for leprosy management.

Purpose of the Study:

• To evaluate the feasibility of integrating contact tracing and single-dose rifampicin (SDR) administration into existing leprosy control programs.
• To generate evidence on the practical implementation of post-exposure prophylaxis in diverse healthcare settings.

Main Methods:

• The Leprosy Post-Exposure Prophylaxis (LPEP) program was a multicenter feasibility study across seven countries.
• It involved systematic tracing and screening of contacts of newly diagnosed leprosy patients.
• Eligible contacts received single-dose rifampicin (SDR) as chemoprophylaxis.

Main Results:

• Over 174,000 contacts were successfully traced and screened.
• SDR was administered to 86.9% of eligible screened contacts, with minimal refusals and no serious adverse events.
• A small proportion of screened contacts (46 per 10,000) were diagnosed with new leprosy cases.

Conclusions:

• Post-exposure prophylaxis with SDR is a safe and well-accepted intervention for leprosy control.
• Integration into routine programs is feasible with established contact tracing systems.
• The study recommends widespread rollout of SDR where contact tracing and screening are in place.