The Leprosy Post-Exposure Prophylaxis (LPEP) programme: update and interim analysis

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Global Health

Background:

• Innovative strategies are crucial for advancing leprosy control, aiming to decrease incidence and transmission.
• Early detection, contact screening, and chemoprophylaxis represent a promising approach to achieving these control objectives.
• The Leprosy Post-Exposure Prophylaxis (LPEP) programme was established to assess the integration of contact tracing and single-dose rifampicin (SDR) into routine leprosy control.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of integrating contact tracing and SDR administration into existing leprosy control programs.
• To generate evidence on the practical implementation of post-exposure prophylaxis in diverse healthcare settings.
• To assess the safety, acceptance, and impact of SDR as a chemoprophylactic intervention for leprosy contacts.

Main Methods:

• The LPEP programme involved tracing, screening, and administering SDR to contacts of newly diagnosed leprosy patients across eight countries.
• Country-specific protocols were adapted for contact definition, minimum age for SDR, and involved healthcare staff.
• Data collection focused on tracing rates, screening outcomes, leprosy incidence among contacts, SDR eligibility, and administration rates.

Main Results:

• Over 123,000 contacts were identified from nearly 6,000 index patients, with 99.1% successfully traced and screened.
• 406 new leprosy cases were detected among contacts, and SDR was administered to 89.0% of eligible contacts.
• Single-dose rifampicin (SDR) was found to be safe, feasible for integration, and well-accepted by patients, contacts, and healthcare workers, while also revitalizing local control programs.

Conclusions:

• Post-exposure prophylaxis with single-dose rifampicin (SDR) is a safe and effective strategy for leprosy control.
• The integration of SDR administration into routine leprosy control programs is feasible and well-accepted.
• The LPEP programme demonstrates the potential of chemoprophylaxis to reduce leprosy transmission and invigorate control efforts.