Leprosy relapse after multidrug therapy: Systematic review and meta-analysis

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Leprosy remains a global health concern, necessitating effective treatment strategies.
• Multidrug therapy (MDT) is the standard treatment for leprosy.
• Understanding leprosy relapse rates post-MDT is crucial for disease control.

Purpose of the Study:

• To systematically review and synthesize evidence on the prevalence of leprosy relapse after multidrug therapy.
• To identify factors associated with leprosy relapse following treatment.

Main Methods:

• A systematic review and random-effects meta-analysis were conducted.
• Studies were identified through comprehensive database searches (Medline, LILACS, Embase, CINAHL, Scopus, WoS, CARPHA).
• Inclusion criteria focused on individuals with leprosy relapse after paucibacillary or multibacillary MDT.

Main Results:

• Nineteen studies comprising 71,385 participants were included in the meta-analysis.
• The pooled prevalence of leprosy relapse was 4% (95% CI: 0.03-0.05).
• Higher relapse rates were observed in working-age males, multibacillary cases with high bacillary load, and individuals with disabilities.

Conclusions:

• Leprosy relapse prevalence varies by geographic region and MDT type, with significant heterogeneity.
• Patient characteristics, treatment adherence, and healthcare capacity are likely contributors to relapse.
• Findings underscore the importance of ongoing monitoring and individualized patient management post-leprosy treatment.