Making post-exposure prophylaxis effective for leprosy elimination: Insights from a multi-country study on...

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Global Health Policy

Background:

• Leprosy transmission interruption in low endemic countries presents unique challenges.
• Scaling up single dose rifampicin (SDR) post-exposure prophylaxis (PEP) is key for leprosy elimination.
• Resource-limited settings require tailored strategies for PEP implementation.

Purpose of the Study:

• To explore challenges and enablers of SDR-PEP implementation in low endemic settings.
• To identify factors influencing active case detection (ACD) and PEP scale-up.
• To provide recommendations for effective leprosy control in non-endemic contexts.

Main Methods:

• Conducted 12 semi-structured in-depth interviews with key informants.
• Interviewees included medical practitioners, program coordinators, researchers, policymakers, and experts.
• Focus on experiences in six countries with low leprosy endemicity.

Main Results:

• Lowering endemicity decreased disease prioritization and awareness.
• Limited funding and resource accessibility pose significant hurdles.
• National leadership and international coordination are vital for procurement and integration.

Conclusions:

• Sustained political will and policy alignment are essential for long-term SDR-PEP success.
• Effective stakeholder coordination facilitates rifampicin procurement and program integration.
• Low endemic settings require specific policy and practice considerations for leprosy elimination.