Leprosy is a preventable disease
Introduction
Early case detection and multidrug therapy (MDT) have been the pillars of leprosy control programmes since the introduction of MDT in 1981. Unfortunately, these key elements have not been able to stop the transmission of M. leprae. Until recently, no measures were available to prevent leprosy. However, since effective post-exposure prophylaxis (PEP) for people at risk of developing leprosy has been identified, leprosy has become one of the preventable infectious diseases.
Immunoprophylaxis (e.g. BCG or M.w vaccination of contacts) and chemoprophylaxis (e.g. single-dose rifampicin) are effective as PEP in contacts of leprosy patients (Sharma et al.,2005; Smith & Smith, 2000; Moet et al., 2008). Chemoprophylactic regimens with dapsone, acedapsone and single dose rifampicin (SDR-PEP) given to contacts have been demonstrated to be effective (Smith et al., 2000). Both dapsone and acedapsone have to be given for a prolonged period (Reveiz, Buendía and Téllez, 2009). SDR-PEP, however, is a single dose, which reduces the risk of developing leprosy by 60% (Moet et al., 2008). Multiple research and pilot projects have shown the feasibility of integrating PEP into routine leprosy control programmes. Contact-based prevention of leprosy should now be adopted as a major control strategy to accelerate progress towards a real elimination of leprosy.
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