Effectiveness of innovative interventions on curbing transmission of Mycobacterium leprae

In this Ph.D., we developed and estimated the effectiveness of innovative active case detection strategies based on Geographic Information Systems-based (GIS-based) technologies for stopping transmission of M. leprae in high-priority countries i.e. Comoros, India, and Madagascar. Using GIS-based technologies, we studied highly prevalent clusters in Comoros and Madagascar. Clustering analysis was nested in a larger ongoing trial on post-exposure prophylaxis (PEP) for leprosy (the PEOPLE trial), where detailed mapping of entire village populations, including leprosy patients, was necessary for assessing different modalities for PEP. In India, we assessed the clustering of leprosy and mobility of leprosy patients, to identify highly prevalent clusters at the hamlet level. For this purpose, we developed a methodology to outline hamlets maps including their population to assess clustering for targeted active case detection strategies coupled with prevention activities.

The following research questions were answered:

1. What are the patterns of clustering of leprosy in Comoros and Madagascar?

2. What is the pattern of clustering and mobility of leprosy patients in Bihar, India?

3. How to build an approach for exploring clustering at the lower administrative levels in Bihar, India?