Preventing Leprosy: Epidemiological and immunological aspects of chemo- and immunoprophylaxis in leprosy patients’ contacts

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Preventing Leprosy: Epidemiological and immunological aspects of chemo- and immunoprophylaxis in leprosy patients’ contacts

Type: Doctoral Thesis
Title: Preventing Leprosy: Epidemiological and immunological aspects of chemo- and immunoprophylaxis in leprosy patients’ contacts
Author: Richardus, R.A.
Issue Date: 2020-02-04
Keywords: biomarkers profiles
adverse events BCG vaccine
rifampicin
prevention
prophylaxis
leprosy
M. leprae
phenolic glycolipid-I (PGL-I)
household contacts
Abstract: Leprosy is an infectious disease caused by Mycobacterium leprae. The global number of new leprosy patients has remained constant over the past decennium, indicating that transmission is ongoing. People living in the same household as untreated leprosy cases have the highest risk of infection. Therefore, it is essential that leprosy control strategy is focused on this risk group. Immunoprophylaxis (vaccination) andchemoprophylaxis (medication) can be used to prevent the spread of leprosy among contacts of leprosy patients, each giving a protective effect of around 60%. In the COLEP trial, an additional additiveprotective effect of SDR (80%) in contacts that had received BCG vaccination in the past was found. To assess the efficacy of a combined strategy, the MALTALEP study was initiated, a cluster randomized controlled trial in the northwest of Bangladesh between 2012 and 2018, in which around 15,000 contacts ofnewly diagnosed leprosy patients received either BCG alone, or BCG plus SDR. The primary outcomewas the development of leprosy within two years. SDR reduced the number of new PB leprosy cases amongst contacts that had been vaccinated with BCG with 42% (non-significant). However, a large proportion of the new leprosy patients (33.6%) arose between vaccination and SDR.
Promotor: Supervisor: Geluk A.
Faculty: Leiden University of Medical Center [LUMC]
University: Leiden University
Uri: urn:isbn:9789463806640
Handle: http://hdl.handle.net/1887/84691
 

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