TY - JOUR
T1 - The long-term impact of the leprosy post-exposure prophylaxis (Lpep) program on leprosy incidence
T2 - a modelling study
AU - Blok, David J.
AU - Steinmann, Peter
AU - Tiwari, Anuj
AU - Barth-Jaeggi, Tanja
AU - Arif, Mohammad A.
AU - Banstola, Nand Lal
AU - Baskota, Rabindra
AU - Blaney, David
AU - Bonenberger, Marc
AU - Budiawan, Teky
AU - Cavaliero, Arielle
AU - Gani, Zaahira
AU - Greter, Helena
AU - Ignotti, Eliane
AU - Kamara, Deusdedit V.
AU - Kasang, Christa
AU - Manglani, Pratap R.
AU - Mieras, Liesbeth
AU - Njako, Blasdus F.
AU - Pakasi, Tiara
AU - Saha, Unnati R.
AU - Saunderson, Paul
AU - Smith, W. Cairns S.
AU - Stäheli, René
AU - Suriyarachchi, Nayani D.
AU - Maung, Aye Tin
AU - Shwe, Tin
AU - van Berkel, Jan
AU - van Brakel, Wim H.
AU - Plaetse, Bart Vander
AU - Virmond, Marcos
AU - Wijesinghe, Millawage S.D.
AU - Aerts, Ann
AU - Richardus, Jan Hendrik
N1 - Funding Information:
This study is part of LPEP project, funded by Novartis Foundation (no grant number). The grant was received by Jan Hendrik Richardus. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright: © 2021, Public Library of Science. All rights reserved.
PY - 2021/3/31
Y1 - 2021/3/31
N2 - Background The Leprosy Post-Exposure Prophylaxis (LPEP) program explored the feasibility and impact of contact tracing and the provision of single dose rifampicin (SDR) to eligible contacts of newly diagnosed leprosy patients in Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. As the impact of the programme is difficult to establish in the short term, we apply mathematical modelling to predict its long-term impact on the leprosy incidence. Methodology The individual-based model SIMCOLEP was calibrated and validated to the historic leprosy incidence data in the study areas. For each area, we assessed two scenarios: 1) continua-tion of existing routine activities as in 2014; and 2) routine activities combined with LPEP starting in 2015. The number of contacts per index patient screened varied from 1 to 36 between areas. Projections were made until 2040. Principal findings In all areas, the LPEP program increased the number of detected cases in the first year(s) of the programme as compared to the routine programme, followed by a faster reduction after-wards with increasing benefit over time. LPEP could accelerate the reduction of the leprosy incidence by up to six years as compared to the routine programme. The impact of LPEP varied by area due to differences in the number of contacts per index patient included and differences in leprosy epidemiology and routine control programme. Conclusions The LPEP program contributes significantly to the reduction of the leprosy incidence and could potentially accelerate the interruption of transmission. It would be advisable to include contact tracing/screening and SDR in routine leprosy programmes.
AB - Background The Leprosy Post-Exposure Prophylaxis (LPEP) program explored the feasibility and impact of contact tracing and the provision of single dose rifampicin (SDR) to eligible contacts of newly diagnosed leprosy patients in Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. As the impact of the programme is difficult to establish in the short term, we apply mathematical modelling to predict its long-term impact on the leprosy incidence. Methodology The individual-based model SIMCOLEP was calibrated and validated to the historic leprosy incidence data in the study areas. For each area, we assessed two scenarios: 1) continua-tion of existing routine activities as in 2014; and 2) routine activities combined with LPEP starting in 2015. The number of contacts per index patient screened varied from 1 to 36 between areas. Projections were made until 2040. Principal findings In all areas, the LPEP program increased the number of detected cases in the first year(s) of the programme as compared to the routine programme, followed by a faster reduction after-wards with increasing benefit over time. LPEP could accelerate the reduction of the leprosy incidence by up to six years as compared to the routine programme. The impact of LPEP varied by area due to differences in the number of contacts per index patient included and differences in leprosy epidemiology and routine control programme. Conclusions The LPEP program contributes significantly to the reduction of the leprosy incidence and could potentially accelerate the interruption of transmission. It would be advisable to include contact tracing/screening and SDR in routine leprosy programmes.
UR - http://www.scopus.com/inward/record.url?scp=85103743812&partnerID=8YFLogxK
U2 - 10.1371/journal.pntd.0009279
DO - 10.1371/journal.pntd.0009279
M3 - Article
C2 - 33788863
AN - SCOPUS:85103743812
SN - 1935-2727
VL - 15
JO - PLoS Neglected Tropical Diseases
JF - PLoS Neglected Tropical Diseases
IS - 3
M1 - e0009279
ER -
