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TropicalMed
Special Issues
Leprosy: Stop Transmission and Prevent Disease
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Leprosy: Stop Transmission and Prevent Disease

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Neglected and Emerging Tropical Diseases".

Deadline for manuscript submissions: closed (20 October 2023) | Viewed by 3881

Special Issue Editors

Dr. Liesbeth Mieras

E-Mail Website
Guest Editor
NLR International Office, Amsterdam, The Netherlands
Interests: leprosy; prevention; post-exposure chemoprophylaxis; single dose rifampicin; transmission; SDR-PEP; skin NTDs; disability
Dr. Anne Schoenmakers

E-Mail Website
Guest Editor
NLR International Office, Amsterdam, The Netherlands
Interests: leprosy; prevention; post-exposure chemoprophylaxis; single dose rifampicin; transmission; SDR-PEP; skin NTDs
Dr. Astri Ferdiana

E-Mail Website
Guest Editor
1. Department of Public Health, Faculty of Medicine, University of Mataram, Mataram, Indonesia
2. NLR Indonesia, Jakarta, Indonesia
Interests: leprosy; disability
Dr. Kidist Bobosha

E-Mail Website
Guest Editor
Mycobacterial Diseases Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Interests: leprosy; disability

Special Issue Information

Dear Colleagues,

Leprosy is an infectious disease that mainly affects the skin and peripheral nerves. It is a neglected tropical disease, even though millions of people are at risk of developing leprosy, which can lead to permanent disabilities. Stigmatisation, mental health problems and increased socio-economic challenges are consequences of the disease that can be experienced by leprosy patients as well as their family members.

The disease is caused by the slow-growing bacteria Mycobacterium (M.) leprae; the incubation period is 3-5 years on average but can be up to 20 years. The route of transmission of M. leprae is assumed to be via droplets from the mouth and nose of an untreated patient to close and frequent contacts. Effective therapy for leprosy is available in the form of multidrug therapy, a combination of antibiotics, given for six or twelve months, depending on the type of leprosy. There is currently no field-friendly test to diagnose leprosy or to identify individuals that have been infected with M. leprae. It is, therefore, hard to control the disease through early detection and prompt treatment alone.

The World Health Organization has advised post-exposure chemoprophylaxis (PEP) with single-dose rifampicin (SDR) for contacts of leprosy patients since 2018. SDR-PEP reduces the risk of developing leprosy for close contacts by 57%. Implementing SDR-PEP and other innovative preventative methods and a better understanding of the transmission of M. leprae can help to decrease the number of new patients and thus reduce the physical, psychological and socio-economic consequences caused by the disease.

Dr. Liesbeth Mieras
Dr. Anne Schoenmakers
Dr. Astri Ferdiana
Dr. Kidist Bobosha
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • leprosy
  • prevention
  • post-exposure prophylaxis
  • single dose rifampicin
  • transmission
  • SDR-PEP

Published Papers (2 papers)

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Research

11 pages, 364 KiB  
Article
Single-Dose Rifampicin Leprosy Chemoprophylaxis for Household Contacts in Kiribati: An Audit of a Combined Retrospective and Prospective Approach
by Patrick O. Campbell, Temea Bauro, Erei Rimon, Eretii Timeon, Caitlin Bland, Nabura Ioteba, Nicholas M. Douglas, Arturo Cunanan and Stephen T. Chambers
Trop. Med. Infect. Dis. 2024, 9(3), 58; https://doi.org/10.3390/tropicalmed9030058 - 1 Mar 2024
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Abstract
Kiribati is a Pacific Island nation with a widely dispersed population and one of the highest rates of leprosy worldwide. Single-dose rifampicin post-exposure prophylaxis (SDR-PEP) of leprosy contacts has reduced new case detection rates in controlled trials. In 2018, an SDR-PEP programme was [...] Read more.
Kiribati is a Pacific Island nation with a widely dispersed population and one of the highest rates of leprosy worldwide. Single-dose rifampicin post-exposure prophylaxis (SDR-PEP) of leprosy contacts has reduced new case detection rates in controlled trials. In 2018, an SDR-PEP programme was introduced in Kiribati that included screening and chemoprophylaxis of household contacts of leprosy cases retrospectively (2010–2017) and prospectively (2018–2022). We conducted a retrospective audit to determine the comprehensiveness, timeliness and feasibility of the SDR-PEP programme. Overall, 13,641 household contacts were identified (9791 in the retrospective and 3850 in the prospective cohort). In the retrospective cohort, 1044 (11%) contacts were absent, 403 (4%) were ineligible for SDR, and 42 new cases were detected (0.4%) Overall, SDR coverage was 84.7%. In the prospective cohort, 164 (4%) contacts were absent, 251 (7%) were ineligible for SDR, and 23 new cases were diagnosed (0.6%). Overall, SDR coverage was 88.1%. Across both cohorts, there were 23 SDR refusals. The median time to SDR administration was 220 days (IQR 162–468) and 120 days (IQR 36–283) for the retrospective and prospective cohorts, respectively. SDR was readily accepted in both cohorts. The new case detection rate (0.5%) is consistent with that in other studies. Overall SDR coverage in both the retrospective and prospective phases met programmatic expectations. Full article
(This article belongs to the Special Issue Leprosy: Stop Transmission and Prevent Disease)
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12 pages, 260 KiB  
Article
The NLR SkinApp: Testing a Supporting mHealth Tool for Frontline Health Workers Performing Skin Screening in Ethiopia and Tanzania
by Nelly Mwageni, Robin van Wijk, Fufa Daba, Ephrem Mamo, Kitesa Debelo, Benita Jansen, Anne Schoenmakers, Colette L. M. van Hees, Christa Kasang, Liesbeth Mieras and Stephen E. Mshana
Trop. Med. Infect. Dis. 2024, 9(1), 18; https://doi.org/10.3390/tropicalmed9010018 - 10 Jan 2024
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Abstract
Background: The prevalence of skin diseases such as leprosy, and limited dermatological knowledge among frontline health workers (FHWs) in rural areas of Sub-Saharan Africa, led to the development of the NLR SkinApp: a mobile application (app) that supports FHWs to promptly diagnose and [...] Read more.
Background: The prevalence of skin diseases such as leprosy, and limited dermatological knowledge among frontline health workers (FHWs) in rural areas of Sub-Saharan Africa, led to the development of the NLR SkinApp: a mobile application (app) that supports FHWs to promptly diagnose and treat, or suspect and refer patients with skin diseases. The app includes common skin diseases, neglected tropical skin diseases (skin NTDs) such as leprosy, and HIV/AIDS-related skin conditions. This study aimed to test the supporting role of the NLR SkinApp by examining the diagnostic accuracy of its third edition. Methods: A cross-sectional study was conducted in East Hararghe, Ethiopia, as well as the Mwanza and Morogoro region, Tanzania, in 2018–2019. Diagnostic accuracy was measured against a diagnosis confirmed by two dermatologists/dermatological medical experts (reference standard) in terms of sensitivity, specificity, positive predictive value, and negative predictive value. The potential negative effect of an incorrect management recommendation was expressed on a scale of one to four. Results: A total of 443 patients with suspected skin conditions were included. The FHWs using the NLR SkinApp diagnosed 45% of the patients accurately. The values of the sensitivity of the FHWs using the NLR SkinApp in determining the correct diagnosis ranged from 23% for HIV/AIDS-related skin conditions to 76.9% for eczema, and the specificity from 69.6% for eczema to 99.3% for tinea capitis/corporis. The inter-rater reliability among the FHWs for the diagnoses made, expressed as the percent agreement, was 58% compared to 96% among the dermatologists. Of the management recommendations given on the basis of incorrect diagnoses, around one-third could have a potential negative effect. Conclusions: The results for diagnosing eczema are encouraging, demonstrating the potential contribution of the NLR SkinApp to dermatological and leprosy care by FHWs. Further studies with a bigger sample size and comparing FHWs with and without using the NLR SkinApp are needed to obtain a better understanding of the added value of the NLR SkinApp as a mobile health (mHealth) tool in supporting FHWs to diagnose and treat skin diseases. Full article
(This article belongs to the Special Issue Leprosy: Stop Transmission and Prevent Disease)
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