The long-term impact of the Leprosy Post-Exposure Prophylaxis (LPEP) program on leprosy incidence: a modelling study

Blok, D. J. and Steinmann, P. and Tiwari, A. and Barth-Jaeggi, T. and Arif, M. A. and Banstola, N. L. and Baskota, R. and Blaney, D. and Bonenberger, M. and Budiawan, T. and Cavaliero, A. and Gani, Z. and Greter, H. and Ignotti, E. and Kamara, D. V. and Kasang, C. and Manglani, P. R. and Mieras, L. and Njako, B. F. and Pakasi, T. and Saha, U. R. and Saunderson, P. and Smith, W. C. S. and Staheli, R. and Suriyarachchi, N. D. and Tin Maung, A. and Shwe, T. and van Berkel, J. and van Brakel, W. H. and Vander Plaetse, B. and Virmond, M. and Wijesinghe, M. S. D. and Aerts, A. and Richardus, J. H.. (2021) The long-term impact of the Leprosy Post-Exposure Prophylaxis (LPEP) program on leprosy incidence: a modelling study. PLoS Negl Trop Dis, 15 (3). e0009279.

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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) continuation 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 afterwards 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.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Steinmann, Peter and Barth-Jaeggi, Tanja and Greter, Helena
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1935-2735 (Electronic)1935-2727 (Linking)
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:19 Dec 2022 14:36
Deposited On:19 Dec 2022 14:36

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