Fw: Ref.: (LML) Epidemiology & an Abstract

Leprosy Mailing List –  June 30,  2025

 

Ref.:  (LML) Epidemiology & an Abstract

From: Joel Almeida, Mumbai, India

 

 

 

 

 

 

Dear Pieter and colleagues,

 

An overview might be useful of the epidemiology of HD and key intervention points.

Once LL HD patients are reliably diagnosed and protected it is like turning off a tap. The flood of viable bacilli stops. Would it be wrong to say that most if not all the problems flow from that open tap?

Re Safe & effective interventions, an abstract of a recently published paper:

"This is a quantitative analysis of data concerning visible deformity among newly diagnosed Hansen's disease - HD (leprosy) patients in Dadra Nagar Haveli, India, before and after the introduction of chemoprophylaxis. Chemoprophylaxis was introduced on 1 April 2015 and consisted of a rifampicin dose >10 mg/kg for contacts of nearly all "primary" patients who were newly diagnosed from 1 April 2013 until 2017. The population had repeated door-to-door surveys in the two years before the introduction of chemoprophylaxis. Data was extracted from published sources.

The variation in the annual number of newly diagnosed HD patients with visible deformity in this population in any given year was predictable to the extent of over 90% by the number of contacts in this population who had received chemoprophylaxis in the preceding year (p =.0002, R2 = 0.9132). The population incidence rate of newly detected visible HD deformity at HD diagnosis increased substantially, from <2/million population/yr during 2010 to 2014 to >60/million population/yr in 2016, the year following the 2015 introduction of chemoprophylaxis.

The evidence suggests that brief chemoprophylaxis among asymptomatic contacts of newly diagnosed HD patients was an important factor in the causation of visible deformity among newly diagnosed HD patients in this population. Biological plausibility is discussed. 

 

By contrast, the frequency of visible HD deformity typically declines between the start and end of full MDT treatment backed by a package of nerve function monitoring and holistic care. Consequently, it is recommended that the underlying biology of visible deformity after brief chemoprophylaxis be elucidated further by non-human experiments before exposing more people in endemic countries to the risks of brief chemoprophylaxis. This will help protect the limbs and eyes of family members and other contacts of persons who experience(d) HD."

With all sincerity,

Joel Almeida

Reference

Almeida JG, Talhari S, Salgado CG, Kumar B, Talhari C, Gonçalves HdS (2025). Visible Deformity after HD (Leprosy) Chemoprophylaxis among Tribal People in India: Quantitative Analysis of Data Extracted from Published Sources. Indian J Lepr. 97: 175-188.

 

PS Many interesting articles in the same Apr-June 2025 issue of Indian J. Lepr,  including

KR Pilaka, MS Pallapati, M Simic, DNJ Lockwood, A Srikantam
Revisiting the Eye-Hand-Foot Score as a Simple Tool in Assessing the Disability Progression in Leprosy Patients in India

KS Baghotia, PSS Rao
Spatiotemporal Changes of Leprosy in the 11 Districts of National Capital Territory of Delhi, India

S Surve, SV Gitte, R Adkekar, S Khera
Investigating the Changing Landscape of Leprosy Cases and Geospatial Analysis: A Study of High and Low Endemic Districts in Maharashtra, India

Katoch VM
Research on Deformities/Disabilities in Leprosy Needs to Focus on Improving the Outcomes. 

________________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

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