Fw: Ref.: (LML) The zebra fish professor

 

 

Leprosy Mailing List – October 16,  2024

 

Ref.:  (LML) The zebra fish professor

From:  Joel Almeida, Mumbai, India

---

 

Dear Pieter and colleagues,

 

Zebra fish were mentioned here recently.

 

 

The Figure. Reproduced from Madigan et al., 2017, Cell 170, 973–985.
CC-BY-4.0 licence

 

Prof. Lalita Ramakrishnan, the corresponding author of that article is from an HD-endemic country, and recently was named as the 2024 winner of the Robert Koch award. Her brother in 2009 had shared the Nobel prize in Chemistry for his work on ribosomes. 

Making room and opportunities for the brightest young people from endemic countries is likely to yield good outcomes. Would it be a bad idea to recognise that we are all students of a tricky bacillus and of human nature, and that knowledge can flow in all directions?

 

The interventions producing the most rapid decline in MB HD incidence rate so far (15 to 20%/yr) have come from endemic countries that were allowed to do their thing. Even more rapid decline seems possible. Would it be unwise for smaller endemic countries to emulate the most successful projects of larger endemic countries? 

 

With all sincerity,

 

Joel Almeida

 

---

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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Fw: Ref.: (LML) The Star

 

 

 

Leprosy Mailing List – October 16,  2024

 

Ref.:  (LML) The Star

From:  José Ramirez, Carville, USA

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Hello,

 

For 100 years the publication, The Star, has endeavored to "radiate the light of truth on Hansen's disease."  It began in the 1930's when patients at the treatment center for leprosy in Carville, Louisiana, United States, embarked on a journey to educate others about this extremely misunderstood disease. 

 

Since then, The STAR has had eight Managing Editors. All eight were patients--sent involuntarily--to Carville. Now, their combined compassion, makes The STAR a publication worth reading for those associated with Hansen's disease, as a medical expert or advocate.  

 

 We hope you enjoy this issue.

 

José Ramirez, Jr., LCSW

Managing Editor, The Star

Chair, Board of Directors, IDEA

---

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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Fw: Ref.: (LML) 2024 winners Alliance Against Leprosy Prize"Case reports in leprosy - shared practice"

 

Leprosy Mailing List – October 14,  2024

 

Ref.:  (LML) 2024 winners Alliance Against Leprosy Prize"Case reports in leprosy - shared practice"

From:  Laila de Laguiche, Curitiba, Brazil

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Dear Pieter,

As you know, the Alliance Against Leprosy ( AAL), together with the journal Hansenologia Internationalis: Leprosy and Other Infectious Diseases (HI), is promoting a special section in the HI journal entitled "Case reports in leprosy - shared practice", offering an annual prize to the three reports that obtain the best scores.

We are pleased to announce the 2024 winners and the editorial team share the understanding that scientific dissemination on leprosy through clinical case reports represents an opportunity to promote the rapid spread of knowledge.

We congratulate the winners and look forward to more articles, always stimulating!

 

Best regards,

 

Laila

Curitiba - Brazil

 

- 1º : 

Ulcerative type 1 lepra reaction in borderline tuberculoid leprosy: A rare presentation;

Autor: Sabha Mushtaq

https://periodicos.saude.sp.gov.br/hansenologia/article/view/40191/38202

 

ABSTRACT

 

Introduction:  

leprosy  is  a  chronic  infectious  disease  caused  by  Mycobacterium  leprae, characterized  by  a  wide  spectrum  of  clinical  presentations.  In  India,  borderline-tuberculoid  leprosy is the most common form encountered in  clinical  practice.

Type  1  lepra  reaction  in  borderline-tuberculoid leprosy usually presents as the development of erythema and/or edema in  pre-existing  skin  lesions. 

Ulceration  of  skin  lesions  in  type  1  lepra  reaction  is  uncommon  and  occurs  in  severe  reactions.  Objective:  to  report  an  unusual  presentation  of  borderline-tuberculoid leprosy with ulcerative type 1 lepra reaction in an immunocompetent patient.

 

Case description:

We present the case of a 65-year old  man  with  chief  complaints  of  ulcerated  plaque  over  his  left  thigh.  He  also  had  other  skin lesions suggestive of borderline-tuberculoid leprosy  over  his  trunk  and  limbs,  as  well  as enlarged,  mildly  tender  left  ulnar  and  lateral  popliteal  nerves.  A  slit  skin  smear  was negative, while a skin biopsy supported the diagnosis of borderline-tuberculoid leprosy.  The  patient  responded  to  multibacillary  multidrug  therapy  according  recommended  by  World  Health  Organization  and  tapering  doses  of  prednisolone,  with complete healing of the ulceration at six weeks follow-up.

 

Discussion:

Type 1 lepra reaction associated with borderline-tuberculoid leprosy usually presents with increased erythema and edema in pre-existing skin lesions. Ulceration in such skin lesions is not commonly seen except in cases with severe type 1 leprosy reactions. Administration of oral corticosteroids along with multibacillary multidrug therapy is the key to managing ulcerative type 1 lepra reaction. The ulceration heals rapidly with tapering doses of oral corticosteroids, limiting the duration of morbidity.

 

Final consideration:

The case emphasizes the need for dermatologists and leprologists to be aware of atypical presentations of leprosy reactions, ensuring timely diagnosis and effective management to achieve optimal patient outcomes.

 

 

 

- 2º : 

Concomitance of lepromatous leprosy and squamous cell carcinoma: case report;

Autors: Hugo Hatanaka, Bruno de Carvalho Dornelas, Pauline Dias Soares Girardi, Caio Oliveira Sena, Marcelo Campos Rocha, Isabela Maria Bernardes Goulart

 https://periodicos.saude.sp.gov.br/hansenologia/article/view/40198/38198

 

ABSTRACT

Introduction:

Leprosy is an endemic disease in Brazil, ranking second worldwide for  the  number  of  new  cases  diagnosed  yearly.  However,  late  diagnosis  of  this disease is still common. Objective: to alert health professionals to the importance  of  recognizing  the  insidious  signs  of  leprosy,  both  clinical  and  histopathological, even in the presence of other, more apparent alterations.

 

Presentation  and  discussion  of  the  case:  

A  man  with  skin  lesions  suggestive of squamous cell carcinoma.

On histological examination,  besides the  carcinoma,  there  were  aggregates  of  foamy  macrophages  full  of  acid-fast  bacilli  compatible  with  lepromatous  leprosy.  A  more  detailed  physical  examination by a multidisciplinary team from a national reference center also revealed skin with a diffuse infiltrated appearance and supraciliary madarosis, alterations  not  noticed  in  the  first  evaluation  at  another  service. 

 

Final considerations:  this  case  can  help  clinical  professionals  and  pathologists  pay  attention  to  skin  alterations  that  can  make  it  challenging  to  diagnose  leprosy, especially in endemic regions, to enable early diagnosis and reduce the disabilities related to the disease. 

 

 

- 3º : 

Quantitative PCR diagnostic value in monitoring a patient with leprosy: case report

Autors: Marcos Daniel Silva Pinheiro, Maisa Pereira Vieira, Daisy Cristina Monteiro dos Santos, Alexandre Castelo Branco, Lorena Bruna Pereira de Oliveira, Lucia Alves de Oliveira Fraga.

https://periodicos.saude.sp.gov.br/hansenologia/article/view/40201/38180

 

ABSTRACT

Introduction: 

Leprosy  is  a  chronic  granulomatous  disease  caused  by  Mycobacterium  leprae. Objective:  the  study  aims  to  report  the  follow-up  of a patient with leprosy, presenting a positive quantitative polymerase chain reaction (qPCR).

 

Case description:

The patient is a 53-year-old male residing in  the  rural  area  of  São  Geraldo  da  Piedade,  Minas  Gerais  State,  Brazil. 

In  2015,  the  patient  sought  care  at  the  Governador  Valadares  Municipal  Central  Polyclinic  and  was  referred  to  the  Dr.  Alexandre  Castelo  Branco  Reference Center for Endemic Diseases and Special Programs (CREDEN-PES) to  initiate  treatment. However,  he  did  not  adhere  to  the  therapy,  citing  difficulty accessing the center.

In 2017, he returned to CREDEN-PES, where he was examined  and  collected  material  for  bacilloscopy  and  qPCR.  The  bacilloscopy index (BI) result was zero and positive for qPCR. The patient was  referred  for  treatment  in  his  hometown  and  adhered  to  two  doses  of  multibacillary multidrug therapy (MB-MDT).

In 2021, he sought CREDEN-PES for new evaluations, resulting in BI = 1.5 and decreased plantar sensitivity.
He  began  a  unique  treatment  regimen  for  leprosy  (U-MDT). 

In  2023,  he  moved to Paraná State and recently reported his condition: regular health, altered  balance,  frequent  falls,  loss  of  strength  in  the  knees,  dry  skin,  and swelling behind the ear. The positivity of the qPCR reaction prompted the team to follow up with this patient, who initially did not adhere to the treatment.

 

Conclusion:

It is believed that using laboratory tools to assist and reinforce the diagnosis and treatment has contributed to more effective leprosy control

 

 

 

---

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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Fw: Ref.: (LML) Highly bacillated lesions despite treatment of drug-susceptible bacilli

 

Leprosy Mailing List – October 13,  2024

 

Ref.:  (LML)  Highly bacillated lesions despite treatment of drug-susceptible bacilli

From:  Joel Almeida, Mumbai, India

---

 

 

Dear Pieter & colleagues,

 

 

Continuing the interesting discussions:

 

Should training be confined to urban professionals?

Probably not. Training professionals, especially those who have settled in poorly served highly endemic rural areas, seems necessary for many reasons. One of the most important reasons is that missed LL (lepromatous) patients can otherwise suffer eventual damage, as well as shed millions of viable bacilli per day.(1) This is sufficient to maintain transmission regardless of all other efforts. Without constant replenishment of concentrated viable bacilli, the viability of environmental extracellular bacilli is lost within as little as five months in dry, shady locations or 1.5 months in moist soil.(2) Our job is to protect all patients from current or lasting damage, and to shut down sources of concentrated viable bacilli. Shutting down sources of bacilli can be achieved by competent diagnosis and sufficient treatment of infected LL patients, including the prevention of re-infection.(3) In armadillo territory, contact with armadillos and armadillo-infected soil can be avoided altogether or minimised using protective gear.

 

Training is also necessary for quarterly monitoring of nerve function, because about 85% of nerve function impairment during treatment occurs without any signs or symptoms ("silent" nerve damage). (4) 

 

                                                                   Is this challenge to HD control well known?

Colleagues in endemic countries have shared examples of highly bacillated forms of HD (leprosy) in patients who faithfully completed fixed duration therapy including 12 monthly doses of rifampicin. (personal communications from Brazil and India) This happened even in some patients whose bacilli did not show mutations in the usual gene loci associated with drug-resistance. Better anti-microbial protection for highly bacillated LL (lepromatous) patients can be explored to protect such patients from damage and to help stop transmission. Bacilli with only the wild type rpoB gene can still show epigenetic tolerance to rifamycins, inversely related to drug concentration. These variant bacilli are genomically rifampicin-susceptible but phenotypically tolerant, being able to grow and divide in the presence of rifampicin.(5) It even seems likely that up-regulation by rifamycins of the rpoB gene in a sub-population of mycobacteria can lead to accelerated growth and division, with accompanying increased virulence of this sub-population of M. leprae. 

 

Tolerance to rifamycins can also arise from up-regulation of genes for efflux pumps. (6,7) Efflux pumps are proteins that actively translocate chemicals across the bacillary membrane, affecting not only tolerance to rifamycins but also virulence. 

 

Alongside this, dormancy of most of an M. leprae population seems probable, and could be the main explanation for the long observed doubling time of the bacillary population. The transition rate to dormancy (sometimes called the natural "death rate" of M. leprae) can result in a long doubling time despite a much shorter generation time. Hastings and Morales (8) treated the transition to dormancy as death and showed that a doubling time of more than one week is explicable by a generation time of only about 26 hours plus a relatively high "death" (transition to dormancy) rate. Accordingly, upon exposure to rifamycins, most of the M. leprae population could well be dormant with sporadic growth and division in a genomically drug-susceptible but phenotypically rifamycin-tolerant sub-population. This could well explain the highly bacillated types of LL HD sometimes observed in endemic countries despite faithful ingestion of 12 monthly doses of rifampicin + daily dapsone and clofazimine, even when known drug-resistance mutations are not detectable.

 

Incidentally, until recently we had never witnessed exactly how mycobacteria grow and divide. Now, a microscopic movie of the fascinating process can be viewed in Hannebelle et al.(9) The process turns out to occur at poles of the bacilli, and to be bi-phasic. This is consistent with dormancy interspersed with bursts of growth and division in a sub-population of bacilli. This, along with up-regulation of efflux pumps, may well explain why the anti-microbial efficacy of rifampicin declines markedly after the initial dose. Daily rifampicin has markedly lower efficacy against M. leprae when compared to the initial dose of rifampicin, and monthly rifampicin has less efficacy than even daily dapsone or daily clofazimine.(10,11) 

 

Responding to the challenges

The practical implication of such efflux pumps and bacillary dormancy alongside growth and division of rifampicin-tolerant bacilli is that MIP vaccine (12) is advisable in highly bacillated patients, and alternative drugs deserve testing against M. leprae. Every drug known to be active against every mycobacterium, and every micro-organism, can be tested against M. leprae in animal models using rapid quantitative assessment of viability. Telacebec and bedaquiline are well known active molecules, but there may be others including older molecules not usually considered for use against M. leprae or mycobacteria. After testing for safety including safety of nerves during drug treatment in models such as zebra fish (13) and armadillos (14), use of alternative drugs in humans could help reduce the clinical impact of genomically drug-susceptible but phenotypically drug-tolerant M. leprae. Growth of M. leprae within macrophages is known to increase PGL-1 and so provoke the release of nitric oxide from macrophages that damages mitochondria in nerve axons.(13) That is why up-regulation of rpoB genes and efflux pump genes by rifamycins with consequent bacillary growth, division and shedding can too often be followed by an increased risk of virulence, transmission and nerve damage among previously asymptomatic persons.

 

Preventing re-infection in endemic areas

Enlightened colleagues in centres of excellence in endemic areas have already been protecting LL patients against (re)infection or endogenous relapse, using fully supervised monthly administration of potent bactericidal drugs in combination (eg., rifapentine + moxifloxacin + minocycline, sometimes clarithromycin has been added). Unresponsiveness to MIP vaccine is a useful indicator of the need for such prolonged protection. Careful recording and reporting from such initiatives would be instructive.

 

Is rapid decline of MB HD unachievable?

None of the above alters the fact that rapid decline in new MB (multibacillary) and LL HD is demonstrably achievable in even low income highly endemic populations near the equator, using mobile expert services and prolonged anti-microbial protection against (re)infection of anergic LL patients (15,16) Without expertise, either in person or via telemedicine, and in the absence of nasal smears for bacilloscopy, LL patients can be missed because they lack skin patches or nerve enlargement. Successful projects in low income areas established a benchmark of >15%/year decline in incidence rate of MB HD. That would permit about 65% decline in the incidence rate of MB HD by 2030. The rate of decline can probably be accelerated by using MIP vaccine in highly bacillated patients. Is there some reason to avoid demonstrably effective methods?

 

Bright young talent in endemic countries

Finally, it seems important to create opportunities and invite the brightest young people in endemic countries to participate in the battle against HD. There is no substitute for immersion in the epidemiological, clinical, laboratory and socio-economic context of HD in endemic countries, using well-established as well as rapidly advancing technology and knowledge. Counter-intuitive but crucial clues can then be more readily identified and woven together. Action can steadily be tweaked to defeat M. leprae more rapidly and to protect patients and their families more securely. The brightest young people in endemic countries currently gravitate to working in, or even leading, large global corporations (Microsoft, Alphabet/Google, Adobe etc,) or organizations such as the World Bank. If even a few of the most gifted can be encouraged to participate to some extent in the fight against HD, they will probably strengthen the capability of us all while bringing nearer the defeat of HD. Gaurav et al (6) are one example of such bright young talent in endemic countries. The more, the better.

 

 

With all sincerity,

 

Joel Almeida

 

References

 

1.      Davey TF, Rees RJ. The nasal dicharge in leprosy: clinical and bacteriological aspects. Lepr Rev. 1974 Jun;45(2):121-34.

 

2.     Desikan KV, Sreevatsa A. Extended studies on the viability of Mycobacterium leprae outside the human body. Lepr Rev, 1995; 66: 287–295. 

 

3.    Stefani MMA, Avanzi C, Buhrer-Sekula S, Benjak A, Loiseau C, Singh P Whole genome sequencing distinguishes between relapse and reinfection in recurrent HD cases. PLoS Negl Trop Dis 2017; 11: e0005598

 

4.     Croft RP, Nichols P, Richardus J, Smith WCS. Incidence rates of acute nerve function impairment in leprosy : a prospective cohort analysis after 24 months (The Bangladesh Acute Nerve Damage Study). Lepr Rev (2000) 71,18-33.

 

5.      Zhu J-H, Wang B-W, Pan M. Rifampicin can induce antibiotic tolerance in mycobacteria via paradoxical changes in rpoB transcription Nature Commun. 2018 Oct 11;9(1):4218. doi: 10.1038/s41467-018-06667-3.

 

6.     Gaurav A, Bakht P, Saini M et al. Role of bacterial efflux pumps in antibiotic resistance, virulence, and strategies to discover novel efflux pump inhibitors. Microbiology 2023;169:001333 DOI 10.1099/mic.0.001333

 

7.     Machado D, Lecorche E, Mougari F. Insights on Mycobacterium leprae Efflux Pumps and Their Implications in Drug Resistance and Virulence. Insights on Mycobacterium leprae. Front. Microbiol. 9:3072. doi: 10.3389/fmicb.2018.03072

 

8.     Hastings, R. C. and Morales, M. J. Observations,calculations and speculations on the growth and death of M. leprae in vivo. Int. J. Lepr. 50 (1982) 579-582.

 

9.     Hannebelle MT, Ven JX, Toniolo C et al. A biphasic growth model for cell pole elongation in mycobacteria. NATURE COMMUNICATIONS | (2020) 11:452 | https://doi.org/10.1038/s41467-019-14088-z

 

10.     Grosset, J. H. and Guelpas-Lauras, C.-C. Activity of rifampin in infections of normal mice with M. leprae. Int. J. Lepr. 55 (1987) 847-851.

 

11.     Colston, M. J., Hilson, G. R. F. and Banerjee, D.K. The "proportional bactericidal test": a method for assessing bactericidal activity of drugs against M. leprae in mice. Lepr. Rev. 49 (1978) 7-15.

 

12.     Sharma P, Kar HK, Misra RS. Induction of lepromin positivity following immuno-chemotherapy with Mycobacterium w vaccine and multidrug therapy and its impact on bacteriological clearance in multibacillary leprosy: report on a hospital-based clinical trial with the candidate antileprosy vaccine. Int J Lepr 1999 Sep;67(3):259-69

 

13.     Madigan, Cressida A. et al. A Macrophage Response to Mycobacterium leprae Phenolic Glycolipid Initiates Nerve Damage in Leprosy. Cell, Volume 170, Issue 5, 973 - 985.e10

 

14.   Truman RW, Ebenezer GJ, Pena MT et al. The armadillo as a model for peripheral neuropathy in leprosy. ILAR J 54(2014):304–314. 

 

15.     Norman G, Bhushanam JDRS, Samuel P. Trends in leprosy over 50 years in Gudiyatham Taluk, Vellore, Tamil Nadu. Ind J Lepr 2006. 78(2): 167-185. reviewed and analysed further in: 3a. Almeida J. Karigiri, India: How transmission rapidly was reduced in a low-income population.  LML 29 Oct 2020

 

16.     Tonglet R, Pattyn SR, Nsansi BN et al. The reduction of the leprosy endemicity in northeastern Zaire 1975/1989 J.Eur J Epidemiol. 1990 Dec;6(4):404-6 reviewed in: 13a. Almeida J. Reducing transmission in poor hyperendemic areas - evidence from Uele (DRC). LML 29 Nov 2019

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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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Fw: Ref.: (LML) Post-Exposure Prophylaxis and Vaccins

 

Leprosy Mailing List –  October  12,  2024

 

Ref.:  (LML) Post-Exposure Prophylaxis and Vaccins

From:  Ben Naafs, Munnekeburen, the Netherlands

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Dear Pieter,

The TropMed Society of Brazil asked me to give a Zoom presentation about: "Whether Technological advances improved our understanding of immune responses contributed to the development of vaccines and the treatment of leprosy reaction" Later they added Prep to it.

I adapted this presentation for the readers of LML and hope they will comment on it. Negative appreciations are certainly welcome too, when the writer is willing to share on LML under his own name.

The first part  "Leprosy, reaction diagnosis and treatment" was sent last week. Today we will send both Prep and vaccination.

It is worth mentioning that the first trials of chemoprophylaxis were done in South America (Arq Min Leprol. 1959 jul;19:384-9).

 

 

With regards,

Ben

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

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

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

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Fw: Ref.: (LML) Infolep monthly overview of new publications on leprosy. October, 2024

 

Leprosy Mailing List – October 11,  2024

Ref.:  (LML) Infolep monthly overview of new publications on leprosy. October, 2024

From:  Roos Geutjes, Sophie Vissers and Upasana Regmi, Amsterdam, the Netherlands

---

Dear colleagues, 

We are thrilled to congratulate Jordan on becoming the first country to receive WHO verification for eliminating leprosy—a monumental achievement in global health!

In addition, we are proud to celebrate the recent launch of the InfoNTD e-learning platform, which took place at the NNN conference in Kuala Lumpur this October. The platform, connected to Infolep and InfoNTD, offers various courses such as Leprosy Reactions and SDR-PEP—don't forget to explore these valuable resources.

This month's newsletter brings you a wealth of exciting updates:

• Research highlights: Including systematic reviews on drug resistance, publications on mental health, and stigma, as well as the latest WHO Weekly Epidemiological Record (2023) on leprosy.
• Practical materials: Featuring resources on participatory health research, community engagement, and social and behavior change in NTD programs, developed by WHO and the NNN WASH working group.
• Upcoming events: Such as the 22nd International Leprosy Congress in Bali, along with other key leprosy-related events.
• Insightful case studies: Showcasing rare manifestations of leprosy, including neuropathies, drug reactions, and innovative treatment approaches.

Lastly, we are delighted to welcome Upasana Regmi to the InfoNTD and Infolep team as an interim support officer. At the same time, we say farewell to Sophie Vissers, who will be transitioning out of her role. We thank Sophie for her outstanding contributions and wish her all the best in her future endeavors.


Warm regards,


Roos Geutjes, Sophie Vissers and Upasana Regmi

www.infolep.org
info@infolep.org

Practical Materials

Reactions in Leprosy [E-learning infoNTD; Online Course] 

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Post-exposure chemoprophylaxis for leprosy - SDR-PEP [E-learning infoNTD; Online Course] 

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An Introduction and Practical Guide to Community Engagement and Involvement in Global Health Research  [National Institute for Health and Care Research, MESH Community Engagement Network; Online Course] 

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Skin and Migration: Training for national, district-level, and front-line health workers [World Health Organization, 2024; Online Course] 

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Atopic dermatitis with focus on Sub-Saharan Africa: Training for national and district-level health workers [World Health Organization, 2024; Online Course] 

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Participatory health research and action: A practical guide on designathons [WHO, 2024; Guidelines] 

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Community engagement in WHO guideline development [WHO, 2024; Guidelines] 

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Social and behavior change in NTD programs [NNN Wash Working Group, 2024; Guideliones] 

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Highlighted Publications

Leprosy: Jordan becomes first country to eliminate disease 
Wise J. BMJ. BMJ. 2024. 

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Weekly epidemiological record- Global leprosy (Hansen disease) update, 2023: Elimination of leprosy disease is possible- Time to act!  
World Health Organization. 2024.

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Self-healing in leprosy: A systematic review 
Stuetzle SCW, Bonkass A, van Brakel WH, et al. PLOS Neglected Tropical Diseases. Public Library of Science (PLoS). 2024; 18 (9): 1-10. 

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Interventions to Reduce Skin-related Self-stigma: A Systematic Review.  
Traxler J, Stuhlmann C, Graf H, et al. Acta dermato-venereologica. 2024. 

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Implications of drug resistance in leprosy: disease course, reactions and the use of novel drugs  
Sardana K, Muddebihal A, Scollard DM, et al. International Journal of Dermatology. Wiley. 2024. 

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Review of research progress on different modalities of Macrophage death in Mycobacterium leprae infection.  
Jiang Y, Zou Y, Wang H. International immunopharmacology. 2024. 

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Pure neuritic leprosy: Latest advancements and diagnostic modalities 
Razdan N, V B, Sadhu S. Diagnostic Microbiology and Infectious Disease. Elsevier BV. 2024. 

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New publications

Feel free to contact us to receive full-text versions if these cannot be found through the Infolep portal.

The role of neurologists in the WHO "Toward Zero Leprosy" strategy
Klevor R, El-Sadig SM, Hassane DS, et al. Leprosy Review. Lepra. 2024; 95 (3): 1-3.

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Spatial Model of Geographic Distribution of Leprosy Cases in East Java Province, Indonesia 
Makful M, Handayani Y, Nugraha F. Unnes Journal of Public Health. 2024. 

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Cellular and molecular determinants of bacterial burden in leprosy granulomas revealed by single-cell multimodal omics 
Mi Z, Wang Z, Wang Y, et al. eBioMedicine. Elsevier BV. 2024. 

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The fight against leprosy and lessons for the future: Commemorating the 50th anniversary of the Sasakawa Health Foundation 
Nanri T. Leprosy Review. Lepra. 2024; 95 (3): 1-4.  

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Case reports on leprosy 
Nascimento DCD, Laguiche LD. Hansenologia Internationalis: hanseníase e outras doenças infecciosas. Instituto Lauro de Souza Lima. 2024. 

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Cranial nerve palsies in leprosy: a systematic review of published case reports and case series  
Garg RK, Jain P, Suvirya S, et al. Acta Neurologica Belgica. Springer Science and Business Media LLC. 2024. 

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Correlation of Dermatoscopic Findings in Leprosy with Clinical Spectrum and Histopathology: A Prospective Observational Study 
Chenganasseri SH, Kapilavayi S, Divya B, et al. Indian Journal of Leprosy. 2024. 

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Anemia on Chronic Disease in Leprosy Before and After Completing Multi Drug Therapy 
Setyawati NK, Rusyati LMM, Indira IGAAE, et al. Eduvest - Journal of Universal Studies. Green Publisher. 2024; 4 (9) : 8409-8417.  

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In Silico Investigation of the Constituents of Aroeira Honey (Astronium urundeuva) and the Binding Affinity with Important Proteins of M. leprae and M. tuberculosis  
de Souza VMM, do N. Costa GE, dos S. Silva RF, et al. Molecular Modeling Connect. Scifiniti Publishing. 2024; 1 (1) : 1-24.  

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High-risk spatiotemporal patterns of leprosy in the southeastern region of Yunnan province from 2010 to 2022: an analysis at the township level 
Qiao L, Zhang C, Zhang M, et al. BMC Public Health. Springer Science and Business Media LLC. 2024; 24 (1) : 1-12. 

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Role of histopathological, serological and molecular findings for the early diagnosis of treatment failure in leprosy 
de Carvalho Dornelas B, da Costa WVT, de Abreu JPF, et al. BMC Infectious Diseases. Springer Science and Business Media LLC. 2024; 24 (1) : 1-13. 

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Investigation of community knowledge, attitudes and stigma towards leprosy in Nigeria: a mixed-methods study 
Murphy-Okpala N, Dahiru T, Eze C, et al. Transactions of The Royal Society of Tropical Medicine and Hygiene. Oxford University Press (OUP). 2024; 118 (10) : 697-709. 

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Factors that Influenced and Delayed Self-reporting and Registration of Leprosy Affected People in Different Prevalence Areas of Bangladesh 
Hossain QZ, Boiragee J, Azad-Uz-Zaman Q, et al. Indian Journal of Leprosy. 2024. 

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Atuação da equipe multiprofissional ao paciente sob tratamento hansênico na promoção da qualidade de vida 
Nascimento VFF, Silva RPDC, Araújo GSSD, et al. Revista Eletrônica Acervo Saúde. Revista Eletronica Acervo Saude. 2024. 

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Estratégias de enfrentamento, limitação de atividades diárias e participação social de idosos que têm ou tiveram hanseníase 
Oliveira GTRD, Boconcelo I, Nardi SMT, et al. Revista Brasileira em Promoção da Saúde. Fundacao Edson Queiroz. 2024. 

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Direitos, deveres e a realidade do estigma na hanseníase 
Silva VAMD, Souza DGPD, Santos WEAD, et al. Contribuciones A Las Ciencias Sociales . South Florida Publishing LLC. 2024; 17 (9) : 1-21. 

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Análise do impacto da hanseníase na qualidade de vida de pacientes do estado de mais incidência do nordeste brasileiro 
Batista MRV, Cruz CND, Aragão FBA, et al. CONTRIBUCIONES A LAS CIENCIAS SOCIALES. South Florida Publishing LLC. 2024; 17 (9): 1-28.

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Neglect of mental health issues and lack of integration of psychosocial interventions in Zero Leprosy Roadmaps: A critical oversight 
Fastenau A, Montague-Cardoso K. PLOS Mental Health. Public Library of Science (PLoS). 2024. 

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Leprosy in Brazil: an analysis of the Global Burden of Disease estimates between 1990 and 2019 
de Araújo V, Veloso G, Kerr L, et al. Public Health. Elsevier BV. 2024. 

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Interdisciplinary perspectives on 'what matters most' in the cultural shaping of health-related stigma in Indonesia  
Santosa A, Sopamena Y, Visser M, et al. BMJ Global Health. BMJ. 2024; 9 (9): 1-9.  

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Dapsone-induced haemolysis among leprosy patients on MDT from an endemic area of central India 
Naik KP, Ganguly S, Shukla AK, et al. Journal of Family Medicine and Primary Care. Medknow. 2024. 

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Global patterns of syphilis, gonococcal infection, typhoid fever, paratyphoid fever, diphtheria, pertussis, tetanus, and leprosy from 1990 to 2021: findings from the Global Burden of Disease Study 2021. 
Chen W, Chen Y, Cheng Z, et al. Infectious diseases of poverty. 2024; 13 (1): 1-23.   

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Insights of infected Schwann cells extinction and inherited randomness in a stochastic model of leprosy.  
Ghosh S, Rana S, Mukherjee S, et al. Mathematical biosciences. 2024. 

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Experiences of Patients Living in a Unique Leprosy Hospice in Greece: An Interpretative Phenomenological Analysis.  
Nikoloudi M, Bogdani E, Tsatsou I, et al. Cureus. 2024; 16 (8) : 1-11.  

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Assessment of disability among leprosy patients on treatment initiation in kwale and kilifi counties, Kenya 
Karugu M, Njoroge M, Matu S, et al. East African Medical Journal . 2024. 

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A review on leprosy: Etiology, epidemiology, pathophysiology, risk factors, differential diagnosis, management strategies and treatment modalities  
Tanwar P, Naagar M, Maity MK. International Journal of Pharmaceutical Research and Development. Comprehensive Publications. 2024; 6 (2) : 39-48. 

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Leprosy in the Modern Age: clinical diagnosis and challenges in the 21st Century 
Jaiswal B, Rajpurohit P, Munot Y, et al. International journal of therapeutic innovation. Medic Scientific. 2024. 

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Healing of leprosy-associated chronic plantar wounds with a novel biomembrane containing latex proteins from Calotropis procera 
Nunes MO, Alencar NMN, Pontes MAA, et al. Brazilian Journal of Biology. FapUNIFESP (SciELO). 2024.

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Molecular Identification of Mycobacterium leprae in the Leprosy Patients. 
Warka U, Hatta M, Muslich L, et al. International journal of mycobacteriology. 2024. 

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Exploring the Utility of High-Resolution Ultrasonography and Color Doppler of Peripheral Nerves in Monitoring Response to Treatment in Leprosy Patients: A Prospective, Observational Study. 
Sharma A, Narang T, Prakash M, et al. The American journal of tropical medicine and hygiene. 2024. 

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A Histopathological study of Leprosy on skin and peripheral nerves with clinical correlation 
P TK, Vahini G, Yaswant VMK. Chinese Journal of Evidence-Based Medicine. 2024. 

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A Cross Sectional Study on Quality of Life among Leprosy Affected Persons in Hyderabad 
A Durga , Kusuma AK. Indian Journal of Public Health Research &amp; Development. Institute of Medico-legal Publications Private Limited. 2024; 15 (4) : 30-34. 

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Exhausted CD8 T cells and anti-inflammatory macrophages characterize lepromatous leprosy lesions 
Mayer-Barber KD, Barber DL, Via LE. eBioMedicine. 2024. 

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Podhans: podcast de comunicação pública sobre hanseníase produzido a partir da escuta dos usuários do SUS 
Lima FCD, Oliveira-Costa MSD, Fernandes MFM. JCOM América Latina. 2024. 

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Inovação aplicada ao Diagnóstico com QPCR e o Impacto Hostil do Estigma em Indivíduos portadores da Hanseníase 
Ferreira Neto AG, Dias HM, Rezende GDO. Revista Contemporânea. South Florida Publishing LLC. 2024; 4 (9) : 1-19. 

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Case Reports

A Rare Cause of Pancytopenia From Lepromatous Leprosy Diagnosed in Bone Marrow Aspiration: A Bolt From the Blue 
Shine R, Amitkumar K, Ganapathy S, et al. Cureus. Springer Science and Business Media LLC. 2024. 

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Exploring the therapeutic and prophylactic potential of bedaquiline in leprosy.  
Khera H, Narang T, Sharma A, et al. International journal of dermatology. 2024. 

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Haemophagocytic lymphohistiocytosis secondary to disseminated histoplasmosis in a patient with leprosy.  
Mufarrih S, Lusby H, Watson P. BMJ case reports. 2024. 

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Case Report: Leprosy Masquerading as Relapsing Polychondritis  
Goel R, Rashmi R, Ghosh D, et al. 2024. 

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A rare case of pure neuritic leprosy with hereditary spherocytosis: implications for dapsone use 
Agrawal S, Borkar M, Deoke S. Leprosy Review. 2024. 

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An Unusual Cutaneous Manifestation of Tuberculoid Spectrum in Leprosy  
Satish S, Fernandes S, Bhat RM, et al. Indian Journal of Leprosy. 2024. 

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Managing a Case of Steroid Dependant Erythema Necroticans in a Severely Immune-compromised Patient: Case report 
Mishra S, Madhual S, Panda M. Indian Journal of Leprosy. 2024. 

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Malignant transformation of a long-term ulcer in a patient with leprosy sequelae: a case report 
Santos AGED, Neto AAM. Jornal Vascular Brasileiro. 2024. 

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Unveiling the nerve bumps in Hansen's arm and forearm  
Sugumar R, Gomathy B, Cannane S. Case Reports in Clinical Radiology. Scientific Scholar. 2024. 

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Erythema nodosum leprosum in a patient with lepromatous leprosy: A case report 
Sunil Kumar S, Sivannan S, Balasubramaniyam S, et al. Journal of Acute Disease. Medknow. 2024; 13 (4) : 161-164. 

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Fever of unknown origin, blood and cerebrospinal fluid involvement: a leprosy case report. 
Chen H, Jiang Y, Shi Y, et al. Frontiers in immunology. 2024.   

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Análise dos casos de Hanseníase no Estado do Pará, Brasil 
Junio LFV, Carvalho RRX, Campos FJSS, et al. Revista Eletrônica Acervo Saúde. Revista Eletronica Acervo Saude. 2024. 

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Eritema Nodoso Leproso: Reporte de un caso pediátrico tratado exitosamente con talidomida  
Delgado N, Forero JR, Pérez P, et al. Infectio, Revista de la Asociación Colombiana de Infectologia. 2024. 

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News & Events

Jordan becomes first country to receive WHO verification for eliminating leprosy (WHO) 

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Our new doctors have no clue about leprosy': experts sceptical of India's target to eliminate the disease by 2027 (The guardian)

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Call for Proposals: Mental Health Award - Accelerating scalable digital mental health interventions 
This call will fund research to evaluate and further develop scalable digital interventions to advance early intervention in depression, anxiety and psychosis. Funding amount: £3 to 7 million per project. The application must be submitted by 17:00 GMT on the 5th of December 2024.

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RSTMH Annual Meeting 2024
October 10-11, 2024; Coin Street Conference Centre, London, United Kingdom.
The 2024 Annual Meeting will bring together members, Fellows and supporters from around the world to share knowledge, hear about the latest research and ideas, and encourage new collaborations. The theme of the meeting  is 'Tropical Medicine and Global Health: Innovations and Challenges' with a focus on significant cross cutting issues affecting many disease areas and health challenges. Registration is open.

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Disability-Led Futures for a Just World: DRF's Path to 2029 
October 29; 9:00-10:00 EDT; online 
Join the virtual event celebrating the launch of DRF's new brand and 5-year visionary strategic plan. Please register in advance. 

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Conference on Neglected Tropical Diseases 2024
May 2025; Nairobi, Kenya.
The 1st edition of the Conference on Neglected Tropical Diseases, organized by AME is tentatively scheduled in May 2025 in Nairobi, Kenya, as a hybrid meeting. The abstract-driven conference proposes a platform to disseminate new advancements, real-world data, implementation challenges, and novel governing models to discuss and generate solutions for cross-cutting topics and ultimately reduce the disease burden and societal impact of NTDs. This proposal supports the progress in foundational pillars of the WHO Roadmap by facilitating evidence-based program implementation, leveraging the cross-cutting approach, and providing a forum to discuss a paradigm shift toward country ownership of elimination programs.

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WHO's goodwill ambassador Yohei Sasakawa urges for collaboration to eliminate leprosy (Himalayan Times)

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Call for Proposals: NHIR Global Health Research - Researcher-led funding call bands 1 to 3
GHR – Researcher-led funds research that aims to improve health outcomes for the most vulnerable people in low and middle income countries (LMICs). Research must address evidence needs that are locally identified and prioritised, and must promote health equity, aligning with the aims of Sustainable Development Goal 3. Funding ranges from £250,000 to 7 million over a period up to 5 years depending on the band of application. 
Please check out the website for all eligibility criteria. Deadline for applications is 6th of November, 2024.

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World Health Summit 2024
October 13-15, 2024; Berlin, Germany; hybrid event.
The theme of the conference is: "Building Trust for a Healthier World". You can join the event online live from all around the world for free and without any registration required. Simply click on the session of your interest in the program and get the broadcasting link. Registration is open for on-site participation. Digital participation is possible through YouTube.

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Tropical Infectious Diseases Gordon Research Conference
February 2-7, 2024; Renaissance Tuscany Il Ciocco, Lucca, Italy
The theme of the conference is "Basic and Clinical Research Strategies for Tackling Tropical Infectious Diseases in a Globalized World". Registration is open and deadline is January 5, 2025.

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Global Disability Summit 2025 
April 2-4, 2025; Berlin, Germany. 
The Global Disability Summit aims to galvanize global efforts to realize disability inclusion around the world. It is a mechanism bringing together a wide variety of high-level stakeholders, engaging and discussing the progress in disability inclusion: governments, multilateral agencies, the private sector, academia and civil society organizations, organizations of persons with disabilities, and foundations. 

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22nd International Leprosy Congress (ILC) 
July 5-9, 2025; Bali Nusa Dua Convention Centra (BNDCC), Bali, Indonesia 
This year the 22nd International Leprosy Congress (ILC) will be held in Bali, Indonesia! The congress uphold the theme: "Towards a World with Zero Leprosy". The theme aims to enhance the evidence into the clinical care in leprosy early diagnosis and therapeutics in the global era and prepare to face the new perspective of dermatology practice. Abstract submission and early bird registration is open until November 30th.

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Links

Info Hansen - A innovative hub for knowledge sharing about Hansen's Disease
 

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ALLF - Official website of the Association des Léprologues de Langue Française
 

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LML - Leprosy Mailing List - a free moderated email list that allows all persons interested in leprosy to share ideas, information, experiences and questions
 

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InfoNTD - Information on cross-cutting issues in Neglected Tropical Diseases (NTDs)

ILEP newsletter archive

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GPZL newsletter subscription

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WHO Goodwill Ambassador's Leprosy Bulletin

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Leprosy Review

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Leprosy Review Repository (1928-2001)

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Fontilles Revista de Leprología

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Indian Journal of Leprosy

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Hansenologia Internationalis

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HARP - database of Hansen's Disease Antimicrobial Resistance Profiles

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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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