Leprosy Mailing List Blog

Thursday, August 27, 2026

Fw: Ref.: (LML) Infolep monthly overview of new publications on leprosy. August 27, 2026

Leprosy Mailing List – August 27, 2026

Ref.: (LML) Infolep monthly overview of new publications on leprosy. August 27, 2026

From: Elizabeth Talatu Williams, Amsterdam, the Netherlands

____________________________________________________________________________

Dear colleagues,

We are pleased to share the August 2026 edition of the Infolep newsletter, featuring new research, case reports, global updates, and opportunities from across the leprosy field.

This month's featured articles explore leprosy-related stigma and social representation among persons affected and health workers in Brazil, community-based rehabilitation for people with grade-2 disability in Bangladesh, and factors associated with disability among people affected by leprosy.

We also feature a collection of case reports highlighting diverse and challenging clinical presentations of leprosy, including imported cases in Romania, type 2 reactions, erythema nodosum leprosum, and cases in which leprosy mimicked other conditions such as sarcoidosis and tuberculosis. These reports reveal the continued importance of clinical awareness and capacity to ensure early diagnosis.

Our latest publications section cover a wide range of topics, including disability in the post-elimination era, frailty and health monitoring among older adults affected by leprosy, new approaches to diagnosis, spatial patterns of leprosy transmission, and the use of machine learning to predict leprosy reactions.

In our news and events section, we highlight new opportunities including the AEIP Scholars Programme, Mwele Malecela Mentorship Programme, and AREF-MRC Towards Leadership Programme. We also share the upcoming webinar invite on Strengthening Community-Based Groups for People Affected by Skin-NTDs, taking place on 9 September.

Stay tuned to Infolep for more updates, resources, research, news, and tools supporting the global leprosy community.

Warm regards,
Elizabeth Talatu Williams

www.leprosy-information.org
info@infolep.org

Featured Research Spotlight

Leprosy-Related Stigma and Social Representations Among Persons Affected by Leprosy and Primary Healthcare Professionals: A Structural Analysis in the Brazilian Amazon
de Araújo F, Santos V, da Costa W, et al. Journal of community health. 2026.

Acceptability and challenges of community-based rehabilitation (CBR) of leprosy patients with grade-2 disability in Bangladesh
Akhtar K, Khanam F, Mita A, et al. PLOS global public health. 2026; 6 (8): 1 - 16.

Factors associated with disability among patients with leprosy: a scoping review
Masala CW, Haroen H, Pramukti I. BMC Infectious Diseases. Springer Science and Business Media LLC. 2026.

Other New Publications

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

Socio-Demographic Factors and Deformity Among Patients With Leprosy in the Post-elimination Era: A Prospective Study
Kumar P, Verma P, Rai T, et al. Cureus. Springer Science and Business Media LLC. 2026; 18 (8): 1 - 8.

Why Frailty Should Be Assessed in Older Adults Affected by Leprosy and How the Use of Smartphones Could Enhance This Health Monitoring
Gloria LM, Barreto JG, Oliveira JSDS, et al. JMIR Aging. JMIR Publications Inc. 2026.

A Study to Observe the Incidence of Lepra Reactions After Initiation of Anti-Leprosy Therapy
Dr. Dhruv Pathak, Dr. Nilam Damor, Dr. Mohabatsinh Baria. International Journal of Medical and Pharmaceutical Research. 2026; 7 (4): 2870 ‐ 2875.

A Reexamination of Dr. Masanao Goto's Leprosy Treatment in Hawai'i: New Insights from Japanese and Hawaiian Sources
Yuji K, Yuji W. Hawai'i journal of health & social welfare. 2026; 85 (8): 203 - 209.

Nail changes as clinical markers of disease spectrum and reactional states in Hansen’s disease: A retrospective record-based cross-sectional study
Pradhan S, Sanghai R, Shahid R. Journal of Onychology and Nail Surgery. Scientific Scholar. 2026; 3 (1): 11 - 17.

Evaluating the risk of dapsone hypersensitivity syndrome in Nepalese Leprosy Patients via HLA-B* 13:01 screening using real-time PCR and comparative meta-analysis of international data
Divya RSJB Rana, Shah M, Baral S, et al. PLOS Neglected Tropical Diseases. Public Library of Science (PLoS). 2026; 20 (8) : 1 - 23.

Playful approach to Hansen's disease through an educational comic book
Quandt D, Vendruscolo C, Griboggi I, et al. Revista brasileira de enfermagem. 2026.

Accuracy of Ultrasound-Guided Ulnar Perineural Subcutaneous Aspirate for the Diagnosis and Control of Leprosy: Protocol for a Prospective Diagnostic Evaluation Study
Escarabel C, Barroso D, Monteiro P, et al. JMIR research protocols. 2026.

Histopathological Features of Lucio’s Phenomenon in Leprosy Patients: A Retrospective Study
Khoirunnisa. Berkala Ilmu Kesehatan Kulit Dan Kelamin. 2026; 38 (2): 133 - 142.

Spatial and spatiotemporal analysis of leprosy occurrence in a hyperendemic state in northeastern Brazil: an ecological study
Oliveira LV, Oliveira RS, Pimentel KBA, et al. Brazilian Journal of Biology. FapUNIFESP (SciELO). 2026.

Leprosy control in Sri Lanka after eliminating the disease as a public health problem: implications for elimination of transmission of infectious diseases
Wickremasinghe AR , Perera BPR . BMC Health Services Research. Springer Science and Business Media LLC. 2026;

Amitriptyline for neuropathic pain in patients with leprosy: a bicenter randomized controlled trial
Júnior J, Kubota G, Moreira L, et al. Pain. 2026; 167 (8): 1810 - 1823.

Predicting leprosy reactions: a machine learning framework incorporating clinical, demographic, and healthcare system factors in China
Guo Y, Yin L, Yang H, et al. Scientific Reports. Springer Science and Business Media LLC. 2026.

Peripheral nerve biopsy in pure neural leprosy: a 26-year experience in Brazil
Siquara-de-Sousa A, Hacker M, Vital R, et al. Brain communications. 2026; 8 (4): 1 - 8.

Leprosy in Sudan: What is the current situation?
Niyle RM, Salium JAA, Eltahir MS, et al. Medical Research Updates Journal. Prof Medical Research Consultancy Center. 2025; 3 (2): 21 - 30.

Case Reports

Delayed diagnosis and poor treatment compliance remain key challenges in leprosy control: a case of lepromatous leprosy with type 2 reaction
Thilakarathna M, Uthayarajan N, Siriwardena C, et al. BMC infectious diseases. 2026; 26 (1): 1 – 7.

The First Cases of Imported Leprosy in Romania After More than Four Decades of Absence of New Cases
Briciu V, Lupşe M, Baican A, et al. Tropical Medicine and Infectious Disease. MDPI AG. 2026; 11 (8): 1 - 12.

Pretreatment Reversal Reaction in Borderline Tuberculoid Leprosy Presenting as a Unilateral Anesthetic Plaque on the Dorsum of the Foot: A Case Report
Juliandra Firdaus, Khufitha Tasya, Randy Nugraha. The ASEAN Journal of Military and Preventive Medicine. 2026; 3 (2): 1 - 6.

Lepromatous Leprosy Mimicking Sarcoidosis With Elevated Serum ACE Levels: A Deceptive Granulomatous Presentation
Prashanth G, Dhanasekar T. Cureus. 2026; 18 (5) : 1 - 7.

Laryngeal Involvement in Lepromatous Leprosy: A Retrospective Case Series
Somanath, Sapthami Satish, H M Abhijith, et al. International Journal of Medical and Pharmaceutical Research. 2026; 7 (4): 1 - 4.

When a Mimicker Is Mimicked: A Case report on Acid-Fast Atypical Lepromatous Leprosy Mimicking Tuberculosis
Mohod S, Lade S, Sharma R, et al. Indian journal of medical microbiology. 2026.

Lepromatous Leprosy With Erythema Nodosum Leprosum
Farhoud N, Bhadbhade P. Annals of Internal Medicine: Clinical Cases. American College of Physicians. 2026; 5 (8): 1 - 2.

Fw: Ref.: (LML) WHO Goodwill Ambassador's Leprosy Bulletin NO. 132, August 2026

Leprosy Mailing List – August 27, 2026

Ref.: (LML) WHO Goodwill Ambassador's Leprosy Bulletin NO. 132, August 2026

From: Takahiro Nanri, Tokyo, Japan

____________________________________________________________________________

Dear Dr. Schreuder and Friends,

Warm greetings from the Sasakawa Health Foundation / Sasakawa Leprosy (Hansen’s Disease) Initiative in Tokyo. We are pleased to announce the publication of the WHO Goodwill Ambassador’s Leprosy Bulletin No. 132, August 2026, titled “Indonesia speaks up for active case finding.”

In this issue, we feature:

[MESSAGE FROM THE AMBASSADOR]
From July 8 to 10, the Republic of Indonesia and the Sasakawa Leprosy (Hansen’s Disease) Initiative co-hosted the country’s first national conference on leprosy. The event brought together Coordinating Minister for Human Development and Cultural Affairs Pratikno; Minister of Home Affairs Tito Karnavian; Minister of Health Budi Gunadi Sadikin; government representatives from all 38 provinces; health officials; and persons affected by leprosy.
Read More

[VIEWPOINT]
ASCL/MTN’s experience with the repeal of a discriminatory law in Senegal
Papa Mamadou Diagne, President, Association Sénégalaise Contre la Lèpre et les Maladies Tropicales Négligées (ASCL/MTN)

In 1976, Senegal’s Law 76-03 established villages de reclassement social (VRS) to isolate persons affected by leprosy and block transmission of the disease. Despite the advent of multidrug therapy (MDT), which made leprosy into a curable disease, the law remained in place for 47 years. It was finally repealed in June 2023.
Read more

[VIEWPOINT]
LepVax has potential to both prevent leprosy and protect nerves
Bill Simmons, President and CEO, Hope Rises International

Leprosy is curable, and the medicine is free. Yet every year more than 170,000 people are newly diagnosed, and that number has barely fallen in a decade. Today’s cure, multidrug therapy (MDT), kills the bacteria that causes the disease, stopping active infection.
Read more

[REPORT]
Indonesia mobilizes provincial leadership to accelerate leprosy elimination
Contributed by Dr. Venkata Ranganadha Rao Pemmaraju and Yuta Takashima, Sasakawa Leprosy (Hansen’s Disease) Initiative

In July, Indonesia’s first National Leprosy Conference was convened in Jakarta to translate national policy into subnational action, a necessary step considering that provincial and district governments manage key budgets and regulatory instruments.
Read more

[AMBASSADOR’S JOURNAL]
Indonesia’s National Leprosy Conference raises hopes for coordinated action

From July 8 to 10, 2026, Indonesia held its first National Leprosy Conference in Jakarta. A wide range of stakeholders – including relevant government ministries, local governments, persons affected by leprosy, and NGOs – participated, and more than 400 people attended the high-level session on the final day.
Read more

[REPORT]
Accelerating leprosy elimination in Indonesia through early detection, collaboration, and stigma reduction
Dr. Prima Yosephine BT Hutapea, M.K.M., Director of Communicable Diseases, Ministry of Health, Republic of Indonesia

Leprosy remains one of Indonesia’s neglected tropical diseases that requires sustained attention. Although the disease is curable with free treatment, delayed diagnosis and persistent social stigma continue to hinder elimination efforts.
Read more

[NEXT GENERATION]
Ending social and economic exile must be our generation’s gift to the world
Arnold Putra, Multidisciplinary artist

As an artist and documentarian, my work observes the human form, not only in its independent anatomy but its placement within our social architecture. At Indonesia’s first National Leprosy Conference in Jakarta this July, I was asked to speak about young people and stigma.
Read more

[REPORT]
A journey of awareness, empathy, and support
Harashta Haifa Zahra, Miss Supranational 2024

My journey with the leprosy awareness community began in Makassar, South Sulawesi, in 2024. At that time, I joined activities aimed at raising awareness about leprosy, and I came with the hope of learning and contributing in my own way.
Read more

BACK ISSUES

We hope you enjoy reading the latest issue of the Leprosy Bulletin.

Takahiro NANRI, Ph.D.
President, Sasakawa Leprosy (Hansen's Disease) Initiative

*********************************************************
Sasakawa Leprosy (Hansen's Disease) Initiative
Sasakawa Health Foundation
Tel：81-3-6229-5377, Fax：81-33-6229-5388
email: hansen@shf.or.jp

*********************************************************

____________________________________________________________________________

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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Monday, August 24, 2026

Fw: Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works

Leprosy Mailing List – August 24, 2026

Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works.

From: Pieter AM Schreuder, Maastricht, the Netherlands

____________________________________________________________________________

Dear colleagues,

On August 3, 2026, Benedict Quao on behalf of the ILEP Technical Commission wrote a letter to LML called “Long-lasting adverse impact of chemoprophylaxis & what actually works”. In this letter he encouraged the LML readers to critically evaluate the evidence supporting the conclusion on Single Dose Rifampicin (SDR) as Post-Exposure Prophylaxis (PEP) presented in several letters to LML by Joel Almeida. Joel warns against the use of PEP and the justification of its use by ILEP. Benedict Quao stated that “While novel hypotheses are an important part of scientific progress, they should clearly be distinguished from conclusions supported by robust experimental or epidemiological evidence”.

This letter led to a particularly good, open and rich discussion in which experienced leprologists gave their opinion and led to one of the best discussions on PEP, the way the research has been done and what are the many important points which have not be taken into account when setting up this research. Every leprologist or those involved in leprosy research and leprosy control should at least read this exchange of opinion.

Joel Almeida, Claudio Salgado, Isabela Goulart and Ben Naafs took up the challenge and countered many of the arguments used by the ILEP Technical Commission. Wise words by Claudio Salgado to sidestep the arguments pro and contra with the following statement: “Rather than focusing exclusively on the proposed biological mechanism, I believe the discussion has now reached a broader and perhaps mort important scientific question: what level of evidence is required before a preventive intervention is considered sufficiently safe for widespread implementation?”.

After this first letter by Benedict Quao of 3-8-2026, the ILEP Technical Commission did not take part in the ensuing discussion. A few days ago Benedict even asked what happened with his letter. Apparently, nobody in the ILEP Technical Commission has followed this discussion or did not inform Benedict about it. We would like the reaction of ILEP to this thoughtful, open and scientific discussion.

We thank all who participated. Joel Almeida who as they say: "put a cat among the pigeons" and Benedict Quao who took up the challenge. Ben, Claudio and Isabela who delighted us with their critical remarks, showed us their wide experience in leprosy research over many decades and suggested ways to progress.

On behalf of the LML Board,

Pieter AM Schreuder

____________________________________________________________________________

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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Thursday, August 20, 2026

Fw: Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works

Leprosy Mailing List – August 20, 2026

Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works

From: Joel Almeida, Mumbai, India

___________________________________________________________________

Dear Pieter and colleagues,

Thanks to Dr. Ben Naafs for his comments (LML 18 Aug 2026).

Re: zero of 208 unprotected BL cases showing BI 5+ or 6+ in nasal smears: the data is in the very same Davey and Rees article (1974 Lepr Rev 45(2):121-34 ).

Should fear and prejudice be created against subclinically infected persons who shed few if any bacilli, and who have >95% chance of self-limiting or eliminating the bacilli without developing signs or sequelae or onward transmission? Just protecting their natural macrophage defences is likely to be the most effective approach. Zhijian Chen group's discoveries of cGAS and STING (Science 2013), together with de Toledo Pinto et al demonstration of M. leprae DNA triggering cGAS-STING and the upregulation of OASL with suppression of autophagy and vit D-induced cathelicidin (J Inf Dis 2016 214;311-320) underline the importance of avoiding short-term chemoprophylaxis in order to protect macrophage defences. It does not matter how strong the anti-microbial or how many doses: if anti-microbials are used at all then the duration must outlast the bacillary debris in autophagy-suppressed macrophages, and also the availability of concentrated viable bacilli from the surroundings (typically from unprotected LL high-shedders). Otherwise bacilli will replicate in the macrophages sabotaged by short-term chemoprophylaxis, boosting the risk of "silent" non-inflammatory nerve damage via PGL1 (macrophage iNOS and excess NO, Madigan et al Cell 2017). Then visible deformity can be the very first detectable sign of HD (leprosy). It is no comfort to a person who suffers visible deformity after accepting short-term chemoprophylaxis that M. leprae invariably involves nerves from the very earliest stages of infection, even just within the nose. Subclinical infection with invariable nerve involvement, yet frequent self-limiting or elimination of bacilli, is not the same as visible deformity.

What about a biologically targeted approach that conserves macrophage defences? mLAMP ( for DNA or RNA as desired ) is 100% specific. Financial costs for mLAMP using indigenous kits/methods and large volumes are likely to be much lower than the suggested estimates. As already suggested, it is worth it in any case. The most relevant costs of disease can be measured in lost eyes, hands and feet. A cheap intervention that is ineffective is simply a waste of money. That is even more so if the cheap intervention is both ineffective and harmful. By contrast, a highly effective intervention is affordable in every sense: saving eyes, hands, feet and saving money in an era of severe financial constraints. Ending a disease is one of humanity's biggest dreams and aspirations. A highly effective intervention is affordable in every sense. Even the stream of future financial savings approaches infinity if the only people remaining at risk of HD are reckless or poorly informed gardeners in armadillo states. Besides, the Find Treat End (FTE) strategy by encouraging persons with lived experience to serve as trained aides to health workers (nasal swab collection, muscle weakness testing, encouraging uninterrupted treatment, comforting distressed persons, assisting with social and rehab entitlements etc) helps to replace prejudice and fear with respect. People with lived experience can lead grassroots activities to create the victory. They will also be the most appropriate persons to lead the victory parade in cluster after cluster.

The elephant in the room, identified by Davey & Rees in 1974 yet under-emphasized, has been cryptic asymptomatic LL high-shedders. Without protection for them, it is impossible to stop HD (leprosy). With protection for them, it is difficult to maintain frequent transmission. The environment allows bacilli to survive, but it does not provide a culture medium for replication. Tens of millions of bacilli per sample or per day are not available from a single environmental sample of soil or water, unless it has been recently replenished by an unprotected high-shedder. This means that transmission can be interrupted very rapidly by a synchronous sweep to identify every cryptic asymptomatic LL high shedder in a cluster or a migratory corridor. Prompt full treatment including regular check-ups will not only protect them but also switch off transmission, confirmed and maintained by mop-up rounds. It is like turning off nearly all the taps. It becomes very difficult for the metaphorical ground to remain wet with disease. Transmission is likely to collapse within weeks per cluster.

The process can be visualised. Go into a cluster on Monday, do a sweep for nasal swabs & semi-quantitative mLAMP by Tuesday, start full treatment on Wednesday of every cryptic asymptomatic LL high-shedder. Take nasal swabs in periodic follow-up sweeps. Do this in parallel or in sequence to spread the success.

We are not in the dark if we rely on science. It weighs evidence and inference only. Votes are irrelevant to biology. What was a distant dream during the past decade is now an achievable success. Is it wrong to reach for success?

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 << edit...@gmail.com

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Leprosy Mailing List Blog

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Thursday, August 27, 2026

Fw: Ref.: (LML) Infolep monthly overview of new publications on leprosy. August 27, 2026

Fw: Ref.: (LML) WHO Goodwill Ambassador's Leprosy Bulletin NO. 132, August 2026

Monday, August 24, 2026

Fw: Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works

Thursday, August 20, 2026

Fw: Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works

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