Tuesday, September 8, 2026

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


 

Leprosy Mailing List –  September 9,  2026

 

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

From: Sandra Maria Barbosa Durães, Curitiba, Brazil

____________________________________________________________________________

 

Dear Pieter and colleagues,

Laila makes an excellent point, highlighting the genuine need to base public health policies on scientific evidence. I would add that this applies not only at the national level but also to individual cases; for instance, using unvalidated regimens is highly problematic unless done as part of a research project. In Brazil, some specialists insist on prescribing daily rifampicin—contrary to guidelines—and extending treatment beyond the standard 12 doses when lesions do not fully resolve, a practice that conflicts with current evidence.

As rightly noted, a positive PCR result does not necessarily indicate the presence of viable bacilli, and viability does not automatically imply transmission potential. There have been reports in Brazil of patients with positive PCR results but no clinical symptoms receiving treatment.

Similarly, classifying electroneuromyographic abnormalities—even those accompanied by ultrasound changes—as infection in patient contacts, when there are no clinical manifestations, strikes me as imprecise. I am unaware of electroneuromyography studies involving asymptomatic individuals with no history of leprosy exposure; it is possible that elderly individuals might exhibit abnormalities in these tests—even after age-adjustment—that hold no clinical significance.

Failure to diagnose the disease early is highly detrimental given its potential to cause disability; however, treating individuals who do not have the disease is equally harmful, as the damage caused by stigma and the adverse effects of medication are significant. Furthermore, in the absence of skin lesions, stricter criteria must be applied to establish a definitive diagnosis so as not to overlook other conditions.

Modifications to recommended treatment regimens—whether involving new drugs or changes to the duration of therapy—require controlled studies with long-term follow-up; only in this way can their efficacy be verified.

Best regards, 

Sandra Maria Barbosa Durães 

Associated Professor Clinical Medicine Department - MMc

Fluminense Federal University - UFF

+5521997370722    

duraesandra@gmail.com 

____________________________________________________________________________

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) Long-lasting adverse impact of chemoprophylaxis & what actually works


 

Leprosy Mailing List –  September 8,  2026

 

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

From: Laila de Laguiche, Curitiba, Brazil

____________________________________________________________________________

 

Dear Pieter and colleagues,

This discussion brings us, in my view, to a fundamental question: what level of evidence should be required before changing public health policy in leprosy?

We clearly need better prevention, earlier diagnosis and better treatment. However, regarding transmission and prophylaxis, important questions remain unanswered. 

We still need to distinguish exposure, healthy carriage, subclinical infection and disease. 

Anti-PGL-1 positivity may reflect exposure and does not, by itself, indicate disease. 

Likewise, a positive nasal PCR does not necessarily mean viable bacilli, and viability does not necessarily mean infectiousness. 

We still do not know which asymptomatic carriers actually contribute to transmission, or the minimum infectious dose of M. leprae.

This uncertainty has direct implications for PEP. Before treating asymptomatic individuals, we should know better whom we are treating and why: exposure, presumed latent infection, or a demonstrated risk of transmission or progression to disease.

These uncertainties matter when deciding whom to treat, when to treat and with what regimen.

In 2017, in Brazil, I questioned shortening MDT based on the evidence then available for U-MDT. My concern was not resistance to innovation, but the level of evidence required before introducing a major change in public health practice. I believe the same principle remains valid today.

Leprosy control is implemented largely through public health policies. Whether we discuss PEP, early diagnosis, shorter or prolonged MDT, daily rifampicin or new therapeutic regimens, changes in policy should be supported by robust, reproducible evidence of efficacy and safety.

We need innovation. Hopefully, new evidence will lead us towards better prevention, earlier diagnosis and shorter, safer and effective treatment with fewer adverse effects. 

But innovation and scientific rigor must move together.

Best regards,

Laila de Laguiche


____________________________________________________________________________

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, September 7, 2026

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


 

Leprosy Mailing List –  September 8,  2026

 

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

From: Sandra Maria Barbosa Durães, Rio de Janeiro, Brazil

____________________________________________________________________________

 

Dear Pieter and colleagues,

 

It is interesting to note that people use arguments favouring scientific evidence when they assume it supports their own opinions, yet reject that same evidence when it does not suit their purposes. Thus, I believe it is equally important to ask: What level of evidence is required for unestablished and unapproved therapeutic regimens—such as extending treatment beyond 12 doses or using daily rifampicin—to be considered safe enough for large-scale implementation, as some advocate ?

 

Best regards,

Sandra Maria Barbosa Durães 

Associated Professor Clinical Medicine Department - MMC

Fluminense Federal University - UFF

+5521997370722    

duraesandra@gmail.com 

____________________________________________________________________________

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) Long-lasting adverse impact of chemoprophylaxis & what actually works


 

Leprosy Mailing List –  September 7,  2026

 

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

From: Joel Almeida, Mumbai, India

 

Dear Pieter and colleagues,

The initial letters were on July 9 and 11 ( LML  https://leprosymailinglist.blogspot.com/2026/07/ ). They were concerned solely with the raw data that demonstrate serious long-lasting harm from short-term chemoprophylaxis, as illustrated by Brazil (PEPHans municipalities vs non-PEP Maranhão municipalities). Nothing to do with the views of any fundraising organization. 

The signals of harm in that raw data from Brazil (and convergent data from Dadra Nagar Haveli in India) align with well-established underlying biology. It was elucidated first by Zhijian Chen's group that discovered cGAS-STING (1) and then by de Toledo-Pinto et al (2) who demonstrated that lipofection of macrophages with M. leprae DNA triggered cGAS-STING - iRF3 - IFNbeta - OASL upregulation, resulting in the suppression of autophagy & cathelicidin anti-microbial peptide. 

In this case the stakes are high: human eyes, hands, feet. Robust scientific knowledge can help serve as a shield for potential recipients of short-term chemoprophylaxis. The signals of harm are not only from epidemiological outcomes but also exactly as predicted by well-established highly conserved macrophage biology. Concealment of risks and harms is the exact opposite of what is required for informed consent.

Data & Safety Monitoring Boards (DSMB) likewise are unable to protect recipients of experimental interventions if a true untreated control group is omitted. When the control intervention (SDR-PEP) itself shows an excess of incident MB in raw data then the DSMB can no longer provide the necessary safety net. Similarly, cutting short the duration of observation can conceal the future stream of excess deformity in the intervention arm.

All this occurs against a backdrop of frequent self-limiting or elimination of bacilli by natural macrophage defences (including vit D-induced cathelicidin and autophagy). 25% or more of persons in an endemic area show evidence of infection (serology or Lymphocyte transformation). Yet in many endemic areas the range of new case detection rates is only 0.3 to 1.5 per 10k population/year. (WHO updates) This means that the probability of an individual developing clinical signs over a 70-year remaining lifespan ranges from 0.21% to 1.04% for the general population, and 0.84% to 4.11% for individuals who are infected. In other words, >95% of ever-infected persons and >99% of the general population will die of some unrelated cause without showing lasting signs or sequelae or onward transmission. These are the people in whom the very macrophage defences that protect them were to be subverted by short-term chemoprophylaxis of one sort or another. Sabotaging macrophage defences is the exact opposite of protection. It is a "worst practice", based on the evidence. 

Who are the victims? Too many of them are on low incomes and with minimal schooling. The safety of their eyes, hands and feet is not optional. If their macrophages are sabotaged, they are more likely to develop "silent" nerve damage in mitochondria of motor axons, with visible deformity as the very first detectable sign of HD (leprosy). Visible deformity to them means loss of livelihood, ostracism, mental distress and utter destitution. Is that our goal? For safe and rapid interruption of transmission, we have the Find Treat End strategy.

There is no reason for the hundreds of experts on LML to settle for anything less than the scientific method: mechanistic knowledge, raw epidemiological data and robust scientific inference. Together with respect for human dignity. Even low income people, and they above all, deserve safety of their eyes, hands, feet.

With all sincerity,

Joel Almeida

References

 

1.     Science. 2013 February 15; 339(6121): . doi:10.1126/science.1232458.

 

2.      J Inf Dis 2016 DOI: 10.1093/infdis/jiw144

____________________________________________________________________________

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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Tuesday, September 1, 2026

Fw: Ref.: (LML) IAL 2nd International Webinar Webninar Flyer


 

Leprosy Mailing List –  September 2,  2026

 

Ref.:  (LML) IAL 2nd International Webinar Webninar Flyer

From: Sunil Droga, Chandigarh, India

____________________________________________________________________________

 

Dear Pieter,

 

 

Greetings from IAL. - Request you to please post  the attached webinar flyer to LML members for the benefit of all. 

 

 

Thanks & Best wishes

 

Warm regards

 

Sunil

----------- 

____________________________________________________________________________

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) IAL 2nd International Webinar


 

Leprosy Mailing List –  September 1,  2026

 

Ref.:  (LML) IAL 2nd International Webinar

From: Sunil Droga, Chandigarh, India

____________________________________________________________________________

 

Dear Pieter,

 

 

Greetings from IAL. - Request you to please post this message and the attached webinar flyer to LML members for the benefit of all. 

 

Thanks & Best wishes

 

Warm regards

 

Sunil

----------- 

 

Invitation | IAL 2nd International Webinar – Immunology & Diagnostics in Leprosy | 9 September 2026

Dear Colleagues/ IAL & ILA members / Leprosy Researchers/ Public Health Experts/ ILEP Partners,

 

Greetings from the Indian Association of Leprologists (IAL)!

We are pleased to invite you to our 2nd International CME Webinar, to be held on 9 September 2026 (Wednesday) at 7:00 PM IST

🦠Theme:  Immunology & Diagnostics in Leprosy

The webinar brings together leprosy experts from India and around the world, offering an opportunity for academic exchange and discussion on key contemporary challenges in leprosy.

 

The scientific programme will include perspectives from Dr U. Sengupta (India) and Dr Paul Saunderson (Netherlands) as Keynote Speakers, along with Dr Sundeep Chaitanya Vedithi from the UK and Dr Cynthia de Oliveira Ferreira from Brazil, as well as several other experienced leprosy experts from India. The sessions will cover immunology and diagnostics, nerve involvement, early laboratory diagnosis, antimicrobial resistance and their clinical and treatment implications.

 

An interactive Panel Discussion – “Leprosy Diagnosis in Practice: Early Detection, Drug Resistance and Treatment Implications” will further bring together clinical and laboratory perspectives.

 

 Date: 9 September 2026 (Wednesday)
Time: 
7:00 PM onwards (IST)


Online | Free to Attend

🔗 Registration/ Zoom Link to join: dub.sh/ial.academy.webinar2  

 

The programme is open to all leprosy workers, dermatologists, clinicians, researchers, public health professionals, students and others interested in leprosy WORLDWIDE.

 

We warmly invite you to join this scientific programme and encourage you to share the invitation widely with your colleagues, departments, institutions and students.

 

We look forward to your active participation in this international academic exchange and to strengthening our collective efforts towards Zero Leprosy.

 

With warm regards,

 

Prof. Sunil Dogra
President, IAL

Dr Tarun Narang
Hon. Secretary, IAL

Dr P. Narasimha Rao
Chairperson, IAL Academy

Dr Sujai Suneetha
Convener, IAL Academy

🌐 IAL Website
📧 ialoffice2026@gmail.com


IAL_Logo[10850].jpg

____________________________________________________________________________

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 31, 2026

Fw: Ref.: (LML) New Publications On Cross-Cutting Issues In NTDs. August, 2026


 

New Publications On Cross-Cutting Issues In NTDs. August, 2026.png 

Leprosy Mailing List –  August 31,  2026

 

Ref.:  (LML) New Publications On Cross-Cutting Issues In NTDs. August, 2026

From: Elizabeth Talatu Williams, Amsterdam, the Netherlands

____________________________________________________________________________

 



Dear Colleagues,

We are pleased to share the August 2026 edition of the InfoNTD newsletter, featuring the latest literature, practical resources, and global updates on neglected tropical diseases (NTDs).

This month, we are excited to introduce the
InfoNTD AI Chatbot, now available on the InfoNTD website. We invite you to try this new tool and share your feedback through our short feedback form to help us improve the tool ahead of its official launch.

Our literature reviews section features reviews covering several topics, including mental health and social determinants in skin NTDs, artificial intelligence and leishmaniasis, snakebite care, dengue vector control, WASH and schistosomiasis, and drug repurposing for schistosomiasis.

We also highlight new publications addressing research and programme priorities across NTDs, including mass drug administration, soil-transmitted helminthiasis, lymphatic filariasis, schistosomiasis, onchocerciasis, telemedicine, and the use of explainable AI for the differential diagnosis of skin NTDs in darker skin tones

Don't miss the upcoming webinar on Strengthening Community-Based Groups for People Affected by Skin-NTDs, taking place on 9 September.

Please feel free to contact us if you would like access to full-text articles not directly available through InfoNTD, or if you would like support with literature searches.

Warm regards,
Elizabeth Talatu Williams

www.InfoNTD.org
info@InfoNTD.org

 



 



Explore the InfoNTD AI Chatbot

 



Help us try the new InfoNTD AI Chatbot!

We're excited to introduce the InfoNTD AI Chatbot, a new tool designed to help you quickly find trusted information on cross-cutting issues of neglected tropical diseases (NTDs) from the InfoNTD knowledge platform.

Visit www.infontd.org and click the chatbot icon in the bottom-right corner to start exploring!

Please ask only questions related to cross-cutting NTD issues, such as mental health, WASH, stigma, disability, One Health, or other topics that commonly arise when working in the field.


👉Share your feedback via the form: 
InfoNTD AI Chatbot – User Feedback

Your feedback will directly inform the next phase of development as we improve the chatbot based on user interactions and analytics ahead of its official launch.

 



 



Literature Reviews

 



Mental health, social determinants and One Health in skin neglected tropical diseases (NTDs): A scoping review
Hotopf I, Diallo I, Ljungqvist J, et al. PLoS neglected tropical diseases. 2026; 20 (8): 1 – 27.


How is artificial intelligence being used to discover new treatments for leishmaniasis? A Scoping Review
Blaskovski NR, Fanhani FC, Scheiffer GH, et al. Chemometrics and Intelligent Laboratory Systems. Elsevier BV. 2026.


First-aid, pre-hospital care, and harmful indigenous practices in pediatric snakebite envenomation: A systematic review of global evidence from 1973 to 2025
Gunathilaka N, Dilshan I, Kodikara K, et al. PLOS Neglected Tropical Diseases. Public Library of Science (PLoS). 2026; 20 (7): 1 - 19. 


The Comparative Effectiveness of Vector Control Approaches for Dengue: A Systematic Review and Multilevel Network Meta-Analysis
Low G, Ke Y, Samson E, et al. Tropical medicine & international health: TM & IH. 2026.


Water, sanitation, and hygiene in schistosomiasis control: A scoping review of evidence gaps across transmission pathways
Braun L, Velleman Y, Straily A, et al. PLOS Global Public Health. Public Library of Science (PLoS). 2026; 6 (7): 1 - 16.


Mapping therapeutic alternatives: a systematic review of preclinical drug repurposing for schistosomiasis
França BCS, de Melo DF, da Costa LAG, et al. Naunyn-Schmiedeberg's Archives of Pharmacology. Springer Science and Business Media LLC. 2026.

 



 



Practical materials

 



Accelerating the last mile: A people-centred multidisease elimination approach for the WHO South-East Asia Region
WHO South-East Asia Regional Office. 2026.


Advocacy Guide for Female Genital Schistosomiasis (FGS): A Toolkit for Civil Society Organizations
One Health Society, Tanzania. Global Schistosomiasis Alliance. 2026. 

 



 



New publications

 



Impact assessment of effective rounds of mass drug administration against schistosomiasis and soil transmitted helminthiasis among school age children in Akwa Ibom State, Nigeria
Opara K, Yaro C, Ikpeida N, et al. PLoS neglected tropical diseases. 2026; 20 (8): 1 - 21. 


Research intensity for neglected tropical diseases and other infectious diseases before and after the COVID-19 pandemic
Komorizono R, Tamaki R, Fujita N, et al. Journal of Global Health. International Society of Global Health. 2026; 16 (04255): 1 - 11. 


Explainable AI for differential diagnosis of skin-manifesting neglected tropical diseases (NTDS) in darker skin tones
Innocent DC, Anyakorah PE, Innocent RC, et al. BMC Artificial Intelligence. Springer Science and Business Media LLC. 2026; 2 (1): 1 - 11. 


Awareness gaps of onchocerciasis in endemic Health district of Kéniéba, Séféto, Dioila, Kati and Selingué in 2021: cross - sectional study in Mali
Dolo H, Coulibaly Y, Koureichi M, et al. Frontiers in public health. 2026. 


A cross-sectional study on quality of life and self-care practices among filarial lymphoedema patients in Palakkad District, Kerala, India
Unnikrishnan D, Joy TM, Rose BM, et al. Discover Public Health. Springer Science and Business Media LLC. 2026; 23 (1): 1 - 12.


Prevalence and determinants of soil transmitted helminth infections among children on Highly Active Antiretroviral Therapy (HAART) in Mulobezi and Sesheke Districts, Zambia: A cross - sectional study
Mbonshi B, Kabemba E, Bowa C. PloS one. 2026; 21 (8): 1 - 10. 


Strengthening health research capacity: The role of research platforms in Chagas disease and leishmaniasis
Vera Lucia Luiza, Diogo Lopes Nunes Galvão, Renata da Silva Antunes, et al. Physis: Revista de Saúde Coletiva. Scielo Public Health. 2026; 36 (1): 1 - 21. 


Bringing Care Closer to Home: Decentralisation of Morbidity Management and Disability Prevention (MMDP) Services for Lymphatic Filariasis through Ayushman Arogya Mandirs in Bihar, India
Akhauri S, Ram Pandey R, Pandey S. Technix International Journal for Engineering Research. IJ Research Organization. 2026; 13 (8): 1 - 4. 


Assessing factors influencing noncompliance with mass drug administration for lymphatic filariasis in urban and rural Indonesia
Wahyuni R, Ipa M, Hermawan A, et al. Asian Pacific Journal of Tropical Medicine. Ovid Technologies (Wolters Kluwer Health). 2026; 19 (8): 354 - 366. 

 


How Imported Pathology Becomes Overlooked as Resources Increase: An Example of a Neglected Tropical Disease (NTD)
de la Calle-Prieto F, Platero L, Ligero-López J, et al. Tropical Medicine and Infectious Disease. MDPI AG. 2026; 11 (8): 1 - 9. 


Exploring the potential role of telemedicine in the early diagnosis of skin neglected tropical diseases in remote areas in Afghanistan through the perceptions and experiences of skin NTD health professionals: a qualitative study
Koopmans M, Janssen R, Schlumberger F, et al. BMJ Open. BMJ. 2026; 16 (8): 1 - 9. 


Sources and Channels Rural Communities Use to Access and Use Health Information on Schistosomiasis in Ukerewe District, Tanzania
Frank Charles, Henry Mambo, Lilian Isowe. THE DarTU JOURNAL OF HUMANITIES AND EDUCATION. 2026; 5 (1): 1 - 25. 


Impact of Mass Drug Administration on Soil-Transmitted Helminth Infections Across Different Age Groups: A Retrospective Study From Southern Bihar
Vishwas K, Barnawal RK, Kumar A, et al. Cureus. Springer Science and Business Media LLC. 2026.


Predictors of Community Practice Toward Mass Drug Administration for Lymphatic Filariasis in Pangani District, Tanzania: Evidence from a Cross-Sectional Study
Madilo D, Lusasi JE. Afro-Egyptian Journal of Infectious and Endemic Diseases. Egyptian Knowledge Bank. 2026; 17 (1): 1 - 11. 


Knowledge, Practices, and Health-Seeking Behaviour Regarding Schistosomiasis among Residents of Ifedore Local Government Area, Ondo State, Nigeria
Arajulu G, Odubia J, Adeleke O, et al. Journal of Public Health and Community Medicine. ScopeMed. 2026; 5 (3): 273 - 281. 


Trachoma Prevalence and Associated WASH and Behavioral Risk Among Rural Communities of North Gondar Zone, Ethiopia: A Community-Based Cross-Sectional Study
Alula G. Journal of tropical medicine. 2026.


The pervasive socio-economic and psychological burden of onchocerciasis in endemic communities of Bo District, Sierra Leone: an explanatory sequential mixed-methods study
Moseray AB, Gogra AB, Ansumana R. BMC Public Health. Springer Science and Business Media LLC. 2026.


Schistosomiasis in Yemen: Focal Persistence, Possible Resurgence, and Challenges to Elimination
Abdul-Ghani R, Azazy A, Al-Mikhlafy A, et al. Research and reports in tropical medicine. 2026.

 



 



News & Events

 



Call for applications: 2026-2027 Joint WHO AFRO/TDR Impact Grants for Implementation Research for Regional Priorities [WHO Africa]


AEIP Scholars Programme 2026-2027 [Africa Europe Innovation Platform]


Mentors Call for Application - Mwele Malecela Mentorship (MMM) Programme for Women in Neglected Tropical Diseases (NTDs) Cohort IV [WHO AFRO ESPEN]


Request for Proposals: Sustainable integration of Female Genital Schistosomiasis (FGS) into sexual, reproductive, and primary health systems [Coalition for Operational Research on Neglected Tropical Diseases (COR-NTD)]


NNN Vice Chair: Call for Nomination [Neglected Tropical Disease NGO Network]

 


Strengthening Community-Based Groups for People Affected by Skin-NTDs: Lessons from the UPLIFT Project

Date and Location: Sep 9, 2026, 7:00 AM EST Online
 
Join a global conversation on the future of Community-Based Groups and connect with practitioners, researchers, implementing organizations, and advocates working to improve the lives of people affected by NTDs. 
The session will present study outcomes, discuss practical implications, and introduce guidance documents based on the findings of the UPLIFT Project. Participants will have the opportunity to engage with project partners, researchers, and implementation experts through presentations and moderated discussion.

 




GDPR & the InfoNTD newsletter

 
New EU data protection regulations came into force on 25 May 2018. We have been reviewing our practices with regards to the GDPR, including our
privacy statement and mailing list.

InfoNTD sends out monthly e-mails with an overview of recent publications on NTDs and cross-cutting issues. The purpose of this activity is to keep subscribers up to date.

InfoNTD will only process the data we have (names, email addresses) for the purpose of sending you the newsletter. We take your security seriously and will never share your contact details with anyone else.

You can
update your preferences or unsubscribe from this list at any time.

 


 







____________________________________________________________________________

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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