Leprosy Mailing List – July 15, 2018
Ref.: (LML) Single-dose rifampicin chemoprophylaxis
From: Joel Almeida, London and Mumbai
Dear Pieter,
A recently reported study gave single dose rifampicin (SDR) to most people on a small island. That is a good way to test and demonstrate the potential of chemoprophylaxis.
What were the results?
The number of new cases among the 1071 who had received SDR was 6 and the number of cases among the 410 who had not received SDR was 4. The odds ratio is 0.57 (95% CI: 0.16–2.03).
In short, there was no statistically significant difference between the SDR group and the non-SDR group.
Unfortunately, the report fails to state this clearly. In such matters, however, facts are quite important.
Do these results mean that chemoprophylaxis is completely useless? Of course not. It means merely that claims of its efficacy are insufficiently substantiated by fact in this study.
It is far better to keep attempting elimination on a small island and discover the limitations than to rely on exaggerated claims.
Joel Almeida
Reference
Anuj Tiwari, Steaven Dandel, Rita Djupuri, Liesbeth Mieras and Jan Hendrik Richardus. Population-wide administration of single dose rifampicin for leprosy prevention in isolated communities: a three-year follow-up feasibility study in Indonesia. BMC Infectious Diseases 2018.18:324
https://doi.org/10.1186/s12879-018-3233-3
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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