Fw: (LML) SDR-PEP and the risk of MB HD

 

Leprosy Mailing List – March 8,  2020

Ref.:   (LML) SDR-PEP and the risk of MB HD

From:  Khorshed Alam, Nilphamari, Bangladesh

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Dear Sir,

Regarding the LML post of Joel Almeida on SDR-PEP in Bangladesh (LML, March 5, 2020), I would like to point out the following:

·         SDR was given in northwest Bangladesh to a cohort of app. 10,000 contacts of app. 1000 new leprosy cases in 2002 and 2003 in the COLEP trial.

·         The COLEP trial was conducted in 2 districts Nilphamari and Rangpur (not 4).

·         SDR was never given routinely as part of the national leprosy control programme in Bangladesh, nor in the northwestern districts.

·         The leprosy trend in the 4 districts of Bangladesh mentioned in the LML post by no means can be attributed to SDR: In contrast, the relatively stable trend since 2010 is primarily due to a very high level of leprosy in northwest Bangladesh together with increased active and passive case finding by the leprosy control programme. These conditions have in fact been the enabling factors to conduct clinical trials such as COLEP and MALTALEP successfully at our centre in Nilphamari.

·         These trials were never intended to affect the leprosy situation in the whole population of these districts (over 8,000,000 inhabitants) and obviously too small in scale for that purpose.

·         For further clarification of the COLEP and MALTALEP results I refer to https://www.lepra.org.uk/platforms/lepra/files/lr/June18/Lep173-175.pdf and https://www.ijidonline.com/article/S1201-9712(20)30055-2/fulltext

Yours sincerely,

Md. Khorshed Alam

Project Manager Rural Health Program

The Leprosy Mission Bangladesh

Nilphamari, Bangladesh

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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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