Leprosy Mailing List – August 18, 2026
Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works
From: Ben Naafs, Munnekeburen, the Netherlands
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Joel Almeida “Long-lasting adverse impact of chemoprophylaxis & what actually works”. August 17, 2026.
Dear Pieter,
I think Joël already knows the answer to the his question to me.
BL patients are downgrading patients, and when they reach subpolar LL, I expect them to shed as much bacilli as a polar LL. But by reading the BI in the nasal smear you have to be aware of the fact that many of the AFB’s are not necessarily M. leprae.
What is the reference of the 208 patients?
All persons with M. leprae in their nose together with the ones in the environment will contribute to M. leprae pool.
LL patients according to me do not need to be reinfected since with the present WHO treatment they may stay active, despite WHO’s claim.
I like the places lake/boat comparison. But this is for the readers of LML this is not needed because they have read his many explanations before. Some may even be offended.
Indeed with mLAMP no high shedder will be missed. But it is costly. Needs consumables : "roughly $5–$10/test. With costs of the instrument amortized: will depends heavily on volume, but at 1,000 tests, the instrument adds about $22/test; at 10,000 tests about $2.20/test". But it may be worth it.
The Alinea TREAT: Treat everyone you diagnose by whatever method. And follow-up for reactions and other complications. VMT I feel is not enough, but Graded Sensory Testing should be added as well as nerve sonography, and most importantly clinical care.
Indeed, if we follow these advises we do not need to be pessimistic. But Patients and caretakers should unite and listen and learn from each other. And follow the research with a practical clinical eye.
Be aware: there is no place for politics in leprosy control - enough damage has been done.
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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