Risk factors and leprosy incidence among contacts in Bangladesh: A multilevel analysis.

Background: The Maltalep trial in Bangladesh assessed whether single-dose rifampicin (SDR) given 8-12 weeks after bacillus Calmette-Guérin (BCG) vaccination was able to prevent excess leprosy cases due to BCG in contacts of newly diagnosed leprosy patients. After previous publication of the two years follow-up results of the trial, we now review the results after five years. Furthermore, to better understand the long-term protective effects of BCG against leprosy, we conduct post-hoc in-depth secondary statistical analyses based on the prospective interventional (randomized) Maltalep trial and a non-interventional (non-randomized) cohort study that was conducted simultaneously in the same project area.

Integrative immune analysis in patients with leprosy reveals host factors associated with mycobacterial control.

Background: Leprosy is a debilitating, chronic infectious disease, ranking second after tuberculosis in the order of severe human mycobacterial diseases. If timely treatment is not initiated, infection with its causative agent, Mycobacterium leprae, can result in severe nerve damage leading to life-long disabilities. Host immunity largely dictates the spectral disease presentation, ranging from multi- to paucibacillary.

Rapid test for Mycobacterium leprae infection: a practical tool for leprosy.

Background: Detection of infection with Mycobacterium leprae allows timely prophylactic treatment, thereby reducing transmission as well as the risk of permanent, leprosy-associated nerve damage. However, since there is no worldwide-implemented standard test for M. leprae infection, detection of infection in asymptomatic individuals remains a major challenge for control programs in endemic areas.

The PEP++ study protocol: a cluster-randomised controlled trial on the effectiveness of an enhanced regimen of post-exposure prophylaxis for close contacts of persons affected by leprosy to prevent disease transmission.

Background: Leprosy is an infectious disease with a slow decline in global annual caseload in the past two decades. Active case finding and post-exposure prophylaxis (PEP) with a single dose of rifampicin (SDR) are recommended by the World Health Organization as measures for leprosy elimination. However, more potent PEP regimens are needed to increase the effect in groups highest at risk (i.

BCG-induced immunity profiles in household contacts of leprosy patients differentiate between protection and disease.

Leprosy is an infectious disease caused by Mycobacterium leprae leading to irreversible disabilities along with social exclusion. Leprosy is a spectral disease for which the clinical outcome after M. leprae infection is determined by host factors.

Blood RNA signature RISK4LEP predicts leprosy years before clinical onset.

Background: Leprosy, a chronic infectious disease caused by Mycobacterium leprae, is often late- or misdiagnosed leading to irreversible disabilities. Blood transcriptomic biomarkers that prospectively predict those who progress to leprosy (progressors) would allow early diagnosis, better treatment outcomes and facilitate interventions aimed at stopping bacterial transmission. To identify potential risk signatures of leprosy, we collected whole blood of household contacts (HC, n=5,352) of leprosy patients, including individuals who were diagnosed with leprosy 4-61 months after sample collection.

Prototype multi-biomarker test for point-of-care leprosy diagnostics.

To end the decade-long, obstinately stagnant number of new leprosy cases, there is an urgent need for field-applicable diagnostic tools that detect infection with , leprosy's etiologic agent. Since immunity against is characterized by humoral and cellular markers, we developed a lateral flow test measuring multiple host proteins based on six previously identified biomarkers for various leprosy phenotypes. This multi-biomarker test (MBT) demonstrated feasibility of quantitative detection of six host serum proteins simultaneously, jointly allowing discrimination of patients with multibacillary and paucibacillary leprosy from control individuals in high and low leprosy endemic areas.

Household Contacts of Leprosy Patients in Endemic Areas Display a Specific Innate Immunity Profile.

Leprosy is a chronic infectious disease, caused by , that can lead to severe life-long disabilities. The transmission of is continuously ongoing as witnessed by the stable new case detection rate. The majority of exposed individuals does, however, not develop leprosy and is protected from infection by innate immune mechanisms.

Effectiveness of single-dose rifampicin after BCG vaccination to prevent leprosy in close contacts of patients with newly diagnosed leprosy: A cluster randomized controlled trial.

Objective: To assess the effectiveness of single-dose rifampicin (SDR) after bacillus Calmette-Guérin (BCG) vaccination in preventing leprosy in contacts.

Methods: This was a single-centre, cluster-randomized controlled trial at a leprosy control programme in northwest Bangladesh. Participants were the 14988 contacts of 1552 new leprosy patients who were randomized into the SDR-arm (n=7379) and the SDR+arm (n=7609).

Application of new host biomarker profiles in quantitative point-of-care tests facilitates leprosy diagnosis in the field.

Background: Transmission of Mycobacterium leprae, the pathogen causing leprosy, is still persistent. To facilitate timely (prophylactic) treatment and reduce transmission it is vital to both early diagnose leprosy, and identify infected individuals lacking clinical symptoms. However, leprosy-specific biomarkers are limited, particularly for paucibacillary disease.