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TropicalMed
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Towards Zero Leprosy: Epidemiology and Prevention Strategy
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Towards Zero Leprosy: Epidemiology and Prevention Strategy

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366).

Deadline for manuscript submissions: closed (20 May 2025) | Viewed by 5927

Special Issue Editors

Dr. Christa Kasang

E-Mail Website
Guest Editor
German Leprosy and Tuberculosis Relief Association, 97080 Würzburg, Germany
Interests: leprosy; post exposure prophylaxis SDR; NTDs; tuberculosis
Dr. Nimer Ortuño-Gutiérrez

E-Mail Website
Guest Editor
Damien Foundation, 1081 Brussels, Belgium
Interests: geospatial analysis; prevention of leprosy and tuberculosis; drug-resistant tuberculosis and leprosy; cutaneous leishmaniasis

Special Issue Information

Dear Colleagues,

Leprosy, one of the world's oldest and most stigmatized diseases, continues to persist in pockets of endemicity, particularly in countries with limited resources and infrastructure. Despite significant advances in the development of treatment and control measures, the burden of leprosy remains a significant public health concern, demanding renewed efforts and innovative strategies. In accord with the World Health Organization's (WHO) Zero Leprosy Strategy for 2021–2030, which provides a roadmap for achieving elimination and reducing the burden of the disease worldwide, this Special Issue of our journal aims to spotlight the multifaceted challenges associated with leprosy control, particularly in regions with high endemicity. By focusing on key areas such as epidemiology, prevention, and stigma reduction, this Special Issue seeks to advance our understanding of leprosy as a public health problem and facilitate the implementation of targeted interventions. The scope of this Special Issue encompasses a broad range of topics related to leprosy control and elimination efforts. From epidemiological studies mapping the distribution of the disease to evaluations of post-exposure prophylaxis using single-dose rifampicin, the Special Issue explores innovative approaches and best practices in leprosy prevention and treatment. Additionally, it delves into the social determinants of leprosy, including stigma and discrimination, highlighting the importance of addressing these factors in comprehensive control strategies.

In summary, this Special Issue offers you the unique opportunity to contribute to the advancement of leprosy control strategies, with a focus on research concerning current trends and priorities in the field. We invite authors to submit their original contributions to enrich the discourse and propel progress towards a world free from the burden of leprosy.

Dr. Christa Kasang
Dr. Nimer Ortuño-Gutiérrez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • leprosy
  • neglected tropical diseases
  • skin NTDs
  • disease mapping
  • post exposure prophylaxis single dose rifampicin
  • chemoprophylaxis
  • stigma and discrimination
  • zero leprosy
  • multisectoral interventions
  • infectious diseases
  • epidemiology

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Published Papers (5 papers)

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Research

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13 pages, 1477 KiB  
Article
Evaluating Machine Learning Models for Predicting Late Leprosy Diagnosis by Physical Disability Grade in Brazil (2018–2022)
by Lucia Rolim Santana de Freitas, José Antônio Oliveira de Freitas, Gerson Oliveira Penna and Elisabeth Carmen Duarte
Trop. Med. Infect. Dis. 2025, 10(5), 131; https://doi.org/10.3390/tropicalmed10050131 - 12 May 2025
Viewed by 312
Abstract
The severity of physical disability at leprosy diagnosis reflects the timeliness of case detection and the effectiveness of disease surveillance. This study evaluates machine learning models to predict factors associated with late leprosy diagnosis—defined as grade 2 physical disability (G2D)—in Brazil from 2018 [...] Read more.
The severity of physical disability at leprosy diagnosis reflects the timeliness of case detection and the effectiveness of disease surveillance. This study evaluates machine learning models to predict factors associated with late leprosy diagnosis—defined as grade 2 physical disability (G2D)—in Brazil from 2018 to 2022. Using an observational cross-sectional design, we analyzed data from the Notifiable Diseases Information System and trained four machine learning models: Random Forest, LightGBM, CatBoost, XGBoost, and an Ensemble model. Model performance was assessed through accuracy, area under the receiver operating characteristic curve (AUC-ROC), recall, precision, F1 score, specificity, and Matthew’s correlation coefficient (MCC). An increasing trend in G2D prevalence was observed, averaging 11.6% over the study period and rising to 13.1% in 2022. The Ensemble model and LightGBM demonstrated the highest predictive performance, particularly in the north and northeast regions (accuracy: 0.85, AUC-ROC: 0.93, recall: 0.90, F1 score: 0.83, MCC: 0.70), with similar results in other regions. Key predictors of G2D included the number of nerves affected, clinical form, education level, and case detection mode. These findings underscore the potential of machine learning to enhance early detection strategies and reduce the burden of disability in leprosy, particularly in regions with persistent health disparities. Full article
(This article belongs to the Special Issue Towards Zero Leprosy: Epidemiology and Prevention Strategy)
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12 pages, 646 KiB  
Article
The Safety, Acceptability, and Feasibility of Single-Dose Rifampicin as Post-Exposure Chemoprophylaxis for Contacts of Leprosy Patients in Togo: A Mixed-Method Sequential Explanatory Study
by Akila Wimima Bakoubayi, Falapalaki Haliba, Wendpouiré Ida C. Zida-Compaore, P’tanam P’kontème Bando, Yao Rodion Konu, Abissouwèssim Egbare Tchade, Kodjo Akpadja, Kamevor Alaglo, Maweke Tchalim, P’niwè Patchali, Yaovi Djakpa, Komi Amekuse, Piham Gnossike, Denis A. Yawovi Gadah, Christa Kasang and Didier Koumavi Ekouevi
Trop. Med. Infect. Dis. 2024, 9(11), 276; https://doi.org/10.3390/tropicalmed9110276 - 14 Nov 2024
Cited by 1 | Viewed by 1510
Abstract
The World Health Organization is encouraging countries to include contact screening and single-dose rifampicin administration as preventive chemotherapy for contacts of leprosy patients in their leprosy control activities. However, no study has been conducted to assess the safety of SDR-PEP and the acceptability [...] Read more.
The World Health Organization is encouraging countries to include contact screening and single-dose rifampicin administration as preventive chemotherapy for contacts of leprosy patients in their leprosy control activities. However, no study has been conducted to assess the safety of SDR-PEP and the acceptability and feasibility of this intervention in Togo. To assess the safety of SDR-PEP, we used a cohort design, and for acceptability and feasibility, we used a mixed method, combining a quantitative study to assess the safety of SDR-PEP in a cohort of contacts from recently diagnosed leprosy patients followed by a qualitative study to identify the social, cultural, or institutional factors that would influence the adoption of single-dose rifampicin as post-exposure prophylaxis for contacts of leprosy patients in Togo. For the quantitative study, all identified index patients agreed to the disclosure of their status to their contacts and provided a list of their contacts. All the contacts found agreed to take part in the study, and an appointment was made for screening. However, some contacts were absent on the screening day for no reason. All eligible contacts agreed to take SDR and were followed up after taking the drug. No severe adverse events were reported during the follow-up. For the qualitative study, 72 interviews (66 semi-structured interviews and 6 focus groups) were carried out, and it emerged that, overall, opinions were favorable on the acceptability and feasibility of implementing single-dose rifampicin as post-exposure prophylaxis for contacts of leprosy patients in Togo. However, a number of conditions need to be considered for more effective results. Full article
(This article belongs to the Special Issue Towards Zero Leprosy: Epidemiology and Prevention Strategy)
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Review

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20 pages, 568 KiB  
Review
A Review of the Efficacy, Safety, and Feasibility of Rifamycin-Based Post-Exposure Chemoprophylaxis for Leprosy
by Patrick O. Campbell, Nicholas M. Douglas and Stephen T. Chambers
Trop. Med. Infect. Dis. 2025, 10(4), 84; https://doi.org/10.3390/tropicalmed10040084 - 21 Mar 2025
Viewed by 526
Abstract
In 2021, the World Health Organization (WHO) recommended scaling up leprosy prevention activities, including chemoprophylaxis, as one of the pillars of their ‘Towards Zero Leprosy’ strategy. This recommendation was primarily based on a 57% overall reduction in leprosy incidence among contacts who received [...] Read more.
In 2021, the World Health Organization (WHO) recommended scaling up leprosy prevention activities, including chemoprophylaxis, as one of the pillars of their ‘Towards Zero Leprosy’ strategy. This recommendation was primarily based on a 57% overall reduction in leprosy incidence among contacts who received chemoprophylaxis in the COLEP study conducted in Bangladesh. Since this landmark study, further research on the efficacy, feasibility, and implementation of leprosy chemoprophylaxis has been conducted. Additionally, concerns have been raised regarding the strength of evidence supporting the overall benefit of chemoprophylaxis and the potential for propagation of drug resistance in M. leprae strains. This literature review presents the current evidence for the efficacy and safety of rifamycin-based chemoprophylaxis in preventing clinical disease, and the feasibility of implementing chemoprophylaxis programmes. Post-exposure prophylaxis (PEP) has a reported efficacy of 45–80%, depending on the degree of case contact, the classification of the index case, the selected chemoprophylaxis regimen, the geographical setting, childhood BCG coverage and the implementation approach. As an intervention, it appears to be feasible, cost-effective, and acceptable to patients, contacts, and healthcare staff, with minimal harm. Implementation strategies need to be tailored to specific epidemiological and sociocultural settings for maximal benefit. Further research is required to optimise PEP regimens and strategies in various epidemiological settings and to assess the impact of these programmes on the susceptibility profile of local M. leprae strains. Full article
(This article belongs to the Special Issue Towards Zero Leprosy: Epidemiology and Prevention Strategy)
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Other

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14 pages, 1266 KiB  
Systematic Review
Molecular Detection of Mycobacterium leprae and the Process of Infection and Illness in Contacts of Leprosy Patients: A Systematic Review
by Sarah Lamas Vidal, Lavínia Cássia Ferreira Batista, Daniele dos Santos Lages, Bruna Eduarda Bortolomai, Isabela de Caux Bueno, Eyleen Nabyla Alvarenga Niitsuma, Nathan Guilherme de Oliveira, Ida Maria Foschiani Dias Baptista and Francisco Carlos Félix Lana
Trop. Med. Infect. Dis. 2025, 10(2), 32; https://doi.org/10.3390/tropicalmed10020032 - 23 Jan 2025
Viewed by 1197
Abstract
Various techniques have been used for the molecular identification of Mycobacterium leprae (M. leprae). The aim of this review was to identify the relationship between the molecular presence of M. leprae and the process of infection and/or illness of contact of [...] Read more.
Various techniques have been used for the molecular identification of Mycobacterium leprae (M. leprae). The aim of this review was to identify the relationship between the molecular presence of M. leprae and the process of infection and/or illness of contact of leprosy cases. A systematic review was carried out by searching the Medical Literature Analysis and Retrieval System Online (MEDLINE), Cochrane Library, Embase, Scopus, Web of Science and the Latin American and Caribbean Health Sciences Literature (LILACS) databases in January 2024. The studies were selected by two pairs of reviewers. Observational cross-sectional, case–control and cohort studies were included. A descriptive synthesis of the results by category was carried out. A total of 443 studies were identified, and 36 were included in the review. Twelve molecular targets were tested to identify the presence of the bacillus. A relationship was established between the identification of M. leprae DNA and factors related to the index case, housing characteristics, living conditions, epidemiology and anti-PGL-1 serology. None of the studies identified evaluated the molecular viability of M. leprae among contacts. The detection of M. leprae DNA alone does not necessarily predict the development of infection or clinical illness among contacts. Full article
(This article belongs to the Special Issue Towards Zero Leprosy: Epidemiology and Prevention Strategy)
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5 pages, 207 KiB  
Opinion
Integrating Community Engagement in Zero Leprosy Efforts: A Pathway to Sustainable Early Detection, Control and Elimination
by Anil Fastenau, Matthew Willis, Constanze Vettel, Sophie C. W. Stuetzle, Srilekha Penna, Priyanka Chahal, Fabian Schlumberger, Mowmita Basak Mow, Ngozi Ekeke, Joseph Ngozi Chukwu and Patricia D. Deps
Trop. Med. Infect. Dis. 2024, 9(12), 296; https://doi.org/10.3390/tropicalmed9120296 - 3 Dec 2024
Cited by 2 | Viewed by 1583
Abstract
Community engagement has emerged as a critical component in the effective control and elimination of neglected tropical diseases (NTDs), particularly in regions with persistent stigma and limited healthcare access. Drawing on case studies from Brazil, India, and Nigeria, this opinion piece explores how [...] Read more.
Community engagement has emerged as a critical component in the effective control and elimination of neglected tropical diseases (NTDs), particularly in regions with persistent stigma and limited healthcare access. Drawing on case studies from Brazil, India, and Nigeria, this opinion piece explores how community-driven initiatives have successfully improved leprosy awareness, reduced stigma, and fostered early case detection and treatment adherence. The importance of culturally sensitive, inclusive approaches in health education and stigma reduction campaigns is highlighted, emphasizing the potential for community engagement to enhance national leprosy programs and contribute to the World Health Organization’s Zero Leprosy Strategy. By examining these examples, this article illustrates how integrating community participation into leprosy control and elimination programs can drive sustainable outcomes for achieving Zero Leprosy, even in resource-limited settings. Full article
(This article belongs to the Special Issue Towards Zero Leprosy: Epidemiology and Prevention Strategy)
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