Leprosy primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
Primary prevention of leprosy includes immunoprophylaxis, chemoprophylaxis and education of the populations to prevent infection by the Mycobacterium leprae.
Primary prevention
Unfortunately there are still endemic regions in the world where people are deeply affected by leprosy. These due to international travels, threaten to be a source of the bacteria for the rest world. Considering the importance of early diagnosis and treatment of leprosy to prevent lifetime damages, primary prevention gains an extraordinary importance, particularly in areas of the world with higher incidence of the disease. Unfortunately up to today, there is still no adequate tool for the early detection of leprosy. Immunoprophylaxis studies in different population groups with the BCG vaccine, alone or in combination with killed Mycobacterium leprae or atypical Mycobacteria, have shown an efficacy of 28 to 60%. To the best of today's knowledge, a good coverage of BCG vaccine is still a major contribution to reduce the impact of leprosy in populations.[1]
Chemoprophylaxis of chronic infectious diseases has also shown benefits, particularly in populations with higher risk of infection with leprosy. However, it is still early to define chemoprophylaxis as a public health measure, as more trials are needed to demonstrate safety, efficacy and cost-effectiveness of these therapies.[1]
Other important element of primary prevention is the education of populations. Immediate contacts of leprosy patients have higher risk of being infected, therefore they should be aware of the condition, its transmission and what to do to minimize this risk.[1]