BMJ  2008;336:847-848 (19 April), doi:10.1136/bmj.39549.445521.3A

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Leprosy chemoprophylaxis

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The first 150 words of the full text of this article appear below.

The study reported by Moet et al found benefit at two years after rifampicin, but did not find any significant difference between rifampicin chemoprophylaxis and placebo treatment in the third and fourth years after rifampicin treatment.1 Mycobacterium leprae multiplies very slowly, and the incubation period of leprosy is about five years but can be up to 20 years (www.who.int/mediacentre/factsheets/fs101/en/index.html). Whether the absence of clinical cases of leprosy at two years after rifampicin treatment is due to rifampicin chemoprophylaxis or just due to subclinical infection within the incubation period can therefore not be established.

Any benefit of rifampicin chemoprophylaxis would not exceed 50% under routine conditions.2 In the absence of any long term benefit, individuals at high risk could immediately be reinfected with M leprae as long as transmission persists after the immediate benefit has waned.3

The finding1 that patients with low risk for leprosy, on the basis of . . . [Full text of this article]

Mohammad M Rahman, residency applicant

1 Brampton, ON, Canada L7A 1V7

md.mrahman@sympatico.ca


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Relevant Article

Effectiveness of single dose rifampicin in preventing leprosy in close contacts of patients with newly diagnosed leprosy: cluster randomised controlled trial
F Johannes Moet, David Pahan, Linda Oskam, Jan H Richardus for the COLEP Study Group
BMJ 2008 336: 761-764. [Abstract] [Full Text] [PDF]

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