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Effectiveness Analysis of Single Dose Rifampicin-Post-Exposure Prophylaxis (SDR-PEP) as A Preventive Intervention for Leprosy Transmission: A Systematic Review of Randomized Controlled Trials

*Muhammad Mikail Athif Zhafir Asyura orcid  -  Faculty of Medicine, University of Indonesia, Indonesia
Ilma Ranjani Wijaya  -  Faculty of Medicine, University of Indonesia, Indonesia
Theetouch Toshukowong  -  Faculty of Medicine, Chiang Mai University, Thailand
Rui Sheng Wang  -  Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Open Access Copyright (c) 2021 Journal of Public Health for Tropical and Coastal Region

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Abstract

Introduction: Leprosy is a skin disease that reaches 200,000 cases annually. Considered a neglected tropical disease, 80% of annual leprosy remained in countries such as Brazil, India, and Indonesia. Multi-drug treatment is effective in curing leprosy but ineffective in preventing further transmission. The implementation of large-scale single dose rifampicin-post exposure prophylaxis suggests the inhibition of leprosy transmission and thus needs validation.

Methods: This systematic review was carried out based on the PRISMA statement from multiple databases using set keywords. A total of 646 studies were identified, followed by 4 randomized controlled trials included after screening.

Results: 86,502 subjects were divided into control and interventional groups and were to be followed up in 2-6 years. Most studies showed a significant decrease of leprosy cases by 50-60%. Furthermore, a complementary effect between single-dose rifampicin-post exposure prophylaxis and Bacillus Calmette–Guérin vaccine was identified. Moreover, the cost-effectiveness of the intervention was analyzed which resulted in IDR 80,414,775 being averted in its 25th year of implementation

Conclusion: The review established promising results of implementing single dose rifampicin-post exposure prophylaxis to prevent leprosy transmission. Further national scale intervention with a multi-layered approach is suggested to ensure full support and continuity of the large-scale intervention

 

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Keywords: chemoprophylaxis; leprosy; post exposure prophylaxis; single dose rifampicin

Article Metrics:

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