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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

1Faculty of Medicine, Universitas Indonesia, Depok, Jawa Barat, Indonesia

2Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

3Yong Loo Lin School of Medicine, National University of Singapore, Singapore

Received: 8 Apr 2021; Published: 30 Aug 2021.
Open Access Copyright (c) 2021 The authors. Published by Faculty of Public Health, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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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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Figure 1. PRISMA Flow Chart Diagram of Search Strategies
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Keywords: chemoprophylaxis; leprosy; post exposure prophylaxis; single dose rifampicin

Article Metrics:

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