Leprosy

Leprosy is caused by Mycobacterium leprae, a bacterium  that preferably invades the nerve Schwann cells and macrophages. Leprosy has a long incubation period of 2-5 five years. The vast majority of infected persons mount an efficient immune response and clinical symptoms never appear (subclinical infection). The symptoms of clinical leprosy vary according to the immune response of the patient, the so-called leprosy spectrum.

Epidemiology
Around 300,000 people in the world are currently receiving leprosy treatment. Despite control efforts and the availability of a very efficient treatment regimen, the number of new cases detected each year has remained more or less stable over the past decade. Because of the severe handicaps that result from skin and peripheral nerve damage that remains even after treatment, leprosy is associated with social stigma and economic loss. Thus, the problem of leprosy is greater than the number of cases would suggest.

Diagnosis
Early diagnosis is key to the interruption of leprosy transmission. The diagnosis of leprosy is based on clinical signs and symptoms that can be recognized by a trained health worker. In endemic countries the diagnosis is usually made clinically on the presence of anaesthetic skin lesions, thickened nerves, and, if suitable laboratory facilities are available, the presence of M.leprae in slit skin smears.

Considering that leprosy control programmes are being integrated into the general health services, diagnostic criteria are being loosened and treatment schedules shortened, the use of modern molecular and immunological tools could be valuable aids to efforts to control leprosy.

Leprosy research activities at KIT Biomedical Research
KIT Biomedical Research has a long-time commitment to leprosy research. We were the first to describe a PCR for leprosy diagnosis, were the first to develop a leprosy dipstick and one of the first to instigate clinical trials to prevent leprosy with modern antibiotics.

Approach

KIT Biomedical Research has a long-time commitment to leprosy research. We were the first to describe a PCR for leprosy diagnosis, were the first to develop a leprosy dipstick and one of the first to instigate clinical trials to prevent leprosy with modern antibiotics.

Currently, KIT Biomedical Research performs research activities in the field of leprosy that aim to provide tools and insights that are of direct relevance for leprosy control activities. We collaborate with partners from all over the world, especially with scientists and control programs from leprosy endemic countries. Our main focuses of interest are the epidemiology, diagnosis, prevention and treatment of the disease.

KIT Biomedical Research also serves as a knowledge center and gives advice to researchers, policy makers and health workers from all over the world.

 

Focal points

  • Development, evaluation and application of diagnostic tools for leprosy
  • Epidemiology of the disease, including identification of risk factors
  • Mechanisms involved in transmission and pathogenesis of leprosy
  • Clinical and field trials of new treatment and prophylaxis regimens

Advice to researchers, policy makers and health workers

Example

The COLEP trial is a collaborative research project in which Erasmus MC Medical Centre, The Leprosy Mission Bangladesh and KIT Biomedical Research work closely together to provide insight into the disease, its epidemiology, transmission and risk factors and explore possibilities to prevent the disease among healthy contacts from leprosy patients by means of chemoprophylaxis. The study is carried out in Northwest Bangladesh and involves more that 40,000 people in the area: 20,000 contacts from leprosy patients and 20,000 randomly selected persons from the general population.

 

In a concerted effort we have identified:

·         The spatial distribution of the disease in the study area

·         The contribution of socio-economic factors in the development and transmission of the disease

·         Risk factors for the development of nerve function impairment in patients

·         Risk factors for the development of disease among contacts (genetic, spatial, immunological and demographic factors as well as index patient characteristics)

·         The protective effect of chemoprophylaxis among contacts

 

With this information Help programs have novel tools and information that may help them to more effectively and efficiently help leprosy patients and prevent the disease.

Projects


Publications


Team members


Contact

For more information, please contact Dr. Linda Oskam

Tags

disease control | diagnostics | infectious diseases | leprosy | research |

Royal Tropical Institute