PEP4LEP study protocol: integrated skin screening and SDR-PEP administration for leprosy prevention: comparing the effectiveness and feasibility of a community-based intervention to a health centre-based intervention in Ethiopia, Mozambique and Tanzania.

Autor:	Schoenmakers A; Medical Technical Department, NLR, Amsterdam, The Netherlands., Hambridge T; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands t.hambridge@erasmusmc.nl., van Wijk R; Medical Technical Department, NLR, Amsterdam, The Netherlands., Kasang C; Deutsche Lepra- und Tuberkulosehilfe e.V, Wuerzburg, Germany., Richardus JH; Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Bobosha K; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Mitano F; Lúrio University, Nampula, Mozambique.; Nampula Provincial Health Directorate, Ministry of Health Mozambique, Maputo, Mozambique., Mshana SE; Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania., Mamo E; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Marega A; Lúrio University, Nampula, Mozambique., Mwageni N; Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, United Republic of Tanzania., Letta T; Ministry of Health Ethiopia, Addis Ababa, Ethiopia., Muloliwa AM; Lúrio University, Nampula, Mozambique.; Nampula Provincial Health Directorate, Ministry of Health Mozambique, Maputo, Mozambique., Kamara DV; Ministry of Health Tanzania, Dodoma, United Republic of Tanzania., Eman AM; Deutsche Lepra- und Tuberkulosehilfe e.V. Ethiopia, Addis Ababa, Ethiopia., Raimundo L; NLR Mozambique, Nampula, Mozambique., Njako B; Deutsche Lepra- und Tuberkulosehilfe e.V. Tanzania, Dar es Salaam, United Republic of Tanzania., Mieras L; Medical Technical Department, NLR, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Aug 26; Vol. 11 (8), pp. e046125. Date of Electronic Publication: 2021 Aug 26.
DOI:	10.1136/bmjopen-2020-046125
Abstrakt:	Introduction: Leprosy, or Hansen's disease, remains a cause of preventable disability. Early detection, treatment and prevention are key to reducing transmission. Post-exposure prophylaxis with single-dose rifampicin (SDR-PEP) reduces the risk of developing leprosy when administered to screened contacts of patients. This has been adopted in the WHO leprosy guidelines. The PEP4LEP study aims to determine the most effective and feasible method of screening people at risk of developing leprosy and administering chemoprophylaxis to contribute to interrupting transmission. Methods and Analysis: PEP4LEP is a cluster-randomised implementation trial comparing two interventions of integrated skin screening combined with SDR-PEP distribution to contacts of patients with leprosy in Ethiopia, Mozambique and Tanzania. One intervention is community-based, using skin camps to screen approximately 100 community contacts per leprosy patient, and to administer SDR-PEP when eligible. The other intervention is health centre-based, inviting household contacts of leprosy patients to be screened in a local health centre and subsequently receive SDR-PEP when eligible. The mobile health (mHealth) tool SkinApp will support health workers' capacity in integrated skin screening. The effectiveness of both interventions will be compared by assessing the rate of patients with leprosy detected and case detection delay in months, as well as feasibility in terms of cost-effectiveness and acceptability. Ethics and Dissemination: Ethical approval was obtained from the national ethical committees of Ethiopia (MoSHE), Mozambique (CNBS) and Tanzania (NIMR/MoHCDEC). Study results will be published open access in peer-reviewed journals, providing evidence for the implementation of innovative leprosy screening methods and chemoprophylaxis to policymakers. Trial Registration Number: NL7294 (NTR7503). Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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