Single-dose rifampicin chemoprophylaxis protects those who need it least and is not a cost-effective intervention

About the Authors: Diana N. J. Lockwood * E-mail: Diana.lockwood@lshtm.ac.uk Affiliation: Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom ORCID logo http://orcid.org/0000-0003-2865-8966 Padebettu Krishnamurthy Affiliation: Damien Foundation of India Trust, Chennai, India Bhushan Kumar Affiliation: Department of Dermatology, STD and Leprosy, Postgraduate Institute of Medical Education and Research, Chandigarh, India Gerson Penna Affiliation: Tropical Medicine Centre, University of Brasilia, Brasilia, Brazil Citation: Lockwood DNJ, Krishnamurthy P, Kumar B, Penna G (2018) Single-dose rifampicin chemoprophylaxis protects those who need it least and is not a cost-effective intervention. There are serious ethical problems related to identifying the contacts of patients with leprosy, it is not cost effective for household contacts, and there is a possibility of the widespread use of SDR promoting the development of rifampicin resistance genes in Mycobacterium leprae. If SDR had similar levels of coverage in real life with 57% efficacy and 30% coverage, the intervention efficacy would not be more than 20%. Because SDR does not significantly reduce the number of patients with MB leprosy, it is unlikely to have an effect on transmission, because these are the patients that need to be treated earliest. Leprosy Post-Exposure Prophylaxis (LPEP) programme: study protocol for evaluating the feasibility and impact on case detection rates of contact tracing and single dose rifampicin.