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...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2018-06, Vol.12 (6), p.e0006403-e0006403 |
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| creator | Lockwood, Diana N J Krishnamurthy, Padebettu Kumar, Bhushan Penna, Gerson |
| description | 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. |
| doi_str_mv | 10.1371/journal.pntd.0006403 |
| format | Article |
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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.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0006403</identifier><identifier>PMID: 29879118</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Biology and Life Sciences ; Chemoprevention ; Chemoprevention - economics ; Contact tracing ; Cost-Benefit Analysis ; Dermatology ; Detection ; Disease prophylaxis ; Dosage ; Dosage and administration ; Drug dosages ; Ethics ; Family Characteristics ; Feasibility studies ; Genes ; Health aspects ; Households ; Humans ; Hygiene ; Intervention ; Leprosy ; Leprosy, Multibacillary - economics ; Leprosy, Multibacillary - prevention & control ; Medical research ; Medical sciences ; Medicine ; Medicine and Health Sciences ; Mycobacterium leprae ; Patients ; People and Places ; Prevention ; Preventive Health Services - economics ; Prophylaxis ; Protocols ; Research and Analysis Methods ; Rifampin ; Rifampin - administration & dosage ; Rifampin - economics ; Social research ; Tropical climate ; Tropical diseases ; Tuberculosis ; Viewpoints</subject><ispartof>PLoS neglected tropical diseases, 2018-06, Vol.12 (6), p.e0006403-e0006403</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Lockwood et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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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. 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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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29879118</pmid><doi>10.1371/journal.pntd.0006403</doi><orcidid>https://orcid.org/0000-0003-2865-8966</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Biology and Life Sciences Chemoprevention Chemoprevention - economics Contact tracing Cost-Benefit Analysis Dermatology Detection Disease prophylaxis Dosage Dosage and administration Drug dosages Ethics Family Characteristics Feasibility studies Genes Health aspects Households Humans Hygiene Intervention Leprosy Leprosy, Multibacillary - economics Leprosy, Multibacillary - prevention & control Medical research Medical sciences Medicine Medicine and Health Sciences Mycobacterium leprae Patients People and Places Prevention Preventive Health Services - economics Prophylaxis Protocols Research and Analysis Methods Rifampin Rifampin - administration & dosage Rifampin - economics Social research Tropical climate Tropical diseases Tuberculosis Viewpoints |
| title | Single-dose rifampicin chemoprophylaxis protects those who need it least and is not a cost-effective intervention |
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