@article{102799,
  keywords = {Active case detection, Mapping, Leprosy, Neglected tropical disease},
  author = {Naher K and Rifat M and Biswas DK and Faisal SM and Ortuño-Gutiérrez N and Hasker E},
  title = {Assessing the Feasibility of an Intensified Extended Contact Survey (IECS) Compared to Passive Household Screening for Leprosy in Bangladesh},
  abstract = {<jats:p>Bangladesh is among the 23 WHO priority countries for leprosy, with a new case detection rate of 21 per million population including children among new cases indicating recent transmission. We aimed to compare active versus passive case detection using geospatial tools. A cluster-randomized study was conducted across seven intervention and seven control districts. In the intervention arm, GPS coordinates of new cases were recorded, and contacts within a 75-m buffer were screened. Spatial cluster analysis using Kulldorff’s scan statistics was performed to identify hotspots. The main objective was to achieve early case detection in intervention areas, reflected in a lower proportion of new patients with grade 2 disabilities (G2Ds). A total of 347/382 (90%) index cases were enrolled in the intervention arm, compared to 380/462 (82%) in the control arm. Among household contacts, 7/1482 (5‰) new cases were found in the intervention area and 12/1565 (7.7‰) in the control area. Additionally, 18/25,720 (0.7‰) new cases were detected among neighbor contacts in the intervention arm. G2D proportions were not lower in the intervention arm (15%) than in the comparator arm (11%, p = 0.043). Comparable household contact cases were observed in both arms, with more cases emerging among neighbors in intervention districts. Eight spatial clusters were identified, including 288/844 (34%) index cases, with three significant clusters from 2022 to 2023. Screening within a 75-m buffer detected additional leprosy cases, though fewer than expected due to COVID-19 limitations. Targeting clusters for case detection and prophylaxis could strengthen transmission control efforts.</jats:p>},
  year = {2025},
  journal = {Tropical Medicine and Infectious Disease},
  volume = {10},
  pages = {1-9},
  publisher = {MDPI AG},
  issn = {2414-6366},
  url = {https://www.mdpi.com/2414-6366/10/10/274/pdf?version=1758674993},
  doi = {10.3390/tropicalmed10100274},
  language = {ENG},
}