02854nas a2200337   4500000000100000008004100001260001900042653001700061653001600078653001400094653002100108653001200129100001300141700001400154700001600168700001700184700001500201700001300216700001400229700002500243700001900268700001100287700001600298700001200314245014600326856012200472300001100594490000700605520189000612022001402502       2025                            d  c06/2025bLepra10aTransmission10aProphylaxis10aCommunity10aBlanket Approach10aSDR-PEP1 aMieras L1 aBakker MI1 aBanstola NL1 avan Brakel W1 aBudiawan T1 aHasker E1 aHinders D1 aOrtuño-Gutiérrez N1 aSchoenmakers A1 aTaal A1 aTomlinson J1 aWarne G00a‘Blanket approach’ or community-wide PEP implementation for leprosy: When, Where and How? Report on an expert meeting 23 September 2023  uhttps://leprosyreview.org/admin/public/article_shell/uploads/article_files/Lepra/LEPROSY/96/2/lr2024124/lr2024124.pdf  a1 - 220 v963 a<p>The WHO recommends single-dose rifampicin (SDR) as post-exposure prophylaxis (PEP) for leprosy contacts to curb transmission. Evidence, notably from the COLEP and LPEP studies, supports SDR-PEP’s efficacy in reducing leprosy risk by 57% and shows its integration into routine leprosy control is feasible. The ‘blanket approach,’ offering PEP to screened, eligible members of entire communities, has shown success in very high-endemic areas where targeting close contacts alone may be insufficient to reduce transmission. In this expert meeting, the lessons learned on when, where, and how to implement blanket campaigns were shared. Several studies have shown a significant reduction in the number of new patients after implementing PEP using the blanket approach compared to control groups, emphasizing its effectiveness, especially in remote, high-endemic areas. Follow-up visits are usually required to ensure coverage of more than 80%. Blanket campaigns are labor-intensive, but they improve early detection and community awareness while allowing integration with other health interventions like TB screening, optimizing overall healthcare access and education. The approach seems most suitable for small, high-endemic, highdensity populations where transmission probability is high. GIS-based mapping can help identify such high-endemic clusters. Implementing blanket campaigns requires thorough community preparation, team coordination, and follow-up to ensure coverage&nbsp;and efficacy. Screening is ideally done door-to-door, but community events are viable alternatives. Although resource-intensive, blanket campaigns have reduced new leprosy patients over time in previously high-endemic areas. Further research to determine their cost-effectiveness and to develop urban implementation strategies will contribute to increasing the impact of blanket campaigns.</p>
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