01767nas a2200217   4500000000100000008004100001260001300042653002300055653001800078653001100096653002300107653001200130653002500142100001600167700001600183245007200199300001100271490000700282520124600289022001401535       2011                            d  c2011 Jun10aBacterial Vaccines10aGlobal health10aHumans10aLeprostatic Agents10aleprosy10aMycobacterium leprae1 aRodrigues L1 aLockwood DN00aLeprosy now: epidemiology, progress, challenges, and research gaps.  a464-700 v113 a<p>Leprosy continues to be a challenge to health worldwide, with about 250,000 new cases being detected every year. Despite widespread implementation of effective multidrug therapy, leprosy has not been eliminated. A third of newly diagnosed patients have nerve damage and might develop disabilities, although the proportion varies according to several factors, including level of self-care. Women who develop leprosy continue to be especially disadvantaged, with rates of late diagnosis and disability remaining high in this subgroup. Leprosy was not a specified disease in the Millennium Development Goals, but improvements in the other areas they cover, such as education and levels of poverty, will help leprosy patients and services. We review data and make recommendations for research on diagnosis, treatment, and prevention, such as further use of molecular analysis of the Mycobacterium leprae genome, implementation of BCG vaccination, and administration of chemoprophylaxis to household contacts. We also suggest development of tools for early diagnosis and detection of infection and nerve damage, and formulation of strategies to manage the chronic complications of leprosy, such as immune-mediated reactions and neuropathy.</p>  a1474-4457