01820nas a2200181   4500000000100000008004100001100001400042700001600056700001300072700001200085700001100097700001400108245009300122856005100215300001400266490000700280520135100287       2019                            d1 aButlin CR1 aNicholls PG1 aBowers B1 aSingh S1 aAlam K1 aQuilter E00aHousehold contact examinations: outcome of routine surveillance of cohorts in Bangladesh  uhttps://leprosyreview.org/article/90/3/29-0304  a290–3040 v903 a<p>Introduction: There is a lack of evidence on which to base decisions about the ideal duration of surveillance for household contacts of newly diagnosed leprosy cases. Methods: We reviewed 9538 households of leprosy cases diagnosed in Bangladesh over 21 years, to establish the temporal pattern of new case detection during routine surveillance periods, which were two years for Paucibacillary (PB) cases and five years for Multibacillary (MB) cases. Results: In both MB and PB households we found the highest new case detection rates at the first examination, completed within a few weeks of diagnosis of the index case. These new cases were effectively co-prevalent with the index case. In subsequent years, the new case detection rate fell markedly. However, at each time point we found the new case detection rate to be higher amongst the household contacts of MB index cases as compared with contacts of PB index cases. Discussion: We conclude that an initial contact examination completed at the earliest opportunity after the index diagnosis is a high priority for every PB and MB household. When first seen, those individual contacts found to be healthy should be warned about their continuing risk of developing leprosy. Where resources allow, health workers should prioritise annual re-assessments of contacts of MB index cases.</p>