03059nas a2200541   4500000000100000008004100001260001200042100001100054700001600065700001300081700001900094700001100113700001600124700001400140700001400154700001800168700001500186700001600201700001100217700001300228700001400241700001300255700001300268700001500281700001300296700001200309700001300321700001100334700001700345700001300362700001500375700002000390700001200410700001100422700001700433700001800450700001400468700001400482700001700496700001200513700001700525245012200542856007900664300001300743490000700756520174000763022001402503       2021                            d  c03/20211 aBlok D1 aSteinmann P1 aTiwari A1 aBarth-Jaeggi T1 aArif M1 aBanstola NL1 aBaskota R1 aBlaney DD1 aBonenberger M1 aBudiawan T1 aCavaliero A1 aGani Z1 aGreter H1 aIgnotti E1 aKamara D1 aKasang C1 aManglani P1 aMieras L1 aNjako B1 aPakasi T1 aSaha U1 aSaunderson P1 aSmith CW1 aStäheli R1 aSuriyarachchi N1 aMaung A1 aShwe T1 avan Berkel J1 avan Brakel WH1 aPlaetse B1 aVirmond M1 aWijesinghe M1 aAerts A1 aRichardus JH00aThe long-term impact of the Leprosy Post-Exposure Prophylaxis (LPEP) program on leprosy incidence: A modelling study.  uhttps://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0009279  ae00092790 v153 a<p><b>BACKGROUND: </b>The Leprosy Post-Exposure Prophylaxis (LPEP) program explored the feasibility and impact of contact tracing and the provision of single dose rifampicin (SDR) to eligible contacts of newly diagnosed leprosy patients in Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka and Tanzania. As the impact of the programme is difficult to establish in the short term, we apply mathematical modelling to predict its long-term impact on the leprosy incidence.</p><p><b>METHODOLOGY: </b>The individual-based model SIMCOLEP was calibrated and validated to the historic leprosy incidence data in the study areas. For each area, we assessed two scenarios: 1) continuation of existing routine activities as in 2014; and 2) routine activities combined with LPEP starting in 2015. The number of contacts per index patient screened varied from 1 to 36 between areas. Projections were made until 2040.</p><p><b>PRINCIPAL FINDINGS: </b>In all areas, the LPEP program increased the number of detected cases in the first year(s) of the programme as compared to the routine programme, followed by a faster reduction afterwards with increasing benefit over time. LPEP could accelerate the reduction of the leprosy incidence by up to six years as compared to the routine programme. The impact of LPEP varied by area due to differences in the number of contacts per index patient included and differences in leprosy epidemiology and routine control programme.</p><p><b>CONCLUSIONS: </b>The LPEP program contributes significantly to the reduction of the leprosy incidence and could potentially accelerate the interruption of transmission. It would be advisable to include contact tracing/screening and SDR in routine leprosy programmes.</p>  a1935-2735