Projects

Severity scale for erythema nodosum leprosum

  • Research priorities: Operational research
  • Country: Bangladesh, Brazil, Ethiopia, India, Indonesia, Philippines, United Kingdom
  • Project no.: 703.15.40
  • Budget: € 65,698
  • Duration: May 2015 - July 2017
  • Status: Completed
  • Co-funding partners: Fully funded by the Austrian Leprosy Relief Association

Full project title:
Development and validation of severity scale for erythema nodosum leprosum (ENL)

Project coordination
London School of Hygiene and Tropical Medicine

Partners
Leonard Wood Memorial Center (Philippines)
ALERT Center (Ethiopia)
Anandaban Hospital (Nepal)
Bombay Leprosy Project (India)
FIOCRUZ (Brazil)
The Leprosy Mission (India)
General Soetomo Hospital (Indonesia)
Danish Bangladesh Leprosy Mission Hospital (Bangladesh)

Aim: In order to determine which therapies are most effective, this study developed the ENLIST ENL Severity Scale which measures the severity of ENL before, during and at the end of treatment. 

Final project summary
Erythema nodosum leprosum (ENL) is severe complication of leprosy which is associated with death and increased economic hardship. ENL is a difficult condition to treat and many affected individuals do not have access to safe, effective long term therapies. This project developed and tested the first reliable method of measuring the severity of ENL, the ENLIST ENL Severity Scale, and brought together leprosy workers from around the globe to meet this challenge. This scale is easy to use, and is able to demonstrate meaningful clinical change. Therefore it can now be used to find better ways to treat the condition, and moniter progress of patients receiving treatment.

Impact

Walker SL, Knight KL, Pai VV, Nicholls PG, Alinda M, Butlin CR, et al. The development of a severity scale for Erythema Nodosum Leprosum – the ENLIST ENL severity scale. Leprosy Review. 2016;87(3) pp. 332-46.

Walker SL, Sales AM, Butlin RC, Shah M, Maghanoy A, Lambert SM, et al. A leprosy clinical severity scale for erythema nodosum leprosum - an international, multicentre validation study of the ENLIST ENL Severity Scale. PLoS Negl Trop Dis. 2017;11(7) 

WHO Technical Guidance document: Leprosy/Hansen Disease: Management of reactions and prevention of disabilities. [online]
Available at: https://www.who.int/publications/i/item/9789290227595