Projects
- Research priorities: Operational research
- Country: Nigeria
- Project no.: FP23_CS.5
- Budget: € 20,000
- Duration: September 2023 – October 2025
- Status: Ongoing
This study engages the theory of “collaborative co-design” to role model and deliver lessons on optimal educational collaboration between academic researchers and practitioners (dermatologists, GHWs) to have the greatest coverage and impact for persons affected by skin NTDs, such as leprosy.
Collaborative co-design to optimize evidence-based and contextual general health worker training in
integrated screening for leprosy and other skin NTDs in Nigeria
Project coordination
Project summary
Because a lot of Nigerians have diseases related to their skin, and there are not enough specialty doctors (dermatologists) to treat such illnesses, it is necessary to increase early checks on individuals for skin disease and to train other health workers to provide the care that doctors have been. This means that support workers called General health workers (GHW) are important people to train. But, GHW’s do not
learn much about skin diseases. This is especially the case for neglected tropical skin diseases (skin NTDs) such as leprosy, which can cause disability, exclusion and discrimination. To successfully improve this knowledge gap and foster early diagnosis and treatment of patients with skin NTDs, it is important to not only train GHWs, but to involve them in the design of their training.
This study will use both numerical and language-based information in three different steps. First, we will study what other researchers have written about GHW training for looking at skin diseases, and hold a meeting with GHWs themselves to plan a training. Second, we will conduct three training sessions with Nigerian GHWs, and collect numeral information about whether it was good or not, and whether GHWs learned from it. Third, we will ask the GHWs, and trainers what they learned that can be applied in other places and programmes. This study will give us a well-designed training that can be used by others in different places in the future, a research paper about what we found, a research paper saying what the literature says about such training; and improved skills of participants, including Nigerian GHWs. All materials which resulted from this study will be made available free of charge (open-access) to further enhance capacity strengthening in recognizing leprosy and other skin NTDs internationally.
- Research priorities: Operational research
- Country: India
- Budget: €82,695 | Project number: FP23.19
- Duration: April 2023 - June 2025
- Status: Ongoing
This study will address the following question: What are the perspectives of persons affected by leprosy, their families and healthcare providers on living with chronic aspects of leprosy, to formulate a guideline that can address care after multi-drug treatment?
Addressing healing after multi-drug treatment centred around perspectives of persons affected by leprosy, their families and healthcare providers: a qualitative study
Project coordination
Project summary
Leprosy is an illness with chronic implications, having multidimensional impacts on the patient’s life. Persons affected by leprosy continue to face challenges beyond the completion of Multi Drug Therapy (MDT), as the consequences of nerve damage are lasting, requiring lifelong care. Despite being declared cured medically at the end of their MDT treatment, persons affected by leprosy with impairments themselves feel that they are not cured because they still suffer from persisting symptoms. They continue to endure lingering disabilities, other related difficulties, and stigma. The current model of care does not acknowledge or address the chronic nature of leprosy and the needs of persons affected who are released from treatment (RFT). They continue to struggle with the physical and psychosocial consequences of leprosy without any systematic support from healthcare providers. Though there are few studies that quantify the disabilities faced post-RFT, there are no standard guidelines or holistic care models addressing the needs of persons affected by leprosy to help them on their recovery journey.
This study attempts to understand the perspectives of care after cure in leprosy from the point of view of both patients, the family members and healthcare providers through interviews. Through a literature review, this study will draw lessons from other illnesses like diabetes, tuberculosis, HIV/AIDS and schizophrenia which are similar to leprosy in terms of chronicity, to look beyond the concept of cure, and to identify measures to promote healing. Based on the learnings from the literature and perspectives of the stakeholders, we will attempt to develop a set of guidelines that will help inform care of the chronic aspects of leprosy. The researchers propose that the adoption of the concept of healing will add a new dimension to leprosy care and if incorporated into practice, it would empower people with leprosy to live meaningful lives, even with persisting symptoms.
- Research priorities: Disability
- Country: India
- Budget: €118,674 | Project number: FP23.18
- Duration: April 2023 - September 2024
- Status: Ongoing
This study will address the following question: Can a low-cost technology for measuring baropodometry, undertaken at the community / primary care levels, help design personalized MCR footwear that reduces the risk of new ulcers among people affected by leprosy with a history of plantar ulcers?
Personalised footwear for foot ulcers in leprosy by baropodometry through an innovative community engagement model
Project coordination
Partners
- Sivananda Rehabilitation Home
- Damien Foundation India Trust
- Association of People Affected by Leprosy (APAL)
- Office of Additional District Medical Health Officer
- LEPRA
Project summary
Foot ulcers prevent people from walking and carrying out their daily duties, which impacts their income and well-being. If left untreated they can lead to permanent disability. Foot ulcers/wounds are common complications of leprosy. Their occurrence must be prevented to reduce the burden of disabilities among these individuals. Ulcers develop at points of high repetitive pressure on people’s feet, for example when walking. This is especially problematic for people affected by leprosy who have lost sensation in their feet.
A simple method of measuring foot pressure points involves the patient walking over a piece of paper after applying ink to their feet. This is known as using a Harris mat and is suitable for use in low-resource community settings. Footprints that are recorded using a Harris mat can then be visually enhanced on a computer using the software. The research group proposes to trial the use of these visualisations to produce special footwear for people affected by leprosy that will be tailor-made to reduce their pressure points and prevent ulcers.
People affected by leprosy will be involved in recording their footprints using Harris mats in their communities. Their footprints will then be sent to their local clinic, where customised footwear will be developed for each individual, in accordance with the specific measurements and pressure points of their feet.
The project aims to assess the benefits of this approach by recording the number and duration of ulcers that people affected by leprosy experience. The experiences of two groups of affected people will be compared over a 12-month period – one group will receive shoes that have been custom-made using the enhanced Harris mat visualisations of their footprints and pressure points; the second group will receive shoes that have been custom-made according to standard measuring procedures.
- Grant: LRI Regular Grant
- Research priorities: Diagnostic tests
- Country: Colombia
- Budget: €309,630 | Project number: FP23.17
- Duration: February 2023 - January 2027
- Status: Ongoing
This study aims to determine, in Colombian population, whether differential transcriptomic expression of Hes-1 gene (skin) and RISK4LEP gene signature (blood) areas present in newly diagnosed leprosy patients (mainly PB) as compared to healthy controls without known contact with leprosy patients.
Evaluation of five transcriptomic biomarkers for leprosy in a Colombian population.
Project coordination
Partners
Project summary
Leprosy is an ancient infectious disease caused by Mycobacterium leprae and Mycobacterium lepromatosis. Furthermore, these mycobacteria are responsible for 250.000 new cases of this disease worldwide, and in countries such as Colombia are reported around 400 cases each year. However, leprosy continues being endemic in more than 89 municipalities of this country; the research group considers that the detection of leprosy cases in Colombia could be the tip of the iceberg of the possible cases of leprosy. Given that, more than 70% of leprosy diagnoses are multibacillary with some degree of disability. These findings show the failures of the leprosy control programs to be early detection of this disease. In addition, the research group's previous studies have shown that a group of genes such as RISK4LEP and Hes-1 could be useful to promote the detection of this disease mainly in household contacts of leprosy patients and in skin symptomatic patients. Early detection of leprosy is key to reducing the disability, improving the quality of life of leprosy patients, and cutting the transmission chain of these mycobacteria. For this reason, the objective of this research is to determinate if there are changes of Hes-1 and RISK4LEP in leprosy patients and their household contacts in Colombian population.
In this study, skin scrapping and blood samples will be collected from 120 leprosy patients newly diagnosed or under treatment. Besides, in 1000 household contacts. Furthermore, in cases of skin lesions in household contacts, scrapping of skin for Hes-1 will be taken. Finally, the expected outcome for this study is to evaluate the expression of these group of genes that in a medium-term could be used to the leprosy detection.
- Research priorities: Diagnostic tests
- Country: Bangladesh
- Budget: €60,000 | Project number: FP23.16
- Duration: April 2023 - September 2024
- Status: Ongoing
This study will address the following question: What are the diagnostic/clinical sensitivity and specificity of ML-RPA assay toward detection of leprosy using a mobile suitcase laboratory platform?
Evaluation of Mycobacterium leprae specific RPA assay incorporated in mobile suitcase lab for rapid diagnosis of clinical and sub-clinical leprosy in Bangladesh
Project coordination
Partners
- Damien Foundation, Bangladesh
- University of Leipzig
- Kumasi centre for Collaborative Research in Tropical Medicine
- Dept. of Pharmacology, Institute of Post Graduate Medical Education and Research, India
- Bankura Sammilani Medical College And Hospital
Project summary
Leprosy is a debilitating and contagious disease, caused by an obligate intracellular bacterium Mycobacterium leprae (M. leprae) and is the leading cause of disabilities and deformities among all the communicable diseases. The global leprosy elimination target has been achieved in 2000, however, the transmission of this primeval disease still continues and annually 220,000-250,000 cases are detected in 127 affected countries. Deformities, along with low literacy level of the leprosy afflicted population also give rises to the perpetual social stigma toward the affected persons in the community. Therefore, leprosy remains a major incapacitating disease contributing to significant disability-adjusted life years and social stigma resulting in adverse psycho-social apprehension, even in this modern era.
Early diagnosis is crucial for effective treatment of leprosy cases and to protect the family members/ household contacts of the leprosy patients, who are most susceptible to getting the infection. Therefore, a rapid and confirmatory diagnostic method is crucial for accurate diagnosis of M.Leprae for early management of the patients and limiting the spread of the disease in the community. To address this problem, the research team intends to introduce an isothermal amplification assay- the “Recombinant polymerase amplification assay” in a suitcase lab that is simple, easy to perform, field-friendly, and a cost-effective molecular diagnostic system. The aims of the study are as follows :
1. Develop a test that can accurately detect leprosy patients.
2. Evaluate the test to correctly identify M.Leprae infected patients with visible signs and symptoms.
3. Evaluate the test in the household contacts of leprosy patients who are infected but have not developed the signs and symptoms yet, who are most at risk of developing the disease.
The research group has already developed the ML-RPA test which has shown to be highly accurate with cultured DNA from M.leprae in the laboratory. However, its efficacy to diagnose actual leprosy cases and their contacts remains unknown. Therefore, in this study, it is planned to investigate the diagnostic efficacy of the test in Bangladesh with actual leprosy cases and their household contacts. Samples from leprosy-affected individuals and their household contacts will be taken and tested with ML-RPA assay as well as real-time PCR (another molecular test with high accuracy in detecting leprosy). Results between tests will be compared to decide if the developed ML-RPA assay retains similar efficacy as the real-time PCR. If it proves to be similar to or even better than the real-time PCR, it will be recommended to apply the assay for diagnosis of the leprosy patients in the field, where the patients require the service most.
Co-financer: Turing Foundation