Preventive interventions, such as chemo- or immunoprophylaxis have proven to be effective means of interruption of transmission for other diseases. Post-exposure chemoprophylaxis for contacts of leprosy patients in programmes that can adequately identify and manage these contacts, was included in the 2018 WHO Guidelines on Treatment and Prevention of Leprosy. Immunoprophylaxis has only recently reached the phase of human trials. Priority areas for further research on chemo- and immunoprophylaxis are as follows:
a. Post-exposure prophylaxis (PEP)
LRI will support implementation research of PEP aimed at:
- introducing or scaling up effective contact management and chemoprophylaxis interventions especially among high-risk contacts (e.g. household members);
- reducing or removing barriers to the effective use of contact-based interventions;
- testing of additional contact examination interventions, chemoprophylaxis regimen or other prophylaxis approaches, such as immune-prophylaxis, or combined approaches;
- assessing the distribution of leprosy cases (clustering) and how to optimise PEP protocols for different populations at risk.
The primary interest in vaccines is as (pre- or post-exposure) immuno-prophylaxis providing long-lasting protection against infection and/or disease. Secondary interest involves the role of vaccines for treatment purposes. The LRI therefore supports studies which test leprosy vaccines (prophylactic or therapeutic) – which have reached the stage of human trials. In general, the LRI will only be able to provide partial funding for such trials.
While LRI focuses its funding on research projects that are directly applicable to leprosy services or to the wellbeing of persons affected, the following basic research topics are also eligible for funding:
- study the role of host genetic risk factors in susceptibility and resistance to M. leprae infection, clinical progression of leprosy;
- non-human reservoirs of viable M. leprae and the associated transmission potential to humans.
- study genetic epidemiology of M. leprae.