Primary prevention
Protection against leprosy by BCG vaccination was demonstrated in 5 large field trials conducted in India, Malawi, Myanmar, Papua New Guinea, and Uganda, although the protective effect varied from 20% to 30% in Myanmar and India to 80% in Uganda. In some studies the observed protective effect of BCG was significantly greater among individuals vaccinated at <15 years of age. The results of vaccine trials conducted in India, Malawi, and Venezuela demonstrated a protective effect against leprosy by BCG of around 50%, and second or repeated doses of BCG offered additional protection. However, the addition of killed Mycobacterium leprae did not improve the protection afforded by BCG vaccination.[24][25][26][27]
Single-dose rifampicin has been shown to be effective in reducing the incidence of leprosy in contacts. However, chemoprophylaxis is not recommended outside endemic countries.[28] All contacts should be screened every year for a period of 5 years.[29]
After diagnosis, isolation is not required. The most important measure is treatment, as infectiousness becomes negligible after starting therapy containing rifampicin.[30]
Secondary prevention
If disabilities exist, patients should be advised on how to protect themselves from injuries.
Part of the WHO global strategy is to reduce new cases with visible deformity and disability; also key is the reduction of discrimination and stigma.[1]
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