Leprosy post-exposure prophylaxis with single-dose rifampicin (LPEP): an international feasibility programme

Background Innovative approaches are required for leprosy control to reduce cases and curb transmission of Mycobacterium leprae. Early case detection, contact screening, and chemoprophylaxis are the most promising tools. We aimed to generate evidence on the feasibility of integrating contact tracing and administration of single-dose rifampicin (SDR) into routine leprosy control activities. Methods The leprosy post-exposure prophylaxis (LPEP) programme was an international, multicentre feasibility study implemented within the leprosy control programmes of Brazil, India, Indonesia, Myanmar, Nepal, Sri Lanka, and Tanzania. LPEP explored the feasibility of combining three key interventions: systematically tracing contacts of individuals newly diagnosed with leprosy; screening the traced contacts for leprosy; and administering SDR to eligible contacts. Outcomes were assessed in terms of number of contacts traced, screened, and SDR administration rates. Findings Between Jan 1, 2015, and Aug 1, 2019, LPEP enrolled 9170 index patients and listed 179 769 contacts, of whom 174782 (97·2%) were successfully traced and screened. Of those screened, 22 854 (13·1%) were excluded from SDR mainly because of health reasons and age. Among those excluded, 810 were confirmed as new patients (46 per 10 000 contacts screened). Among the eligible screened contacts, 1182 (0·7%) refused prophylactic treatment with SDR. Overall, SDR was administered to 151 928 (86·9%) screened contacts. No serious adverse events were reported. Interpretation Post-exposure prophylaxis with SDR is safe; can be integrated into different leprosy control programmes with minimal additional efforts once contact tracing has been established; and is generally well accepted by index patients, their contacts, and health-care workers. The programme has also invigorated local leprosy control through the availability of a prophylactic intervention; therefore,

Matrix intensive outpatient treatment for people with stimulant use disorders: counselor's family education.

This comprehensive kit provides substance use disorder treatment professionals with a year-long intensive outpatient treatment model. Professionals can use this model when treating clients who are dependent on stimulant drugs, such as methamphetamine and cocaine. Access family education sessions and handouts. Contents: I. Introduction to the Matrix intensive outpatient treatment for people with stimulant use disorders approach and package II. Session instructions Family education sessions overview Session 1: Triggers and cravings (PowerPoint Presentation) Session 2: Alcohol and recovery (PowerPoint Presentation) Session 3: Recovery (Panel Presentation) Session 4: Methamphetamine and cocaine (PowerPoint Presentation) Session 5: Roadmap for recovery (PowerPoint Presentation) Session 6: Coping with the possibility of a relapse (Multifamily Group Discussion) Session 7: Opioids and club drugs (PowerPoint Presentation) Session 8: Families in recovery (PowerPoint Presentation) Session 9: Rebuilding trust (Multifamily Group Discussion) Session 10: Marijuana (PowerPoint Presentation) Session 11: Living with an addiction (Multifamily Group Discussion) Session 12: Communication traps (Multifamily Group Discussion) III. Family education handouts [For related Matrix publications, see related links below