Effectiveness of single dose rifampicin in preventing leprosy in close contacts of patients with newly diagnosed leprosy

Objective To determine the effectiveness of chemoprophylaxis using a single dose of rifampicin to prevent leprosy in close contacts. Design Single centre, double blind, cluster randomised, placebo controlled trial. SettingLeprosy control programme in two districts of northwest Bangladesh with a population of more than four million. Participants28 092 close contacts of 1037 patients with newly diagnosed leprosy. 21 711 contacts fulfilled the study requirements. Interventions A single dose of rifampicin or placebo given to close contacts in the second month of starting the index patient’s treatment, with follow-up for four years. Main outcome measure Development of clinical leprosy. Results 18 869 of the 21 711 contacts (86.9%) were followed-up at four years. Ninety one of 9452 contacts in the placebo group and 59 of 9417 in the rifampicin group had developed leprosy. The overall reduction in incidence of leprosy using a single dose of rifampicin in the first two years was 57% (95% confidence interval 33% to 72%). The groups did not differ between two and four years. The overall number needed to treat (NNT) to prevent a single case of leprosy among contacts was 297 (95% confidence interval 176 to 537). Differences were found between subgroups at two years, both in reduction of incidence and in NNT. ConclusionA single dose of rifampicin given to contacts of patients with newly diagnosed leprosy is effective at preventing the development of clinical leprosy at two years. The effect was maintained, but no difference was seen between the placebo and rifampicin groups beyond two years. Trial registration Current Controlled Trials ISRCTN61223447

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(Abridged) The Maunakea Spectroscopic Explorer (MSE) is an end-to-end science platform for the design, execution and scientific exploitation of spectroscopic surveys. It will unveil the composition and dynamics of the faint Universe and impact nearly every field of astrophysics across all spatial scales, from individual stars to the largest scale structures in the Universe. Major pillars in the science program for MSE include (i) the ultimate Gaia follow-up facility for understanding the chemistry and dynamics of the distant Milky Way, including the outer disk and faint stellar halo at high spectral resolution (ii) galaxy formation and evolution at cosmic noon, via the type of revolutionary surveys that have occurred in the nearby Universe, but now conducted at the peak of the star formation history of the Universe (iii) derivation of the mass of the neutrino and insights into inflationary physics through a cosmological redshift survey that probes a large volume of the Universe with a high galaxy density. MSE is positioned to become a critical hub in the emerging international network of front-line astronomical facilities, with scientific capabilities that naturally complement and extend the scientific power of Gaia, the Large Synoptic Survey Telescope, the Square Kilometer Array, Euclid, WFIRST, the 30m telescopes and many more