Authors' objectives: To assess the effectiveness, safety, cost effectiveness and social impact of SDR as post-exposure prophylaxis for leprosy contacts.

Authors' results and conclusions: The evidence suggested that administration of SDR-PEP to leprosy contacts was effective in reducing the clinical development of the disease. The SDR-PEP gave a protection effect of 56.5% in leprosy contacts after two years, 34.9% after four years, and no additional effect after six years. Combination of SDR-PEP with childhood BCG vaccine showed a protection effect of 80% against leprosy after two years. Modeling studies on long-term effectiveness suggested that combinations of SDR-LPEP with systematic contact tracing or blanket approach were effective strategies in reducing the risk of developing leprosy. There were no serious adverse events and safety issues reported in the included studies. The SDR-PEP was shown to be cost-effective in India and Bangladesh, with benefit depending on the extent which disability can be prevented and different contact’s level. Integration of SDR-PEP and systematic contact tracing into leprosy control programme could potentially accelerate the interruption of leprosy transmission. The implementations of both interventions are feasible, generally safe, and well accepted by leprosy patients, their closed contacts and healthcare workers.

Authors' recommendations: Based on this review, SDR in combination with systematic contact tracing are recommended as a post-exposure prophylaxis for leprosy contacts.

Authors' methods: Electronic databases were searched through the Ovid interface: Ovid MEDLINE® In-process and other Non-indexed citations and Ovid MEDLINE® 1946 to present, EBM Reviews - Cochrane Central Register of Controlled Trials – September 2021, EBM Reviews - Cochrane Database of Systematic Reviews - 2005 to September 2021, EBM Reviews - Health Technology Assessment – 4th Quarter 2016, EBM Reviews – NHS Economic Evaluation Database 1st Quarter 2016. Google was used to search for additional web-based materials and information. Additional articles were identified from reviewing the references of retrieved articles. Last search was conducted on September 2021.

Authors' identified further research: None

Project Status: Completed

Year Published: 2021

URL for published report: https://www.moh.gov.my/index.php/database_stores/store_view_page/30/391

Requestor: Ministry of Health, decision-making committee

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment

Contact Address: Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229

Contact Name: htamalaysia@moh.gov.my

Contact Email: htamalaysia@moh.gov.my

Copyright: Malaysian Health Technology Assessment Section (MaHTAS)