Chemoprophylaxis of leprosy with rifampicin in contacts of multibacillary patients: study protocol for a randomized controlled trial.

Abstract

BACKGROUND:

The annual new-case detection rate for leprosy, while generally stable over the last decade, shows that transmission rates have remained stagnant despite the successful worldwide administration of multidrug therapy since the 1980s. As such, novel control strategies are urgently needed. Focusing on managing leprosy patient contacts, the most susceptible to contracting the disease, has been seen as a potential strategy in limiting the spread of leprosy as shown by a number of recent epidemiological studies. Immunoprophylaxis with Bacillus Calmette-Guérin (BCG) has been seen as an effective preventive measure due to its ability to stimulate the development of cellular immunity which is essential in controlling the disease, especially in its multibacillary (MB) forms. The association of immunoprophylaxis with chemoprophylaxis in a single dose of rifampicin has been shown to be a promising preventive strategy, although a variety of studies have found instances of early case detection just a few months after BCG vaccination.

METHODS/DESIGN:

The present study is a phase IV chemoprophylactic clinical trial consisting of administration of a single dose of rifampicin in MB leprosy patient contacts under care at the Souza Araújo Outpatient Clinic/FIOCRUZ as part of a randomized (2:1), double-blind, placebo-controlled study. It is comprised of two groups: 1) rifampicin + BCG; and 2) placebo + BCG.

DISCUSSION:

The aim is to evaluate whether the use of chemoprophylaxis with a single dose of rifampicin in MB leprosy patient contacts prior to the BCG vaccine would be able to prevent the onset of leprosy in those cases that may occur just a few months after vaccination. Contact subclinical infections (polymerase chain reaction) and the immunological parameters (anti-PGL-1, anti-LID-1, and IFN-γ) will be evaluated and the results will be compared after 12 months of follow-up.

TRIAL REGISTRATION:

The Brazilian Registry of Clinical Trials (ReBEC), RBR-69QK5P . Retrospectively registered on 1 June 2017.

• Authors: Daiane Santos Dos Santos, Nádia Cristina Duppre, Euzenir Nunes Sarno, Roberta Olmo Pinheiro, Anna Maria Sales, José Augusto Da Costa Nery, Milton Ozório Moraes, Luiz Antônio Bastos Camacho
• Journal: Trials (Trials) Vol. 19 Issue 1 Pg. 244 (Apr 23 2018) ISSN: 1745-6215 [Electronic] England
• PMID: 29685164 (Publication Type: Clinical Trial Protocol, Journal Article)

Chemical References

• BCG Vaccine
• Leprostatic Agents
• Rifampin

Topics

• Adolescent
• Adult
• Aged
• BCG Vaccine (administration & dosage, adverse effects)
• Brazil
• Child
• Child, Preschool
• Clinical Trials, Phase IV as Topic
• Contact Tracing
• Double-Blind Method
• Drug Administration Schedule
• Female
• Humans
• Infant
• Leprostatic Agents (administration & dosage, adverse effects)
• Leprosy, Multibacillary (immunology, microbiology, prevention & control, transmission)
• Male
• Middle Aged
• Randomized Controlled Trials as Topic
• Rifampin (administration & dosage, adverse effects)
• Time Factors
• Treatment Outcome
• Vaccination
• Young Adult