Leprosy Post-Exposure Prophylaxis with Single-dose Rifampicin Health economic aspects in India

Leprosy is a preventable infectious disease, but still pose a public health challenge in India. Every year, more than 100,000 new cases are detected in India which are around 60% of the global leprosy burden. Among new cases, around 3.5% new cases are detected very late after developing a severe form of disability. The objective of the thesis was to study the health economic aspects of leprosy prevention through post-exposure prophylaxis (PEP) with single-dose rifampicin (SDR). The Leprosy Post-Exposure Prophylaxis program (LPEP) was a multi-centre study, included India where single-dose rifampicin was administered to the contacts of the leprosy patients. We found that SDR is feasible to implement along with the national leprosy control programme. The unit cost of SDR delivery is not high and it is also cost-effective from short (5 years) to long-term (25 years). The cost-effectiveness of SDR is even further expected to improve in the high disability burden areas, due to increased chance of disability prevention. We recommend to scale-up SDR in India, ascertain cost-effectiveness of SDR in other endemic countries, and develop a leprosy elimination investment case.

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