BCG vaccine is the most effective prophylactic intervention of leprosy among contacts

Objectives:
Vaccination and single-dose rifampin are the main proven effective intervention types for preventing leprosy among contacts of Mycobacterium leprae endemic areas. Currently, no high-quality evidence is available regarding the best prophylactic (preventing or contributing to the prevention of disease) intervention. Therefore, this review article has been conducted.

What is the most effective prophylactic intervention of leprosy among contacts?

Study design:
This review article included 11 RCTs with 326,264 patients; 8 were eligible for NMA while 4 were eligible for MA.

Results and conclusions:
The investigators found that BCG vaccination was the most effective intervention compared to placebo [risk ratio = 0.49, 95% CI = 0.30 to 0.80], followed by combined BCG vaccination and single-dose rifampicin (SDR) with similarly low values [risk ratio = 48%].

The investigators found BCG revaccination was the least effective intervention compared to placebo [RR = 1.08, 95% CI = 0.36 to 3.22].

The investigators concluded that the BCG vaccine is the most effective prophylactic intervention of leprosy among contacts. The combination of BCG vaccination + single-dose rifampicin (SDR) has nearly the same efficacy as BCG vaccination alone, while BCG revaccination is the least effective. Thus, vaccination is proven to be a more effective treatment than SDR alone. A well-designed multicenter RCT is warranted to evaluate the safety of these vaccines.

Original title:
Efficacy of chemoprophylaxis and immunoprophylaxis in leprosy prevention: a systematic review and network meta-analysis of randomized controlled trials by Tawfik GM, Biala M, […], Nguyen TH.

Link:
https://pubmed.ncbi.nlm.nih.gov/34332107/

Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, vaccination and food fortification/malnutrition right here.

Leprosy is a chronic infectious disease, caused by Mycobacterium leprae, that can lead to severe life-long disabilities.

The BCG (Bacillus Calmette-Guérin) vaccination is used against tuberculosis.