Leprosy research updates: Shaping the future of global health

Leprosy, or Hansen’s disease, remains a majorly neglected tropical disease. In 2023, 1,82,815 new cases were reported globally, primarily from India, Brazil, and Indonesia. The disease, caused by Mycobacterium leprae (M. leprae) and M. lepromatosis, is known for its skin lesions but often leads to severe complications, including neural damage resulting in permanent disabilities.

Despite significant advances, leprosy’s transmission mechanisms remain unclear, with zoonotic transmission via armadillos emerging as a concern, especially in Latin America. Diagnostic challenges persist, with skin smears offering limited sensitivity, underscoring the need for advanced, point-of-care diagnostics, such as anti-PGL-I antibody tests and multiplex PCR assays. Recent advancements in PCR technology and M. leprae genotyping have enhanced the accuracy of diagnostics, aiding in the detection of the disease and understanding its transmission patterns. Additionally, new therapies, including bedaquiline, and Telacebec, show promise in treating leprosy, although management of reactions and neuritis remains a challenge.

Leprosy prevention efforts are focused on post-exposure prophylaxis (PEP) and vaccines, with the BCG vaccine showing limited efficacy in leprosy prevention. Innovative approaches, including single-dose rifapentine and bedaquiline for PEP, are being explored. Mental health support and addressing stigma through human rights-based interventions are critical for improving the quality of life for those affected.