Using novel molecular approaches to understand the transmission dynamics of Mycobacterium leprae in the Comoros.

Leprosy is a serious mutilating disease and although Mycobacterium leprae was the first human pathogen discovered, the precise way of spreading between humans remains a mystery. This is part of the reason why leprosy control fails despite the availability of effective treatments. Over 200,000 new leprosy patients are diagnosed worldwide each year, and the high proportion in children indicates its ongoing spread. To stop transmission chains once and for all, new approaches to leprosy control are needed. Therefore, this study will revisit fundamental questions regarding transmission in an innovative way. Firstly, we will evaluate minimally invasive, field-friendly tests to quantify the bacillary load in each patient and correlate with the effectiveness of treatment and the identification of the most infectious patients. In this study, we will be the first to apply targeted Next Generation Sequencing of M. leprae. Within the ongoing "ComLep" study in the Comoros, we will classify the bacteria in M. leprae subtypes and associate them with the GPS data of each patient's house, to identify transmission links. Once these transmission chains have been established, we can determine define where transmission occurs and if a reservoir of asymptomatic people is sustaining transmission of the disease. This in turn will inform which contacts should receive leprosy preventive therapy. These findings will inform optimal control strategies to eliminate leprosy in the Comoros and elsewhere.

Keywords:MOLECULAR DYNAMICS, INNOVATIONS, INFECTIONS

Disciplines:Public health care, Public health sciences, Public health services

Project type:Collaboration project