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An intervention study was implemented on five Indonesian islands highly endemic for leprosy to determine whether rifampicin can be used as chemoprophylaxis to prevent leprosy. The population was actively screened before the intervention and subsequently once a year for three years. In the control group, no chemoprophylaxis was given. In the contact group, chemoprophylaxis was only given to contacts of leprosy patients and in the blanket group to all eligible persons. The cohort consisted of 3,965 persons. The yearly incidence rate in the control group was 39/10,000; the cumulative incidence after three years was significantly lower in the blanket group (P = 0.031). No difference was found between the contact and the control groups (P = 0.93). Whether this apparent reduced leprosy incidence in the first three years in the blanket group is due to a delayed development of leprosy or a complete clearance of infection needs to be determined.
Received October 8, 2004. Accepted for publication November 16, 2004.
Acknowledgments: We appreciate the permission and active support given by the manager and personnel of Health District Pangkep. We thank all people who were part of the research team: H. Hasan Basri, H. Baso Datu, H. Azis Nur, I. Nengah Sudja, Hj. Asriah, Mr. Saeni, Hj. Rabiah, Amril, Arief, Sufrianti, Syahuni, Romi Usman, Marwani, Syafri, and Mus Jebaru. We are grateful to all the inhabitants of the five islands (Sapuka Besar, Sailus Besar, Kembanglemari, Pelokang, and Tampaang) for their cooperation. We also thank Wim van Brakel, Pieter Feenstra, Jan Hendrik Richardus, and William Faber for critically reading the manuscript and giving their comments.
Financial support: This work was supported by the Netherlands Leprosy Relief.
Authors’ addresses: Mirjam I. Bakker, Birgit H. B. van Benthem, Stella M. van Beers, Paul R. Klatser, and Linda Oskam, KIT Biomedical Research, Koninklijk Instituut voor de Tropen/Royal Tropical Institute, Meibergdreef 39, 1105 AZ Amsterdam, The Netherlands, Telephone: 31-20-566-5450, Fax: 31-20-697-1841, E-mail: m.bakker{at}kit.nl. Mochammad Hatta and Agnes Kwenang, Department of Microbiology, Faculty of Medicine, Hasanuddin University, Kampus Tamalanrea KM 10, Jln. Perintis Kemerdekaan, Makassar, Indonesia.
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