It is a pleasure to be publishing the 'Review of Leprosy Research Evidence and Implications forPolicy and Practice' (pp. 226 –273) in this issue of Leprosy Review. This literature review has beenconducted by members of the ILEP Technical Committee and focuses on evidence published since2002, when the last review was published. The review has been done using the principles of EvidenceBased Medicine with standardised literature searches being done to identify trials and studies andreviewers then assessing the quality of trials against the criteria developed by the Centre for EvidenceBased Medicine, Oxford, UK. The authors then synthesised the evidence into seven reviews discussingthe strength of the evidence, identifying areas where evidence can be put into practice and areas wheremore research is needed. The evidence was presented and discussed at an ILEP Technical Committeemeeting in March 2010. We are now publishing the review and anticipate that it will be a very usefulresource tool for leprosy workers including programme managers, clinicians, policy makers, researchleaders and academics. There are seven sections, concerning immuno- and chemo-prophylaxis,diagnosis, chemotherapy, treatment of reactions, prevention of disability, stigma and rehabilitation.There are markedly different levels of activity in these areas. In chemotherapy there has been almost nowork done, even though new shorter treatment courses are badly needed. The results of U-MDT studiesare awaited as is more data on the role of .uoquinolones. Similarly very little work has been done onearly diagnosis. In the field of prophylaxis evidence is accumulating that BCG vaccination helps protectpeople against developing leprosy. Several studies on chemoprophylaxis have been published and thelargest shows that a giving a single dose of rifampicin to people in a high endemic area for leprosy givessome protection over 4 years against developing paucibacillary disease. The review on reactions foundthat we still do not have good data on either the dose or duration of treatment with steroids for treatingType 1 reactions (T1R) and the high relapse rate with T1R continues to be a problem. It was also foundthat scales for measuring both T1R and Erythema Nodosum Leprosum (ENL) are need for both patientmanagement and research. There is no good quality data on the management of ENL and multi-centrestudies are need with adequate numbers of patients and using validated scales to assess patients. Studieson the optimal management of people with HIV infection and reactions are needed urgently.In prevention of disability studies on footwear, the treatment of ulcers and wound care are needed.Implementation research is needed to identify operational factors in the implementation of self-care inlow income countries. Stigma is now an active research area with many studies published, and thishighlighted the importance of including multiple perspectives such as cultural, political and religiousaspects into studies on stigma and rehabilitation. The review on rehabilitation showed how thepromotion of self-care within the Community Based Rehabilitation matrix is important. The humanrights aspect is also a vital part of rehabilitation work. The reviewers s have compiled a majorcontemporary review of the evidence in leprosy and I am confident that it will be heavily used toimplement and improve practice and also to develop research in the areas that have been identified asweak in evidence
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