In the light of detection of new cases of leprosy in different parts of the country, the Indian Council for Medical Research (ICMR) has decided to begin research in several priority areas of leprosy. The priority areas of research include studies related to National Leprosy Eradication Programme (NLEP), clinical research, operational research, basic research, drug resistance studies and surgical aspects.
Senior officials in the ICMR said that even though India achieved leprosy elimination as a public health problem in December 2005, there are pockets of endemicity where the number of new case detection is still high and the community is at higher risk of being infected with M. leprae. So, to address these issues, the secretary, department of health research has taken steps to promote research by funding projects on the priority areas.
Scientists from various recognized research institutions, universities and medical colleges in the country are eligible to participate in the study.
On studies related to NLEP, the focus will be on Health Systems Research & Operational Research on integration issues;? Studies evaluating current IEC strategies in increasing community awareness;? Studies addressing psychosocial issues for formulation of newer approaches to reduce the stigma, for encouraging early detection and completion of MDT; Studies for encouraging early detection (through self reporting) and completion of MDT; and? Development of indicators for stigma at community level and evaluation of participation scale for wider use.
The study in this area will also focus on? Nerve Damage and Care of the Disabled at the Community level and impact of field interventions Epidemiological studies;? Estimating trends/prevalence/incidence in India with special emphasis on biological reasons and genetics;? Behavioural and social factors influencing the epidemiology of disease;? and Transmission dynamics of leprosy to identify sources/genotypes, its presence in soil and water and establish chain of transmission in endemic pockets.
Other priority areas are? study addressing issues related to changing profile of disease;? Precise epidemiological data on pooled grade-2 disabilities in rural communities;? and Leprosy in Children / dynamics of childhood leprosy.
In the clinical research area, the study will focus on Clinical - Laboratory studies on complications of leprosy and its management; Evaluating effect of newer anti-leprosy drugs/molecules;? Studies addressing leprosy relapse and reactions;? Detection of early bacteriologically positive Multibacillary Bacillary leprosy and its early management;? Use of immunomodulators in relation to leprosy and tuberculosis in children;? and use of chemoprophylaxis in household contacts.
In Operational Research area, the research will focus on the effect of inclusion of leprosy in a community based integrated rehabilitation disability care programme; Research on disability prevention and identification of predictors of early nerve damage in leprosy;? Varying distribution pattern of patients with nerve damage,acute, chronic or "silent"; and? Identification of pre-clinical disease markers like nerve conduction tests etc.
In the area of basic research, the focus will be on studies using genomics, proteomics and other approaches to understand the host-parasite interaction and pathogenesis of the disease; basic immunology; translational research including newer technology such for detection of M. leprae from environment; and? tools to identify leprosy susceptibility.
The priority area in drug resistance studies include? resistance to anti-leprosy drugs; and? studies on use of second line newer drugs for resistant and relapse cases.
In the Surgical aspects area, the study will focus on Trials on immediate post-operative active mobilization of hand following deformity correction and to investigate if the benefits of tendon transfers can be improved with early mobilization; effects of early mobilization to reduce dependence on therapist to attain a satisfactory result;? investigation of economic and social impact of this technique in varied patient groups;? trials regarding the safety of immediate active mobilization protocol (IAMP) to other tendon transfers;? assessment of economic impact of earlier return to work by RCS patients and also the cost of care;? understanding the neurobiology of tendon transfer rehabilitation; and standard of ulcer care in leprosy.