Stigmatisation is a major issue faced by those affected by leprosy globally. Reducing stigmatisation encourages care seeking behaviour to occur earlier and can help reduce harm and spread of leprosy. This systematic literature review aimed to summarise what effective stigma reducing interventions exist for leprosy, and as a secondary question explore what evidence exists regarding their cost. A systematic literature review was conducted. Three databases–PubMed, Embase and Web of science–were searched using the search terms “leprosy”, “interven*”, “reduc*”, and “stigma*”.Seventeen publications were eligible for inclusion in the review. The current manuscript identified interventions under 6 main categories (i) Information, education, and communication (IEC) (ii) community led projects, (iii) Socioeconomic rehabilitation, (iv) mixed interventions, (v) integration of leprosy within the health system and (vi) Cosmetic or surgical care. Specific evidence regarding cost was only provided by one out of the seventeen papers. Multiple interventions were shown to successfully reduce leprosy related stigma, however, information on their cost is not readily available. The evidence uncovered by this review is restricted to three Asian countries; Nepal, India and Indonesia. To ensure the success of stigma reduction in leprosy interventions worldwide these interventions need to be tried in other leprosy endemic areas to test their effectiveness across contextual and cultural scenarios.

(1) Background: The global burden of leprosy is not shared equally; with the majority of cases being diagnosed in Brazil, India, and Indonesia. Understanding the methods of active case detection (ACD) used in high and low endemic regions is vital for the development of future screening programs. (2) Methods: A systematic search of three databases, PubMed, Embase and Web of Science, was conducted for English language papers, published since the year 2000, which discussed the use of active case detection methods for leprosy screening. The paper utilised the Integrated Screening Action Model (I-SAM) as a tool for the analysis of these methods. (3) Results: 23 papers were identified from 11 different countries. The papers identified 6 different methods of active case detection: Household contact/social contact identification; door-to-door case detection; screening questionnaire distribution; rapid village surveys; school-based screening; and prison-based screening. 15 were located in high endemic regions and 8 of these were located in low endemic regions. (4) Conclusions: For selecting the appropriate methods of active case finding, the leprosy endemicity must be taken into consideration. The findings contribute to policy decision making allowing for more successful future leprosy case detection programs to be designed, ultimately reducing the global burden of the disease, and achieving the WHO’s aim of zero leprosy.

Delays in diagnosis and detection of skin neglected tropical diseases (NTDs) pose obstacles to prompt treatment, which is crucial in preventing disability. Recent developments in digital health have given rise to approaches that could increase access to diagnosis in resource-poor areas affected by skin NTDs. This scoping review provides an overview of current digital health approaches that aim to aid in the diagnosis of skin NTDs and provides an insight into the diverse functionalities of current digital health tools, their feasibility, usability, and the current gaps in research around these digital health approaches. This scoping review included a comprehensive literature search on PubMed, EMBASE and SCOPUS, following the PRISMA guidelines. Eleven studies were included in the review and were analysed using a descriptive thematic approach. Most digital tools were found to be mobile-phone based, such as mobile Health (mHealth) apps, store-and-forward tele-dermatology, and Short Messaging Service (SMS) text-messaging. Other digital approaches were based on computer software, such as tele-dermatopathology, computer-based telemedicine, and real-time tele-dermatology. Digital health tools commonly facilitated provider-provider interactions, which helped support diagnoses of skin NTDs at the community level. Articles which focused on end-user user experience reported that users appreciated the usefulness and convenience of these digital tools. However, the results emphasized the existing lack of data regarding the diagnostic precision of these tools, and highlighted various hurdles to their effective implementation, including insufficient infrastructure, data security issues and low adherence to the routine use of digital health tools. Digital health tools can help ascertain diagnosis of skin NTDs through remote review or consultations with patients, and support health providers in the diagnostic process. However, further research is required to address the data security issues associated with digital health tools. Developers should consider adapting digital health tools to diverse socio-cultural and technical environments, where skin NTDs are endemic. Researchers are encouraged to assess the diagnostic accuracy of digital health tools and conduct further qualitative studies to inform end-user experience. Overall, future studies should consider expanding the geographical and disease scope of research on digital health tools which aid the diagnosis of skin NTDs.

While multi-drug therapy revolutionised the treatment of physical symptoms for leprosy, a lack of psychosocial interventions, to combat the psychological burden of the disease, is noticeable. This is especially the case in a lower-middle-income country like India, where leprosy prevalence is highest, yet, it has one of the lowest rates of mental health services in place. This paper (i) conducts a systematic review to gather academic evidence on best practices of psychosocial care interventions of to leprosy patients from across the globe, and (ii) compiles good practices of mental wellbeing and quality of life to propose plausible actions for leprosy patients in India. Following the PRISMA protocol, keywords were searched in four databases, namely PubMed, PsycInfo, Web of Science and Infolep. After examining all 145 search results through inclusion and exclusion criteria, 17 peer reviewed research articles could qualify for final review exercise, whereby the data was systematically appraised. The systematic review reveals several successful psychosocial interventions implemented worldwide. These interventions were categorised into four sub-groups: educational, counselling, cognitive behavioural therapy, and technology-supported interventions. All the studies included in the analysis showcased effective psychosocial interventions that enhanced the quality of life and reduced depression, anxiety, and stress levels in individuals affected by leprosy. These findings highlighted several promising strategies that could be integrated into India’s mental healthcare system. The studies underscored the significance of involving healthcare professionals, and adopting innovative approaches. Consequently, this research proposes a comprehensive blend of diverse psychosocial interventions to alleviate the burden faced by leprosy-affected individuals in India. It is crucial to take into account various confounding factors and local contexts to tailor these interventions to the specific population group. Additionally, enhancing awareness and updating policies related to leprosy care are essential steps in reducing stigmatization against individuals with leprosy in India and other endemic regions.

Community engagement has emerged as a critical component in the effective control and elimination of neglected tropical diseases (NTDs), particularly in regions with persistent stigma and limited healthcare access. Drawing on case studies from Brazil, India, and Nigeria, this opinion piece explores how community-driven initiatives have successfully improved leprosy awareness, reduced stigma, and fostered early case detection and treatment adherence. The importance of culturally sensitive, inclusive approaches in health education and stigma reduction campaigns is highlighted, emphasizing the potential for community engagement to enhance national leprosy programs and contribute to the World Health Organization’s Zero Leprosy Strategy. By examining these examples, this article illustrates how integrating community participation into leprosy control and elimination programs can drive sustainable outcomes for achieving Zero Leprosy, even in resource-limited settings.

Although leprosy was widespread in Europe in the Middle Ages, the whole continent is now on the brink of declaring an end to local transmission of the disease. With the high level of international travel, leprosy is still diagnosed in many European countries, but rarely in people who have never traveled to or lived in a more endemic area of the world. The occurrence of leprosy in local children is an indication of recent transmission and this seems to have stopped throughout Europe, although confirming this with reliable data is a major challenge. Sporadic cases (occasional new cases occurring in a given area that are unrelated to other known cases) and autochthonous (locally acquired) cases in older adults point to some transmission in previous decades. In countries where local transmission has stopped, there is no evidence of any spread of leprosy from international travelers or migrants to the local population. Verification by WHO of the end of transmission of leprosy is beginning to occur in some countries, but crucially depends on good data concerning new cases diagnosed over previous years. Policies for the future should include: (a) sustainable provision within national health services for the diagnosis and treatment of leprosy in the few cases that do occur, usually in the migrant population, with meticulous recording and reporting of case data; (b) sustainable services for the care of people with leprosy-related disability, and the continued fight against stigma and discrimination towards those affected.