{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:08:50Z","timestamp":1767179330831,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011870","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000}}],"reference-count":66,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00c3fico e Tecnol\u00c3\u00b3gico","doi-asserted-by":"publisher","award":["403245\/2021-4"],"award-info":[{"award-number":["403245\/2021-4"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize the scientific evidence regarding the prevalence of leprosy relapse following multidrug therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A systematic review was conducted following the JBI methodology for prevalence studies and reported according to the guidelines, with the registration number CRD42020177141. The inclusion criteria were based on the mnemonics (Population, Condition, Context). Population: Individuals of any age or sex diagnosed with leprosy relapse and previously treated with paucibacillary or multibacillary multidrug therapy. Conditions: Leprosy relapse after multidrug therapy, measured as the proportion of cases. Context: Studies conducted within the healthcare service settings. The databases searched included Medline, Latin American and Caribbean Health Sciences Literature (LILACS), Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, WoS, and Caribbean Public Health Agency (CARPHA). The references were managed using Mendeley. A random-effects meta-analysis model was employed, and heterogeneity was assessed using Higgins\u2019 I\u00b2 statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 26 studies (a combined sample of 71,385 participants), 19 were included in the meta-analysis. A higher prevalence of relapse was observed in working-age males, multibacillary cases with a high bacillary load, and those with established physical disabilities. The estimated prevalence of relapse across studies ranged from 0% to 10%, with a pooled estimate of 4% in India (95% CI: 0.03\u20130.05). The overall point estimate for relapse using regular multidrug therapy was 0.04 (95% CI: 0.02\u20130.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The prevalence of relapse varied according to the geographic location and type of multidrug therapy, with substantial heterogeneity across studies. These findings suggest that factors such as individual patient characteristics, treatment adherence, and capacity for healthcare services may have influenced the outcomes observed in this review.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0011870","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T17:36:33Z","timestamp":1760376993000},"page":"e0011870","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Leprosy relapse after multidrug therapy: Systematic review and meta-analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6922-4120","authenticated-orcid":true,"given":"Fabiane Veronica","family":"da Silva","sequence":"first","affiliation":[]},{"given":"Gutembergue Santos","family":"de Sousa","sequence":"additional","affiliation":[]},{"given":"Eric Brito","family":"Ferraz","sequence":"additional","affiliation":[]},{"given":"P\u00e3mela Rodrigues De Souza","family":"Silva","sequence":"additional","affiliation":[]},{"given":"Juliana Akie","family":"Takahashi","sequence":"additional","affiliation":[]},{"given":"Omar Ariel","family":"Espinosa","sequence":"additional","affiliation":[]},{"given":"Jack Roberto Silva","family":"Fhon","sequence":"additional","affiliation":[]},{"given":"Roberta Olmo","family":"Pinheiro","sequence":"additional","affiliation":[]},{"given":"Vilanice Alves de Ara\u00fajo","family":"P\u00fcschel","sequence":"additional","affiliation":[]},{"given":"Z\u00e9lia Ferreira Ca\u00e7ador","family":"Anast\u00e1cio","sequence":"additional","affiliation":[]},{"given":"Silvana Margarida Benevides","family":"Ferreira","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"issue":"7","key":"pntd.0011870.ref001","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.3201\/eid2907.230024","article-title":"Systematic Review of Hansen Disease Attributed to Mycobacterium lepromatosis","volume":"29","author":"SM Collin","year":"2023","journal-title":"Emerg Infect Dis"},{"key":"pntd.0011870.ref002","volume-title":"Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021\u20132030","author":"World Health Organization","year":"2020"},{"key":"pntd.0011870.ref003","first-page":"365","article-title":"Global leprosy (Hansen disease) update, 2024: beyond zero cases \u2013 what elimination of leprosy really means","volume":"37","author":"WHO World Health Organization","year":"2025","journal-title":"Wkly Epidemiol Rec"},{"key":"pntd.0011870.ref004","volume-title":"Guidelines for the diagnosis, treatment and prevention of leprosy","author":"World Health Organization, Regional Office for South-East Asia","year":"2017"},{"key":"pntd.0011870.ref005","volume-title":"Technical Report Series N\u00b0 768","author":"World Health Organization (WHO)","year":"1988"},{"key":"pntd.0011870.ref006","volume-title":"Risk of relapse in patients with leprosy","author":"World Health Organization (WHO)","year":"1994"},{"issue":"7","key":"pntd.0011870.ref007","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005725","article-title":"Uniform multidrug therapy for leprosy patients in Brazil (U-MDT\/CT-BR): Results of an open label, randomized and controlled clinical trial, among multibacillary patients","volume":"11","author":"GO Penna","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"issue":"3","key":"pntd.0011870.ref008","first-page":"255","article-title":"Retreatment of leprosy relapse","volume":"80","author":"MDF Medeiros Brito","year":"2005","journal-title":"An Bras Dermatol"},{"issue":"10","key":"pntd.0011870.ref009","doi-asserted-by":"crossref","first-page":"2555","DOI":"10.11124\/JBISRIR-2016-003301","article-title":"Effectiveness of rifampicin chemoprophylaxis in preventing leprosy in patient contacts: a systematic review of quantitative and qualitative evidence","volume":"15","author":"SMB Ferreira","year":"2017","journal-title":"JBI Database System Rev Implement Rep"},{"issue":"2","key":"pntd.0011870.ref010","first-page":"238","article-title":"Risk of relapse in leprosy after fixed-duration multidrug therapy","volume":"65","author":"HY Li","year":"1997","journal-title":"Int J Lepr Other Mycobact Dis"},{"issue":"3","key":"pntd.0011870.ref011","first-page":"421","article-title":"Relapses among leprosy patients treated with multidrug therapy: experience in the leprosy control program of the All Africa Leprosy and Rehabilitation Training Center (ALERT) in Ethiopia; 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