Participants
cough, liver or kidney disease, leprosy, allergy
LEPROSY, ALLERGY
Participants will be enrolled from 44 clusters: 34 in Anjouan and 10 in Mohéli. We will screen for leprosy including all residents and all ages, whenever leprosy is diagnosed treatment will be provided according to national guidelines. At baseline, all permanent residents aged two years or above, living within 100 m of an index case diagnosed during the period of 2018–2023, will be eligible for PEP. If this entails more than 50% of the population, the entire village population will be eligible for PEP. In arm 1 the BE-PEP regimen will be offered, except for participants not eligible because of age (below five years) and/or weight (below 20 kg) criteria. Such individuals may still receive SDR-PEP if otherwise eligible. In both arms, the exclusion criteria include cough of more than two weeks’ duration (presumptive pulmonary TB), signs of extrapulmonary TB, self-reported pregnancy or breastfeeding, antecedents of liver or kidney disease (clinically or documented by lab tests), allergy to rifampicin, and treatment with rifampicin in the last two years. For arm 1 there will be some additional criteria which include use of medications in the three weeks preceding PEP that are not included in the safe list for bedaquiline.