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MaPs partners at Kathmandu, Nepal in 2018.

Methotrexate and Prednisolone study in Erythema Nodosum Leprosum – MaPs in ENL

Methotrexate and Prednisolone study in Erythema Nodosum Leprosum (MaPs in ENL) is an international multicentre randomised clinical trial funded by Leprosy Research Initiative, Turing Foundation and The Hospital & Homes of St. Giles charity.

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About

MaPs is the largest clinical trial on ENL treatment ever to be conducted in six leprosy referral centres in five countries – Bangladesh, Ethiopia, India, Indonesia, and Nepal. We aim to recruit 414 participants across the six centres.

MaPs is a study conceived, developed, and implemented by the ENLIST group. Our dedicated ENLIST team is composed by experienced clinicians, laboratory scientists and health researchers from around the world.

Other activities will run alongside the trial, including clinical trial training evaluation, economic assessment, and quality of life assessments. We want to establish a solid framework to facilitate future clinical trials clinical trials in leprosy and leprosy reactions.

MaPs is sponsored by the London School of Hygiene & Tropical Medicine, UK.

Locations

MaPs will take place in 6 different centres around the world.

Map showing MaPs collaborators in UK, Nepal, Bangladesh, Ethiopia, Mumbai, India, Indonesia
Recruitment update

Recruitment start date: 17th January 2023

Participants screened: 184

Participants recruited: 101

Last update: 16th February 2024

Weekly updates every Friday

Donations
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Partners
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AHRI/ALERT Hospital

Dr. Saba Lambert: Registered doctor with a licence to practice in Ethiopia. She has have worked in Ethiopia for 8 years, 6 of which were based at ALERT Hospital under a research project sponsored by the London School of Hygiene and Tropical Medicine, for which she obtained her PhD in 2015. During her time at ALERT, she worked with AHRI on various projects, was involved in teaching in the ALERT training centre on leprosy courses, was a founding member of the LEAG (Leprosy Expert Advisory Group) and was involved in many leprosy projects with the Ministry of Health (Leprosy Mapping and Leprosy Referral Centres Assessment and Strengthening). She has presented the ALERT work at many international conferences. She has a passion for her work in Leprosy and especially for ALERT.

Dr. Shimelis Doni: Currently I am working as a clinician and head of Dermatology Department at ALERT Hospital.

Primary Affiliation: All African Leprosy and Dermatology Education and Training Center - Addis Ababa, Ethiopia

Specialties: Dermatovenereology

Research Interests: Leprosy, dermatology and seal transmitted infection

DBLM Hospital Program, The Leprosy Mission International – Bangladesh

Dr. Benjamin Jewel Rozario: Residential Medical Officer, DBLM Hospital Program, The Leprosy Mission International -Bangladesh.

Responsible for medical care and medical services of DBLM Hospital including surgery, and with the team of staff work towards holistic care of people affected by leprosy or other disabilities. Responsible for supervising all medical, surgical and disability services, providing necessary supervision for physiotherapy technicians and assistive device section, laboratory and nursing department and responsible for usage of budget. Also responsible for facilitating good understanding and smooth cooperation between all different persons involved in the project and other relevant stakeholders, including local officials in health and civil administration, and other NGOs who refer patients to DBLM Hospital.

The Leprosy Mission Trust India

Dr. Joydeepa Darlong: Experienced leprologist with a demonstrated history of working in the non-profit organization management industry. Skilled in Non-profit Organizations, Epidemiology, Research, Fundraising, Monitoring evaluation, quality assurance and infectious diseases and International Health.

The Leprosy Mission Trust India

The Leprosy Mission Nepal – Anandaban Hospital, Nepal

Dr. Deanna Hagge, PhD: Research Scientist, Nepal. She is the Research Director of the Mycobacterial Research Laboratories (MRL) at Anandaban, a tertiary leprosy referral hospital in Kathmandu, Nepal where she has worked since 2007. Previously, she spent a decade in leprosy laboratory research with the Molecular Biology and Immunology Departments of the U.S. Department of Health and Human Services National Hansen’s Disease Programs. She acts as the onsite coordinator for several international collaborative research projects as well as primary clinical and laboratory studies. Leprosy research areas include: clinical trials, immunological complications, drug resistance, medical chart reviews, patient surveys, diagnostics, neuropathy, genetic susceptibility, transmission and helminth co-infections.

http://www.tlmnepal.org/

Dr. Soetomo General Hospital – Surabaya, Indonesia

Dr. Medhi Denisa Alinda: Dermatologist from Surabaya, Indonesia, who works in the Leprosy Division. She graduated from the Universitas Airlangga Medical Faculty in 2014, she was the youngest graduate. Dr. Medhi has been practising in the Department of Venereology Dr. Soetomo Hospital, one of the referral hospital in East Java. Her practice focuses on Leprosy at the Dr. Soetomo Hospital and the Tropical Disease Centre. She also often fills a charity event for leprosy patients and for general practitioners. Currently she has already been part in many research projects about leprosy.

Bombay Leprosy Project – Mumbai, India

Dr. Vivek V. Pai: Director - Bombay Leprosy Project

  1. Medical Officer in Bombay Leprosy Project for 1987 to 1993.
  2. Assistant Director in Bombay Leprosy Project since 1993 to March 1996.
  3. Dy Director in Bombay Leprosy Project April 1996 to 2004.
  4. Addl. Director in Bombay Leprosy Project since January 2004 and currently Director since February 2007 till date.

http://www.bombayleprosy.org/

 

Site visits

 A number of visits are scheduled during the study. Each centre will be visited twice a year at least. These visits will be an excellent opportunity for the study team to address any clinical and administrative issues that might happen and to update documents and procedures if necessary.

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Visit to TLM Nepal - Anandaban Hospital, Nepal

The first study site visit happened in the preparation phase.

MAPs team outside Anandaban Hospital November
Nepal – Anandaban Hospital November 2018

Anandaban Hospital is a special place, specialised in tertiary leprosy care. We are looking forward to our next visit.

Anandaban Hospital garden
Anandaban hospital beautiful garden

Photo below is the entrance of Anandaban hospital administrative area, in the top photo at the left is Princess Diana in 1993 visiting the hospital, talking to patients. Years later, her son, Prince Harry, also visited Nepal and received a copy of his mother’s photo.

Anandaban Hospital entrance

 

Visit to Bombay Leprosy Project - Mumbai, India 

And we kick off our project in November 2022!

Dr. Barbara de Barros travelled to India on the 31st October for 6 weeks to expedite the start training and recruitment.

Bombay Leprosy Project (BLP) is an NGO founded by Dr R Ganapati, an eminent Leprologist, who has transformed leprosy work from a closed institutionalised endeavour to a widespread community based work. Based in the city of Bombay (Mumbai) since 1976, BLP is managed by a team of dedicated staff leaded by Dr. Vivek Pai and is recognised as an outstanding scientific organisation by the Government of India, local state government and international scientific bodies like WHO.

It is a pleasure to work with such a enthusiastic team!

Bellow is the BLP team.

Bombay Leprosy Project team and Dr. Barbara de Barros

Dr. Bhagyashree enrolling first participant on our study MaPs!

Dr. Bhagyagyashree filling up the paper work for MaPs first participant.
Visit to TLM Barabanki hospital - Barabanki, India

TLM Barabanki Hospital was established in the year 1961.The Mission to Lepers (now, The Leprosy Mission Trust India) started work amongst people affected by leprosy in Barabanki, in 1958, as a weekly roadside clinic run by its Faizabad hospital. Dr Frances Bramwell, Dr Chandy and Dr G.S. Partick, working in TLM Faizabad Hospital pioneered these clinics. In 1961, it became a full-fledged hospital, and in 1978, it became a separate, independent hospital.

The Leprosy Mission Barabanki team in front of the hospital
Visit to TLM Nepal - Anandaban Hospital, Nepal 

On my second visit to Anandaban Hospital, I was welcomed by the hospital amazing team. The gardens are still beautiful and we had curious little neighbours  in t he lab. I found a few differences from the last time. A new hospital wing is now ready to start receiving patients. The laboratory building had to adapt to COVID-19 rules and it got a new outside staircase. 

New building in Anandaban Hospital constructed since 2018.
New building constructed since 2018 at Anandaban Hospital.
Mycobacterial Research Laboratory with new staircase
Mycobacterial Research Laboratories with new staircase outside the main entrance.

We started with the right foot, with Dr. Bishwanath Acharya, clinical researcher, we set up MaPs, training the team and screened participants. 

MaPs research team at Mycobacterial Research Laboratories at Anandaban Hospital.
MaPs research team at Anandaban Hospital.

Despite raining season, the weather in Anandaban Hospital was very pleasant. And as always walking around the hospital garden is a pleasure. But not in the evening, tiggers are around, unlike our friends the monkeys, we need to stay away from them.  

Gardens at Anandaban guesthouse with view to the valley.
Gardens at the Anandaban guesthouse with views to the valley.

 

 

Training materials
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Publications
Publications
Publications List
Methotrexate and prednisolone study in erythema nodosum leprosum (MaPs in ENL) protocol: a double-blind randomised clinical trial
de Barros B, Lambert SM, Shah M, et al
2020
BMJ Open 2020;10:e037700. doi: 10.1136/bmjopen-2020-037700
A day in the life of a Researcher
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Barbara de Barros
Dr. Barbara de Barros first day at LSHTM in 2016

I am an infectious disease doctor from Brazil. I moved to London to do a MSc in Control of Infectious. Following my degree, I applied for a position at LSHTM as a clinical research fellow with the Leprosy team. In 2018 I started working on MaPs. It was and still is an exciting experience. MaPs is my PhD project too.

During the covid-19 pandemic, when the study was on hold, I worked intensely to keep the trial on track. At that time, I worked from home.

We are about to start recruiting so I need to have everything in order. My typical day starts answering e-emails from partners and collaborators. Normally I have a zoom meeting with one of our partners or our project manager Luciana Alves, also a Brazilian. She has been a key colleague liaising with partners and other administrative officers at LSHTM.

My home office is not that bad when the weather in London is sunny.

Barbara de Barros' home office

But I miss the office. We have a nice building in central London, just around the corner of the British Museum, where sometimes I like to take a lunch break.

Entrance of LSHTM Keppel Street with LGBTQ+ flag above entrance

Sometimes, as part of the job, I teach the MSc students. My favourite class to teach is the leprosy practical lessons, where I demonstrate how to examine to do skin biopsies and skin slit smears.

Lecture room with books

Part of the job is to review articles and be up to date with leprosy research. Normally I like to have a quiet reading time in the library.

Library with bookshelves and desks

One day a week I attend the leprosy clinic at the Hospital for Tropical Diseases with Dr. Steve Walker, MaPs principal investigator.

Soon I will start to travel to the study sites.

Next time you will follow me to our first travel! 


 

 

News and events
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The 20th International Leprosy Congress - Manila, The Philippines

MaPs protocol was presented at the ILC in 2019.

More than 1,000 delegates from 55 countries met in Manila to share research and experience on all facets of leprosy.

Our group and our partners presented in several sessions.

The International Leprosy Congress is a once-in-three-years ‘snapshot’ of the leprosy world.

ENLIST meeting - 8 November 2022, Hyderabad, India

21st International Leprosy Congress - 9-11 November 2022, Hyderabad, India

LRI Spring Meeting - 20th and 21st April 2023

Dr. Steve Walker, Dr. Barbara de Barros, Dr. Vivek Pai, Dr. Deanna Hagge and Dr. Diana Lockwood at the LRI spring meeting, Breukelen, Netherlands.

Coming Events

LRI Spring Meeting 2024

International Leprosy Congress - 2025 to be confirmed.