The Turing Foundation

LEPROSY

The Turing Foundation aims at the elimination of leprosy as a disfiguring disease and supports scientific research into diagnosing and curing the desease, and preventing its spread.

Leprosy is a cruel, disfiguring disease which strikes almost exclusively the poorest of the poor (to such extent that people in richer countries are often unaware that the disease still exists). Its victims hardly ever die as a result of it, but leprosy often leads to loss of hands or feet or loss of sight. Leprosy has an incubation period of many years. A key challenge is to detect the disease in an early stage and to treat it before it infects others and before nerve damages have become irreparable.

The Turing Foundation focuses on scientific research in the area of diagnostics and treatment of leprosy.

Most recent projects:

July 2024	ENLIST Randomised controlled trials of methotrexate in Erythema Nodosum Leprosum, 2024-2025 Erythema Nodosum Leprosum (ENL) is a serious and very painful leprosy complication. It is... more	March 2024	Use of handheld ultrasound for the early detection of leprosy, India en Nepal, 2024-2025 Early detection of leprosy is important to ensure treatment starts before the disease... more
March 2024	Role of drug resistance and M. lepromatosis in African leprosy transmission, Burundi, Cameroon, D.R. Congo, Ghana, België, 2024-2027 In a number of African countries leprosy is still... more	March 2024	Holistic investigation for environmental presence of Mycobacterium leprae and its implications in leprosy transmission, India, 2024-2027 Leprosy infections are known to spread from person... more
March 2024	Immunomodulation by Mycobacterium Indicus Pranii (MIP) in MB leprosy, 2024-2026 Leprosy patients can be effectively treated with multi-drug treatment (MDT), but they are still... more	March 2024	LepVax: safety and vaccin-induced immune response, Brazil, 2024-2026 Researchers from the Infectious Disease Research Institute (IDRI), in collaboration with the America Leprosy... more
March 2024	Point-of-care tests for leprosy in South America, 2024 The Leiden University Medical Center (LUMC) team has developed a simple diagnostic test in previous studies. This... more	January 2024	Mobile suitcase lab for rapid diagnosis of clinical and sub-clinical leprosy, Bangladesh, 2024 Early diagnosis of leprosy is crucial for effective treatment of cases and preventing... more
January 2024	Evaluation of five transcriptomic biomarkers for leprosy, Colombia, 2024-2027 Approximately 400 of the leprosy cases reported each year in the world are from Colombia. In this... more	January 2024	COMBINE: Leprosy elimination by community screening & mass chemoprophylaxis, Kiribati, 2024-2026 Transmission of both leprosy and tuberculosis is through the respiratory tract and... more
January 2024	Contribution to the leprosy research department of Netherlands Leprosy Relief, 2023-2024 The Turing Foundation has been co-financing projects related to the fight against leprosy... more	April 2023	MetLep Trial: Metformin as adjunct therapy for MB leprosy, 2023-2024 Metformin is a cheap and safe medicine which has been used to treat diabetes for a long time. Research into... more
April 2023	Extra clofazimine for MB cases at high risk of ENL reactions, 2023-2027 Erythema Nodosum Leprosum (ENL) is a serious and very painful leprosy complication. The disease can be... more

Scientific Research

ENLIST Randomised controlled trials of methotrexate in Erythema Nodosum Leprosum, 2024-2025
Erythema Nodosum Leprosum (ENL) is a serious and very painful leprosy complication. It is often chronic and causes serious morbidity, not only affecting the skin but also bones, joints, eyes, nerves, testes, and kidneys. Effective treatment for ENL is available but expensive, has considerable side-effects, and is often inaccessible in many countries where leprosy is endemic. Methotrexate is cheap and has been used all over the world to treat conditions like psoriasis since the 1950s. This medicine is possibly an effective alternative to prednisolone (the most widely used corticosteroid treatment for ENL). The London School of Hygiene and Tropical Medicine will validate this by inviting patients with ENL in Bangladesh, Brazil, Ethiopia, India, Indonesia, Nepal and the Philippines to take part in a study where some patients are prescribed methotrexate, and others prednisolone.

The Turing Foundation is contributing €350,000 towards this research (€25.000 in 2024).

Randomised controlled trials of methotrexate in Erythema Nodosum Leprosum

Use of handheld ultrasound for the early detection of leprosy, India en Nepal, 2024-2025
Early detection of leprosy is important to ensure treatment starts before the disease progresses and other people are infected. Leprosy symptoms are now often diagnosed "by hand and eye" registrations. However, ultrasound scans provide a quick and more accurate results and is cheap. Nonetheless, this requires large equipment which is not available everywhere.

American Leprosy Missions investigates whether a recently developed portable ultrasound device can detect leprosy symptoms as accurately (and possibly detect changes after treatment has started).

The Turing Foundation is contributing €57,974 to this project (of which €36,699 in 2024). The Leprosy Research Initiative contributes the same amount.

Use of handheld ultrasound for the early detection of leprosy, India en Nepal

Role of drug resistance and M. lepromatosis in African leprosy transmission, Burundi, Cameroon, D.R. Congo, Ghana, België, 2024-2027
In a number of African countries leprosy is still discovered relatively late during which the disease has already advanced. In addition, there is no research conducted in Central Africa to investigate the resistance to antibiotics in standard leprosy treatments. Lastly, there are no insights into the possible presence of M. lepromatosis, a bacterium related to M. leprae that also causes leprosy.

Institute of Tropical Medicine Antwerp researches in Burundi, Cameroon, D.R. Congo and Ghana the presence, quantity and resistance of the two bacteria at infected patients. The entire genome of the bacterium is being examined, which may also enable new biomarkers to be found that could demonstrate resistance. The research provides insight into how the bacteria changes and spreads.

The Turing Foundation is contributing €160,408 to this project (of which €42,416 in 2024). The Leprosy Research Initiative contributes the same amount.

Role of drug resistance and M. lepromatosis in African leprosy transmission

Holistic investigation for environmental presence of Mycobacterium leprae and its implications in leprosy transmission, India, 2024-2027
Leprosy infections are known to spread from person to person, but leprosy bacteria have also been found in certain animals, in water, and in the soil. Till date it is not clear whether contamination can also occur via these bacteria.

LEPRA Society - Blue Peter Public Health and Research Center investigates the link between leprosy cases and their exposure to livestock, water and soil in four villages in India. If the presence of leprosy bacteria in open water, wastewater, soil and/or livestock is identified together with a link to the leprosy cases, a stronger strategy against leprosy and leprosy transmission can be developed.

The Turing Foundation is contributing €100,466 to this project (of which €35,078 in 2024). The Leprosy Research Initiative contributes the same amount.

Holistic investigation for environmental presence of Mycobacterium leprae and its implications in leprosy transmission

Immunomodulation by Mycobacterium Indicus Pranii (MIP) in MB leprosy, 2024-2026
Leprosy patients can be effectively treated with multi-drug treatment (MDT), but they are still susceptible to being reinfected with leprosy. It has been demonstrated that the MIP (Mycobacterium indicus pranii) vaccine can teach the immune system to activate an immune response when it encounters M. leprae. This process is called 'immune modulation'. The National Institute of Research in Tribal Health (ICMR) in India uses advanced techniques to investigate the cells involved in an immune response and the differences between MIP-vaccinated and unvaccinated patients. The research aims to better understand the underlying mechanism of immune response and immune modulation, and use the knowledge gained to fight leprosy more effectively.

The Turing Foundation is contributing € 94,000 towards this project.

M. Leprae bacterie

LepVax: safety and vaccin-induced immune response, Brazil, 2024-2026
Researchers from the Infectious Disease Research Institute (IDRI), in collaboration with the America Leprosy Mission (ALM), have developed a leprosy specific vaccine called LepVax. This vaccine has both prophylactic properties (preventing leprosy) and immunotherapeutic properties (treating leprosy reactions). That means that LepVax should prevent further development of the disease, both deformities after infection and new infections. This study is focused on testing the safety of and immune response to LepVax. The project includes collaboration with a clinic for leprosy research in Brazil (FioCruz).

The Turing Foundation has already contributed € 200,000 towards the earlier phases of this research, and is contributing € 175,000 towards this follow-up research. The Leprosy Research Initiative is contributing an equal sum.

LepVax: safety and vaccin-induced immune response, Brazil

Point-of-care tests for leprosy in South America, 2024
The Leiden University Medical Center (LUMC) team has developed a simple diagnostic test in previous studies. This point-of-care (POC) test uses a finger prick to determine whether and to what extent someone is infected with leprosy. The test can be performed by primary health care workers without complicated laboratory techniques. The LUMC is going to expand the use of the POC test to populations in Brazil and Bolivia, and investigate how the test functions in a Latin American population. The results will be compared with the previous studies in Bangladesh. This study builds on previous studies which received € 1,812,500 funding from the Turing Foundation.

The Turing Foundation is contributing €152,742 towards this LUMC project (of which, €34,683 in 2024). The Leprosy Research Initiative is matching this contribution.

Point-of-care tests for leprosy in South America

Mobile suitcase lab for rapid diagnosis of clinical and sub-clinical leprosy, Bangladesh, 2024
Early diagnosis of leprosy is crucial for effective treatment of cases and preventing infection of their close contacts, who are the group most at risk. Microbiological diagnosis of leprosy outside well-equipped laboratories with specifically trained personnel is difficult. This project focuses on a reliable, simple and cost-effective rapid diagnostic test, which is easy to use and can be used on the ground. A molecular diagnostic test, the ML-RPA test, has already been developed for this purpose. This rapid diagnostic test provides results within 20 minutes and proved very accurate in previous studies using laboratory-grown DNA. The test is conducted in a 'mobile suitcase lab' to research the effectiveness of diagnosis of leprosy cases and their close contacts on the ground. The suitcase lab is easily transportable, uses solar panels and a portable charger, and does not have to be cooled. The ML-RPA test is compared to an RT-PCR test (which is also a molecular diagnostic test able to detect the leprosy bacteria accurately). The results of the two tests are being compared and if the ML-RPA test shows comparable or greater accuracy than the RT-PCR test then it will be recommended for difficult cases and their contacts, especially in areas lacking a good laboratory.

The Turing Foundation is contributing € 30,000 towards this project.

M. Leprae bacteria

Evaluation of five transcriptomic biomarkers for leprosy, Colombia, 2024-2027
Approximately 400 of the leprosy cases reported each year in the world are from Colombia. In this project of the Instituto Colombiano de Medicina Tropical, researchers in the five regions with the highest incidence of leprosy in Colombia are taking samples from cases, their close contacts and people with other skin diseases. They are researching how genes associated with leprosy - biomarkers - occur in both uninfected people and cases in various phases of infection and disease. The results of this research will be used specifically for the further development of diagnostic tests: the successful and technologically advanced tests used to diagnose leprosy. This will make it possible to detect leprosy as early as possible, which will have a significant impact on controlling and preventing the disease and on cases and their families. This research is a partial continuation of research projects that the Turing Foundation has supported in the past (IDEAL follow-up and INDIGO).

The Turing Foundation is contributing € 154,815 towards this project (of which, € 41.425 in 2024).

M. Leprae bacteria

COMBINE: Leprosy elimination by community screening & mass chemoprophylaxis, Kiribati, 2024-2026
Transmission of both leprosy and tuberculosis is through the respiratory tract and is greatly increased in places where many people live close together in poor economic conditions. The Pacific Leprosy Foundation trial "COMBINE" in Kiribati (an island republic in Oceania) focuses on population-wide screening, treatment and MDA chemoprophylaxis for both leprosy and tuberculosis. Patients with skin lesions potentially caused by leprosy are referred to a specialised clinic for diagnosis and treatment. Patients with active or latent tuberculosis are also treated. Everyone else is given SDR as prophylaxis for leprosy. GIS mapping of new patients means that the project will contribute to a clearer impression of the local transmission of both leprosy and tuberculosis. The effectiveness and acceptance of a combined approach will be clear by the end of the study, enabling the method to be applied in other countries where tuberculosis and leprosy are highly endemic.

The Turing Foundation is contributing € 103,000 towards this project (of which, € 26,000 in 2024). The Leprosy Research Initiative contributes the same amount.

PLF/COMBINE: Leprosy elimination by community screening & mass chemoprophylaxis, Kiribati

Contribution to the leprosy research department of Netherlands Leprosy Relief, 2023-2024
The Turing Foundation has been co-financing projects related to the fight against leprosy with Netherlands Leprosy Relief for years. On top of this, every year we donate 5% of the total sum of these donations directly to Netherlands Leprosy Relief as a contribution towards the overhead costs it incurs as a member of the Leprosy Research Initiative: the international partnership for financing leprosy research.

In 2023 the Turing Foundation contributed a total of € 235,555 towards various studies. This means that our contribution towards Netherlands Leprosy Relief's overhead costs in 2023 has been set at € 11.778.

M. Leprae bacteria

MetLep Trial: Metformin as adjunct therapy for MB leprosy, 2023-2024
Metformin is a cheap and safe medicine which has been used to treat diabetes for a long time. Research into tuberculosis patients, which is caused by a bacterium similar to leprosy, has demonstrated that metformin has a beneficial effect on the immune system. The IOCRL (Universities of Indonesia and Oxford Clinical Research Laboratory) is investigating the extent to which treatment of leprosy with metformin can reduce the degree and severity of leprosy reactions and prevent its consequences. The research is being conducted in Indonesia.

The Turing Foundation is contributing € 100,000 towards this project (of which, € 22,000 in 2023).

M. Leprae bacterie

Extra clofazimine for MB cases at high risk of ENL reactions, 2023-2027
Erythema Nodosum Leprosum (ENL) is a serious and very painful leprosy complication. The disease can be treated with the drug clofazimine. This research project aims to evaluate whether treating leprosy patients with extra clofazimin reduces the severity and frequency of ENL and whether it prevents nerve damage over a 24-month period. The Bombay Leprosy Project research is being conducted in Bangladesh and India.

The Turing Foundation is contributing € 100,000 towards this project (of which, € 27,500 in 2023).

M. Leprae bacterie

5 year followup Maltalep/IDEAL, Bangladesh, 2023
The Maltalep trial in Bangladesh, co-funded by the Turing Foundation, evaluated the extent to which a single preventative dose of the antibiotic rifampicine reduced cases of leprosy in the year after a BCG vaccination (this vaccination is usually given to prevent tuberculosis, which is caused by a bacterium closely related to the leprosy bacterium). Two years after the dose of rifampicine, there was (as yet) no convincing proof of any effect. This study examined the results of the five-year trial after administration of the rifampicine. This focused on comparing new cases of leprosy in the two intervention groups (people who received a BCG vaccination with or without a dose of rifampicine). In addition, a comparison is being made with a non-intervention cohort, without vaccination, which has been followed in the same period (the IDEAL study, which was also co-financed by the Turing Foundation). The results of this research will contribute towards knowledge of the effects of a single preventative dose of rifampicine and lead to recommendations for the use of this antibiotic to prevent leprosy.

The Turing Foundation is contributing € 23,840 towards this research.

Monitoring the effect of prophylactic interventions in contacts of leprosy patients including field-application of a novel immunodiagnostic test, Bangladesh

Contribution to the leprosy research department of Netherlands Leprosy Relief, 2022-2023
The Turing Foundation has been co-financing projects related to the fight against leprosy with Netherlands Leprosy Relief for years. On top of this, every year we donate 5% of the total sum of these donations directly to Netherlands Leprosy Relief as a contribution towards the overhead costs it incurs as a member of the Leprosy Research Initiative: the international partnership for financing leprosy research.

In 2022 the Turing Foundation contributed a total of € 178,320 towards various studies. This means that our contribution towards Netherlands Leprosy Relief's overhead costs in 2022 has been set at € 8,916.

M. Leprae bacteria

Molecular Methods in Subclinical Models of Leprosy to Test PEP, 2023
Whilst multi-drug therapy has been very successful in reducing the global prevalence of leprosy, new cases still occur. This indicates that leprosy transmission is still taking place despite effective treatment. Treating individuals known to have been exposed to leprosy, also known as post exposure prophylaxis (PEP), can reduce the number of subclinical infections and transmission of the disease. This study will evaluate different PEP treatments and provide experimental evidence on the level of effectiveness. The goal is to determine the most effective PEP treatment regardless of the host's level of immune functionality.

This study by National Hansen's Disease Programs builds on a previous study by the same group, which also received funding from the Turing Foundation.

The Turing Foundation is contributing €36,500 towards this NHDP project (of which, €11,500 in 2022). The Leprosy Research Initiative is matching this contribution.

Molecular Methods in Subclinical Models of Leprosy to Test PEP

Erasmus MC: Monitoring the effect of prophylactic interventions, Bangladesh, 2022
This sudy by Leiden University Medical Centre and Erasmus University Rotterdam is focused on determining the long-term effect of the BCG vaccination on leprosy patients. New blood samples and new biomarker profiles are being used for this purpose. The second aim of the study is to test the effect of the antibiotic rifampicin on preventing leprosy from developing in new leprosy patients' contacts. Blood will be taken from these contacts at different times with a finger prick over the course of the study. The third and final goal of the study is to introduce the test as part of the national leprosy programme and train health centre staff to perform the test.

The Turing Foundation has contributed approximately € 1,700,000 towards IDEAL/INDIGO research in recent years, and is contributing more than € 112,500 towards this follow-up research in the period 2019-2021. The Leprosy Research Initiative is contributing an equal sum.

Monitoring the effect of prophylactic interventions in contacts of leprosy patients including field-application of a novel immunodiagnostic test, Bangladesh

Endgame strategy for leprosy in the Maldives: optimal targeting of post-exposure prophylaxis to interrupt transmission, Maldives, 2022-2023
The Maldives want to become leprosy-free in the next decade: the aim is to break transmission of the disease (zero children diagnosed with leprosy; zero patients contracting the infection). An end-game strategy must be developed as part of this ambition. The generally recommended strategy is contact screening and prophylactic treatment of a patient's contacts with rifampicin (SDR). It is unclear what the best implementation strategy is in a low-endemic setting such as the Maldives and what, for example, the best target group is for prophylactic treatment (only close contacts or an entire population in a high-endemic cluster?) to break the transmission. Therefore, the research question of Erasmus MC is: 'What would be an optimal end-game strategy to break M. leprae transmission in a low-endemic setting?'

The Turing Foundation is contributing € 24,400 towards this project. The Leprosy Research Initiative contributes the same amount.

Endgame strategy for leprosy in the Maldives: optimal targeting of post-exposure prophylaxis to interrupt transmission, Maldives

Dapsone Hypersensitivity Syndrome Biomolecular Predictive Test, Papua and Nepal, 2021
Leprosy is treated with a combination of three drugs: dapsone, rifampicin and clofazimine. People with dapsone allergy develop what is called dapsone hypersensitivity syndrome (DHS). DHS is associated with skin disorders and organ failure, leading to the death of about 10% of DHS patients. The highest prevalence is found in east Asia. Earlier studies found a genetic mutation associated with a greatly increased risk of DHS. This study is investigating the use of a screening test which can determine whether someone has this genetic mutation. Leprosy patients who test positive will not be given dapsone, which will reduce the number of DHS cases.

The Turing Foundation is contributing € 76,661 towards this project by the Microbiology Department, Institute of Health Research and Development, Papua (of which € 24,000 in 2021). The Leprosy Research Initiative is contributing an equal sum.

Dapsone Hypersensitivity Syndrome Biomolecular Predictive Test, Papua and Nepal

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