Cambridge-led project secures £1.2m from UKRI to pioneer same-day AMR diagnosis for leprosy in Southeast Asia

Leprosy is a chronic infectious disease caused by the bacterium Mycobacterium leprae (M. leprae). It primarily affects the skin and peripheral nerves, leading to disfiguring lesions and, if untreated, permanent disabilities.

Despite global efforts, leprosy remains a significant health challenge especially in tropical regions, with approximately 175,000 new cases reported worldwide in 2022. The Philippines alone accounts for nearly 2,000 new cases annually.

Standard treatment for leprosy involves a multidrug regimen including dapsone, rifampicin, and clofazimine. However, M. leprae has developed resistance to some of these drugs, making it harder and longer to treat leprosy. Since the bacterium cannot be cultured in the lab, detecting antimicrobial resistance relies on genome sequencing directly from patient samples, which traditionally requires centralised laboratories and often takes weeks to deliver results.

Led by Professor Andres Floto and Dr Sundeep Chaitanya Vedithi from the Department of Medicine at Cambridge, the project aims to overcome these barriers by bringing advanced molecular diagnostics and DNA sequencing technologies to the front lines of healthcare in resource-limited settings, starting with the Philippines.

The initiative, in collaboration with the Science and Technology Facilities Council (STFC), will implement rapid, field-compatible diagnostic tools including Biomeme qPCR and MinION-based sequencing in regional hospitals in the Philippines. The team is also developing AI-powered computational pipelines to analyse sequencing data, identify resistance-conferring mutations, and predict their effects on drug binding and protein function.

Working with 11 peripheral sites across the Philippines, including the University of the Philippines and the Philippine General Hospital, the project also focuses on building local technical capacity. Healthcare staff will receive training to perform on-site sequencing, detect genetic mutations linked to resistance, and interpret their clinical significance using the bioinformatics workflow. This will reduce the current waiting time for results from weeks to the same day, enabling timely diagnosis and management.

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With this study, we would aim to develop and standardise the molecular diagnostic tools for diagnosing leprosy and DNA sequencing at the periphery of the health system, using Philippines as a model that could be translated to other Southeast Asian nations. Dr Sundeep Chaitanya Vedithi, Senior Research Associate in the Department of Medicine and co-lead on the project

We are extremely excited by the opportunity to help transform the care of people with leprosy. If successful, our approach could be a template to tackle AMR in many other infections, particularly in resource-poor settings. Professor Andres Floto, Professor of Respiratory Biology at the Victor Philip Dahdaleh Heart and Lung Research Institute, Co-Director of the Cambridge Centre for AI in Medicine, and co-lead on the project

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This project is funded under the UKRI Southeast Asia Collaboration on Infectious Diseases programme through the International Science Partnership Fund, which supports partnerships between UK researchers and researchers in Southeast Asia working in collaboration on diseases with epidemic and AMR potential.