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The declining prevalence of leprosy has not been matched by a declining incidence. Widespread adoption of mutliple drug therapy (MDT) in closely mon itored control programmes has not prevented transmission of My cobacterium leprae. Despite the rarity of lepromatous patients, most of those living in endemic areas have immunological evidence of exposure to M. leprae. This paradox could be explained if, for many such individuals, infection was transient, did not result in disease development, butdoi:10.5935/0305-7518.19980011 fatcat:qnb6u6mmnvdjrbq2bewvby4pdi