To B or Not To B Project

The “2B (to B-or-not-to-B)” project is funded by TLMGB and being implemented in Bangladesh and Nepal through The Leprosy Mission partners TLM International Bangladesh (TLMI-B) and The Leprosy Mission Nepal (TLMN), in collaboration with the Leiden University Medical Center (LUMC), the Netherlands.

The research explores the role of B-cells and antibody responses during leprosy and Mycobacterium leprae infection, with the aim of identifying immune mechanisms that can be translated into more broadly applicable, practical diagnostic tools. The study will recruit 500 participants across the two countries (250 per country), including people with multibacillary and paucibacillary leprosy, household contacts, and endemic controls, and will use advanced immunological techniques and exploratory biomarker plaforms to identify the most optimal diagnostic signals across the disease spectrum.

The ultimate goal is not only to improve scientific understanding, but to translate these findings into a field-friendly, diagnostic test that can be used in low-resource settings—supporting earlier detection, faster referral, and timely treatment of various forms of leprosy. By facilitating point-of-contact diagnosis, the study aims to help prevent disability, reduce transmission, and ensure people affected by leprosy can access care earlier—before the disease has the chance to cause lasting harm.

Publications

van Hooij A, van Meijgaarden KE, Khatun M, Soren S, Walburg K, Alam K, et al. Integrative immune analysis in patients with leprosy reveals host factors associated with mycobacterial control. EBioMedicine. 2025;118:105855