title: Longitudinal study on relapses of leprosy in Polynesian multibacillary patients on dapsone monotherapy between 1946 and 1970.
abstract: Between 1946 and 1970, 295 new leprosy patients were detected in French Polynesia, of whom 145 were multibacillary. Of these 145, put on dapsone monotherapy, 131 reached bacteriological negativity in a period of time ranging from 2 to 12 years (average 4.72 years) and were followed-up for a period of time ranging from 19 to 43 years (median follow-up period after bacteriological negativity; 18 years). Among the 131 patients, 36 relapses were detected, the first one 4 years after bacteriological negativity and the last one 26 years after. The crude relapse rate was 27.5%, the risk of relapse was 1.39 per 100 patient years and the cumulative relapse probability, calculated using the lifetable method, reached 0.38 +/- 11 by year 31 of the study. From these findings one may assume that, at least in French Polynesia, one-third to one-half of multibacillary patients put on dapsone monotherapy would relapse if still present 36 years after bacteriological negativity. Such results re-emphasize the need for leprosy patients to be treated with multidrug therapy as recommended by WHO.
authors.affiliation: Institut Territorial de Recherches Medicales Louis Malarde, Papeete Tahiti-Polynesie Francaise.
authors.forename: J L
authors.initials: JL
authors.lastname: Cartel
authors.forename: J P
authors.initials: JP
authors.lastname: Boutin
authors.forename: A
authors.initials: A
authors.lastname: Spiegel
authors.forename: R
authors.initials: R
authors.lastname: Plichart
authors.forename: J F
authors.initials: JF
authors.lastname: Roux
mesh_terms: D003622:Dapsone / Q000627:therapeutic use*; D006801:Humans; D007918:Leprosy / Q000188:drug therapy*; D008137:Longitudinal Studies; D011114:Polynesia; D011336:Probability; D012008:Recurrence; D012306:Risk
chemical_list: D003622:Dapsone