Fixed duration MDT in paucibacillary leprosy.
The World Health Organization (WHO) has recommended a fixed duration of multidrug therapy (MDT) for paucibacillary leprosy which is currently widely implemented in India. A clinico-pathological study was initiated in 1984 to assess the efficacy of this regimen. The clinical and histological responses of the patients to MDT were assessed at the end of 6 months, when their treatment was stopped, and at 2 1/2 years, when they were released from surveillance, and compared with the responses of a matched patient group to conventional dapsone (DDS) monotherapy during the same period. Of 28 patients who completed the MDT schedule, there was less than 60% improvement in 33% of them when treatment was stopped at the end of 6 months and in 20% of them at the end of 2 1/2 years. Of 26 patients receiving DDS monotherapy, 37% showed less than 60% improvement at the end of 6 months but only 8.8% had less than 60% improvement at 2 1/2 years. It is concluded that MDT for paucibacillary leprosy as recommended by WHO may not have a major advantage over DDS monotherapy, since about 20% of those patients on MDT continue to have evidence of active disease when discharged from surveillance.
Mathai
R
R
Department of Dermatology, Christian Medical College & Hospital, Vellore, South India.
George
S
S
Jacob
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003622:Dapsone / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007918:Leprosy / Q000188:drug therapy*; D015439:Leprosy, Borderline / Q000188:drug therapy; D015441:Leprosy, Tuberculoid / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D003622:Dapsone; D012293:Rifampin