Preliminary appraisal of a WHO-recommended multiple drug regimen in paucibacillary leprosy patients in Malawi.
A study was undertaken within the framework of the LEPRA Evaluation Project and the LEPRA Control Project in Malawi (Central Africa) to study the incidence rates of type 1 reactions and of relapses in paucibacillary leprosy patients treated with the current World Health Organization-recommended multiple drug regimen (WHO/MDT). Of 503 patients recruited into the study, 488 were reviewed at the end of treatment and 480 have now been followed for 1 year after completion of treatment. At the end of treatment the skin lesions had completely disappeared in 27.4%, but were judged to be still active in 4.3%. During the follow-up period two patients were found with new active skin lesions, giving a relapse rate of 4.17 (2 of 480) per 1000 person years during the first year after completion of WHO/MDT (95% confidence interval 1.14 to 15.06 per 1000 person years). The incidence rate of marked type 1 reaction (renewed inflammation in previously inactive lesions) during the first year after completion of WHO/MDT was 47.8 per 1000 person years in self-reporting patients but zero in patients identified by active case finding. Data are presented which suggest that the incidence rate of late type 1 reactions is closely related to the classification and stage of the disease at detection.
Boerrigter
G
G
LEPRA Control Project, Lilongwe, Malawi.
Ponnighaus
J M
JM
Fine
P E
PE
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003622:Dapsone / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007918:Leprosy / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D008295:Malawi; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use*; D012737:Sex Factors
D003622:Dapsone; D012293:Rifampin