Multidrug therapy and eye disease in leprosy: a cross-sectional study in the People's Republic of China.
BACKGROUND
Factors associated with leprosy-related eye disease in a multidrug therapy (MDT) treated population in China were assessed to determine if status prior to inclusion in the MDT programme (newly diagnosed leprosy patient or leprosy patient on prior dapsone monotherapy) contributed to the prevalence of ocular pathology.


METHODS
Trained leprosy paramedical workers in Sichuan Province examined 974 leprosy patients in a standardized fashion. Univariate analyses and multiple logistic regression were used to assess the contribution of demographic and clinical parameters to leprosy-related eye disease.


RESULTS
In both groups (prior dapsone and new MDT) leprosy-related eye disease was associated with a longer distance to leprosy health worker or health centre. Among patients with a history of prior dapsone monotherapy, age and duration on dapsone monotherapy were also associated with leprosy-related ocular morbidity. Among newly diagnosed leprosy patients the prevalence of ocular morbidity remained between 8% and 11% regardless of when the patient started MDT.


CONCLUSIONS
Our findings suggest that, even when case detection is good, ocular pathology will still occur in MDT treated leprosy patients. There remains an important role for health workers in the prevention of ocular morbidity. Our data also demonstrated that pooling of results from all patients (newly diagnosed and on prior dapsone monotherapy) in a leprosy control programme will likely give rise to inadequate estimates of risk of ocular disease due to variable clinical disease histories in these groups.
Courtright
P
P
International Centre for Eye Health, London.
Hu
L F
LF
Li
H Y
HY
Lewallen
S
S
D000328:Adult; D000367:Age Factors; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use*; D007918:Leprosy / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D016015:Logistic Models; D008297:Male; D008507:Medically Underserved Area; D015201:Meta-Analysis as Topic; D008875:Middle Aged; D009017:Morbidity; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors
D007917:Leprostatic Agents