title: Field treatment of acute nerve function impairment in leprosy using a standardized corticosteroid regimen--first year's experience with 100 patients.
abstract: In this study, a fixed regimen of prednisolone for the treatment of acute nerve function impairment (NFI) in leprosy patients was developed and introduced at field level in one area (Thakurgaon) of the Danish-Bangladesh Leprosy Mission's field in NW Bangladesh. The assessment, management and follow-up of patients was undertaken by leprosy control supervisors and physiotechnicians. One hundred patients were treated and followed up 6-8 months after completion of a 4-month course of prednisolone. At a level of change of 2 points (where a change of at least 2 points in the motor/sensory score was taken to indicate a change of status, i.e. full or partial recovery, or deterioration), 42/65 (64.6%) patients with sensory loss experienced some sensory recovery at completion of prednisolone treatment, and 40/65 (61.5%) at 6-8 months' follow-up. 41/85 (48.3%) of patients with motor loss experienced improvement, and 42/85 (49.4%) at follow-up. Analysis of the mean scores at start of prednisolone treatment, completion and at follow-up using Student's t-test showed highly significant (p < 0.001) differences between scores before and after treatment. The benefit is maintained as seen after a period of 6-8 months follow-up. It was concluded that treatment of acute nerve function impairment at field level by paramedical workers, using a standardized regimen of prednisolone is feasible, practical and effective.
authors.affiliation: Danish-Bangladesh Leprosy Mission, District Nilphamari, Bangladesh.
authors.forename: R P
authors.initials: RP
authors.lastname: Croft
authors.forename: J H
authors.initials: JH
authors.lastname: Richardus
authors.forename: W C
authors.initials: WC
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001459:Bangladesh; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D007918:Leprosy / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology; D010865:Pilot Projects; D011239:Prednisolone / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone