title: The Malta Project--a country freed itself of leprosy. A 27-year progress study (1972-1999) of the first successful eradication of leprosy.
abstract: The successful conclusion of the first leprosy eradication program carried out with combination therapy is reported. This program started in Malta in June 1972. It was based on extensive experimental and clinical studies and was formally concluded on 31 December 1999. No new infections occurred after the start of this 27-year progress report. The youngest patient was 16, and the eldest 83 years old. Of the total of 261 cases in the project, 201 had already received pretreatment [mainly with diaminodiphenylsulfone (DDS)] at the start. Sixty-one cases had no pretreatment. These were predominantly elderly patients who were late in deciding to have treatment. The very long follow-up period totaling 27 years was consistently maintained in order to be able to refute all potential objections empirically, e.g. with regard to relapses at a late stage. Besides the overall symptoms which are typical for the broad picture of leprosy, the involvement of the eyes was very striking (at least 50%). The therapeutic effect was of very rapid onset in these cases without surgery. Rifampicin (RMP) + isoniazid + prothionamide + DDS (trade name Isoprodian-RMP) was used as medication in a fixed combination. This fixed combination had already proved to be highly effective in the treatments during the course of the project, surprising therapy results (including lifesaving effects) were also noticed in other diseases.
authors.affiliation: Borstel Research Institute, Borstel, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Freerksen
authors.forename: M
authors.initials: M
authors.lastname: Rosenfeld
authors.forename: G
authors.initials: G
authors.lastname: Depasquale
authors.forename: E
authors.initials: E
authors.lastname: Bonnici
authors.forename: P
authors.initials: P
authors.lastname: Gatt
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D003622:Dapsone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D007917:Leprostatic Agents / Q000627:therapeutic use*; D007918:Leprosy / Q000188:drug therapy / Q000517:prevention & control*; D008297:Male; D008319:Malta / Q000453:epidemiology; D008875:Middle Aged; D015397:Program Evaluation; D011515:Prothionamide / Q000627:therapeutic use; D011634:Public Health; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007917:Leprostatic Agents; D011515:Prothionamide; D003622:Dapsone; D007538:Isoniazid; D012293:Rifampin