title: Comparison of multidrug therapy treatment results between multibacillary leprosy patients in hyperendemic and hypoendemic areas in Gowa Regency, South Sulawesi, Indonesia.
abstract: We studied 88 multibacillary (MB) leprosy patients, who received multidrug therapy (MDT) treatment in hyperendemic (44 persons) and hypoendemic (44 persons) areas in Gowa Regency, South Sulawesi, Indonesia. Bacteriological examinations were carried out (bacteria index and morphology index), immunological examinations (MLPA and TNF-alpha) and genetic variation in blood and ear lobe slit skin smears of MB leprosy patients, which had been treated by MDT, were performed. The collected data were analyzed with the chi-square test and discriminant analysis. Eight persons (9.1%) had a positive bacteria index and 2 persons (2.4%) had a morphology index. All patients (100%) increased their TNF-alpha concentration. All the samples (100%) showed an increase in the TNF-alpha concentration, compared to controls. MLPA positive conversion was found in 4 persons (47.7% samples) and TNF-alpha gene genetic variation at the position of -308, occurred in 12 persons (13.6% samples). Statistic test results showed a significant difference (p<0.01) in the TNF-alpha concentration between hyperendemic and hypoendemic areas. On the basis of a positive conversion by bacteriological results and its association with immunological results, it can be concluded that multibacillary leprosy patients with MDT treatment did not become a source of leprosy transmission.
authors.affiliation: Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia.
authors.forename: Rasdi
authors.initials: R
authors.lastname: Nawi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015169:Colony Count, Microbial; D004198:Disease Susceptibility; D004359:Drug Therapy, Combination; D019353:Endemic Diseases; D005260:Female; D005843:Geography; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007917:Leprostatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007918:Leprosy / Q000188:drug therapy* / Q000453:epidemiology* / Q000382:microbiology; D008262:Macrophage Activation / Q000235:genetics; D008297:Male; D009166:Mycobacterium leprae / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D012111:Residence Characteristics; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics
chemical_list: D007917:Leprostatic Agents; D014409:Tumor Necrosis Factor-alpha