Retreatment in leprosy: a case-control study.
OBJECTIVE
To assess risk factors for retreatment of leprosy patients.


METHODS
A case-control study with patients from two reference care units in Recife, northeastern Brazil, in 2003. The case group included retreated patients (N=155) and the control group comprised those patients who were not retreated (N=155) matched by year of diagnosis and health care unit. Univariate and multivariate analyses were conducted to test the associations and odds ratios and related 95% confidence intervals were estimated.


RESULTS
The following factors were found to be significantly associated (p<0.05) with retreatment: occurrence of adverse immunological reactions after treatment completion (OR=2.3; 95% CI=1.18;4.83), final bacterial index > or = 1 (OR=6.43; 95% CI=1.67;24.74), therapeutic regimen consisting of sulfone monotherapy (OR=10; 95% CI=0.01;0.78) and reports of household contacts (OR=2.2; 95% CI=0.24;0.85).


CONCLUSIONS
The study findings reinforce that the use of dapsone monotherapy should be discontinued, and highlight the need for epidemiological monitoring of specific groups of leprosy patients after treatment completion through periodical clinical and laboratory evaluation. Further studies to explore the association between final bacterial index and retreatment are strongly recommended.
Ximenes
Ricardo Arraes Alencar
RA
Departamento de Medicina Tropical, Centro de Ciências da Saúde, Universidade Federal de Pernambuco, Recife, PE, Brasil.
Gallo
Maria Eugênia Novinsk
ME
Brito
Maria de Fátima de Medeiros
Mde F
D000293:Adolescent; D000328:Adult; D001938:Brazil; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007917:Leprostatic Agents / Q000008:administration & dosage; D007918:Leprosy / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019233:Retreatment / Q000706:statistics & numerical data
D007917:Leprostatic Agents