Classification of leprosy into multibacillary and paucibacillary groups: an analysis.

Classification of leprosy patients into multibacillary and paucibacillary determines the duration of their treatment. Misclassification leads to increased risk of relapse due to insufficient treatment if a multibacillary patient is classified as paucibacillary. This also prolongs the time the patient is infective. Over the years, the criteria used for classification (for treatment purpose) of leprosy patients have changed significantly from bacterial index measuring approach through number of skin lesions. The reliability of both of these criteria has been questioned. Several studies have shown that the presence of antibodies to the Mycobacterium leprae-specific antigens correlates with the bacterial load of a leprosy patient. Further, there are reports where results of serology and bacteriological approaches have been found to agree substantially. Thus, serology seems to be a worthwhile convenient alternative tool for classification of leprosy into multibacillary or paucibacillary. Nevertheless, in view of the limitations of various classification criteria, follow-up studies are called for to understand the efficiency of various approaches in preventing relapse after treatment. The method ensuring the lowest rate of relapse could be adopted for future use in classifying these patients.