OBJECTIVE: To determine the frequency, time interval to relapse and the possible risk factors for relapse in multibacillary (MB) leprosy after 1 year's treatment with the standard multi-drug therapy (MDT). MATERIALS AND METHODS: Smear positive MB patients treated with MDT for 1 year were enrolled in a prospective relapse study between 1999 and 2005 at the Leonard Wood Memorial Center for Leprosy Research (LWM). After treatment completion, at yearly intervals, patients underwent slit-skin smear examination and were clinically monitored for possible signs of relapse. RESULTS: 300 patients were recruited, and by 2009, follow-up totaled 1,913 patient years, with a mean of 6.4 years per patient. Only one case of relapse was detected, with an absolute relapse rate of 0.3% (0.52 per 1000 patient-years at risk (PYAR)); among a subset with pre-treatment bacterial indices (BI) of > or = 4 +, the rate was 0.6%. Relapse occurred 7 years after MDT. CONCLUSION: These data provide strong evidence of the long-term efficacy of the one year WHO-MDT for multibacillary (MB) leprosy patients, even in those with a high initial BI.
OBJECTIVE: To determine the frequency, time interval to relapse and the possible risk factors for relapse in multibacillary (MB) leprosy after 1 year's treatment with the standard multi-drug therapy (MDT). MATERIALS AND METHODS: Smear positive MB patients treated with MDT for 1 year were enrolled in a prospective relapse study between 1999 and 2005 at the Leonard Wood Memorial Center for Leprosy Research (LWM). After treatment completion, at yearly intervals, patients underwent slit-skin smear examination and were clinically monitored for possible signs of relapse. RESULTS: 300 patients were recruited, and by 2009, follow-up totaled 1,913 patient years, with a mean of 6.4 years per patient. Only one case of relapse was detected, with an absolute relapse rate of 0.3% (0.52 per 1000 patient-years at risk (PYAR)); among a subset with pre-treatment bacterial indices (BI) of > or = 4 +, the rate was 0.6%. Relapse occurred 7 years after MDT. CONCLUSION: These data provide strong evidence of the long-term efficacy of the one year WHO-MDT for multibacillary (MB) leprosy patients, even in those with a high initial BI.
Authors: Wei Li; Rama M Sakamuri; Danielle E Lyons; Florenda M Orcullo; Vidyagouri Shinde; Edred Lao Dela Pena; Armi A Maghanoy; Irene B Mallari; Esterlina V Tan; Indira Nath; Patrick J Brennan; Marivic Balagon; Varalakshmi Vissa Journal: Antimicrob Agents Chemother Date: 2011-08-22 Impact factor: 5.191