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Long-term efficacy of 2 year WHO multiple drug therapy (MDT) in multibacillary (MB) leprosy patients.
Int J Lepr Other Mycobact Dis. 2003 Dec; 71(4):308-19.IJ

Abstract

Relapse rate estimates after 2 year WHO multiple drug therapy (MDT) in multi-bacillary (MB) leprosy vary. Between 1987 and 1994, 500 MB leprosy patients completing 2 year MDT were enrolled in a prospective relapse study. The majority of patients (N = 316) were treated and followed at the physician-staffed Cebu Skin Clinic (CSC), whereas others (N = 184) received therapy from government clinics and were followed by CSC technicians in the field. Relapse definition was an increased bacteriologic index (BI) and new skin lesions, supplemented with mouse footpad inoculations. Through 2002, follow-up was 5368 person-years, with a mean of 10.8 years per patient. The absolute relapse rate was 3% (15/498; 0.28/100 person-years), with a cumulative risk estimate of 3.9% at 15 yrs. For a subset of 217 patients followed for >or=12 yrs or until relapse, relapses occurred in 9% (13/142) attending the CSC, versus 3% (2/75) assessed in the field (p = 0.09). The rate for patients followed at CSC for >or=12 yrs and a pre-treatment BI >or=2.7+ was 13% (13/98). All relapses were BL or LL, with pre-treatment BI's of >or=2.7+. Relapses occurred long after completion of therapy, between 3 and 11 yrs from the midpoint of the examination without relapse to detection, or between 6 to 13 yrs to the actual year of detection, 7 occurring at >or=10 yrs. Lesion material from all relapses contained M. leprae that was rifampin and clofazimine sensitive, whereas 3 showed partial or full dapsone resistance. [Follow-up rigor and time], medical expertise, and pre-treatment bacterial load influence relapse rates after 2 yr MDT.

Authors+Show Affiliations

Leonard Wood Memorial Center for Leprosy Research, Cebu City, Philippines.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14763888

Citation

Cellona, Roland V., et al. "Long-term Efficacy of 2 Year WHO Multiple Drug Therapy (MDT) in Multibacillary (MB) Leprosy Patients." International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association, vol. 71, no. 4, 2003, pp. 308-19.
Cellona RV, Balagon MF, dela Cruz EC, et al. Long-term efficacy of 2 year WHO multiple drug therapy (MDT) in multibacillary (MB) leprosy patients. Int J Lepr Other Mycobact Dis. 2003;71(4):308-19.
Cellona, R. V., Balagon, M. F., dela Cruz, E. C., Burgos, J. A., Abalos, R. M., Walsh, G. P., Topolski, R., Gelber, R. H., & Walsh, D. S. (2003). Long-term efficacy of 2 year WHO multiple drug therapy (MDT) in multibacillary (MB) leprosy patients. International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association, 71(4), 308-19.
Cellona RV, et al. Long-term Efficacy of 2 Year WHO Multiple Drug Therapy (MDT) in Multibacillary (MB) Leprosy Patients. Int J Lepr Other Mycobact Dis. 2003;71(4):308-19. PubMed PMID: 14763888.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term efficacy of 2 year WHO multiple drug therapy (MDT) in multibacillary (MB) leprosy patients. AU - Cellona,Roland V, AU - Balagon,Maria F V, AU - dela Cruz,Eduardo C, AU - Burgos,Jasmin A, AU - Abalos,Rodolfo M, AU - Walsh,Gerald P, AU - Topolski,Richard, AU - Gelber,Robert H, AU - Walsh,Douglas S, PY - 2004/2/7/pubmed PY - 2004/3/26/medline PY - 2004/2/7/entrez SP - 308 EP - 19 JF - International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association JO - Int J Lepr Other Mycobact Dis VL - 71 IS - 4 N2 - Relapse rate estimates after 2 year WHO multiple drug therapy (MDT) in multi-bacillary (MB) leprosy vary. Between 1987 and 1994, 500 MB leprosy patients completing 2 year MDT were enrolled in a prospective relapse study. The majority of patients (N = 316) were treated and followed at the physician-staffed Cebu Skin Clinic (CSC), whereas others (N = 184) received therapy from government clinics and were followed by CSC technicians in the field. Relapse definition was an increased bacteriologic index (BI) and new skin lesions, supplemented with mouse footpad inoculations. Through 2002, follow-up was 5368 person-years, with a mean of 10.8 years per patient. The absolute relapse rate was 3% (15/498; 0.28/100 person-years), with a cumulative risk estimate of 3.9% at 15 yrs. For a subset of 217 patients followed for >or=12 yrs or until relapse, relapses occurred in 9% (13/142) attending the CSC, versus 3% (2/75) assessed in the field (p = 0.09). The rate for patients followed at CSC for >or=12 yrs and a pre-treatment BI >or=2.7+ was 13% (13/98). All relapses were BL or LL, with pre-treatment BI's of >or=2.7+. Relapses occurred long after completion of therapy, between 3 and 11 yrs from the midpoint of the examination without relapse to detection, or between 6 to 13 yrs to the actual year of detection, 7 occurring at >or=10 yrs. Lesion material from all relapses contained M. leprae that was rifampin and clofazimine sensitive, whereas 3 showed partial or full dapsone resistance. [Follow-up rigor and time], medical expertise, and pre-treatment bacterial load influence relapse rates after 2 yr MDT. SN - 0148-916X UR - https://www.unboundmedicine.com/medline/citation/14763888/Long_term_efficacy_of_2_year_WHO_multiple_drug_therapy__MDT__in_multibacillary__MB__leprosy_patients_ DB - PRIME DP - Unbound Medicine ER -