Field evaluation of WHO-MDT of fixed duration, at ALERT, Ethiopia: the AMFES project--II. Reaction and neuritis during and after MDT in PB and MB leprosy patients.

For a cohort of 286 leprosy patients the incidence rates and clinical manifestations of leprosy reactions during treatment and surveillance are described. Currently, individual patients had been observed for up to 4 years. It is intended that surveillance within this project should continue for up to 5 years after treatment.

Loss of viability of Mycobacterium leprae isolated from nasal secretions of lepromatous leprosy patients following daily rifampicin and DDS therapy.

Excreta from blowing their noses was collected from 4 previously untreated multibacillary (LL) patients in the ALERT hospital, immediately before and during daily treatment with 600 mg rifampicin and 100 mg dapsone (DDS). The Mycobacterium leprae recovered from the nasal secretions were enumerated and inoculated into the footpads of normal mice. Bacilli recovered from 2 of the patients failed to infect mice after 1 day's treatment, and all infectivity of the bacilli from the other 2 patients was lost after 2 days' treatment.

Damage and regeneration of peripheral nerves in advanced treated leprosy.

Despite the rapidly falling prevalence of leprosy, the disability and handicap resulting from loss of protective sensation, due to irreversible nerve damage, will remain a huge medical problem for many years. To elucidate the location and consequences of permanent nerve damage in treated leprosy, a prospective study involving nine patients who underwent leg amputation was conducted. Full-length nerves dissected from amputated legs were studied with histological and immunohistochemical methods.

Heel ulcer in leprosy treated with fasciocutaneous island flap from the instep of the sole.

Twenty-four leprous patients with longstanding ulcer of the weight bearing area of the heel underwent reconstruction by use of fasciocutaneous island flap from the instep. One flap was lost because the vascular pedicle was accidentally severed during the dissection. Infection delayed healing in three cases, and one patient developed minor necrosis of the edge of the flap without any adverse consequences.