Prevalence of HIV infection and high-risk characteristics among leprosy patients of south India; a case-control study.

With the observation of the occurrence of the human immunodeficiency virus (HIV) infection among leprosy patients in our pilot study carried out in Tamil Nadu, South India, a case-control study was planned to explore whether HIV infection is a risk factor for leprosy and to understand the characteristics of HIV infection and high-risk behaviors among leprosy patients. We screened 556 patients and 1004 nonleprosy controls (matching 502 cases for age, sex and area of residence) for HIV-1 and HIV-2 antibodies. They also were interviewed for personal information on history of blood transfusion, intravenous drug abuse, high-risk sexual behavior, and sexually transmitted diseases.

Deformity incidence in leprosy patients treated with multidrug therapy.

The records of 2,285 (2,007 paucibacillary (PB) and 278 multibacillary (MB)) cases of leprosy which were declared as released from treatment (RFT) after multidrug therapy (MDT) and under surveillance as per the National Leprosy Eradication Programme (NLEP) guidelines in the rural field practice area of Central Leprosy Teaching & Research Institute (CLTRI), Chengalpattu, between September 1986 and September 1993 were analyzed for collecting data on the incidence of deformity. Of the 2,285 cases 2,053 (1,947 PB and 106 MB) did not have deformity at the commencement of treatment. Three MB cases and one PB case out of the 2,053 developed deformity (all grade II) during the course of treatment.

Ofloxacin-containing combined drug regimens in the treatment of lepromatous leprosy.

A total of 26 clinically diagnosed adult patients, with active untreated lepromatous leprosy, with a Bacteriological Index of 4+ or more, were admitted to the hospital of the Central Leprosy Teaching and Research institute, Chengalpattu, India, between 1989 and 1991. After prescribed investigations, the patients were randomly allocated in groups of 3 to 3 treatment regimens, namely: 1, clofazimine 50 mg daily and 300 mg once in 4 weeks + dapsone 100 mg daily (AA); 2, (AA)+ofloxacin 400 mg daily (BB); and 3, (AA)+ofloxacin 800 mg daily (CC). The drugs were administered for 56 days continuously under supervision.

Indeterminate leprosy: a seroimmunological and histochemical evaluation.

An effort was made to differentiate indeterminate (IND) leprosy from other types of the paucibacillary (PB) group of leprosy and to identify among indeterminate leprosy cases those which may evolve to multibacillary (MB) leprosy, using serological, immunological and histochemical parameters. A total of 92 untreated, histologically classified (TT-19, BT-30, IND-32) patients, including 11 cases diagnosed as nonspecific dermatitis (NSD), which were clinically strongly suspected to be leprotic, were screened for antibodies against PGL-I, 35-kDa and LAM antigens. Lepromin tests and antigen demonstration in tissue by indirect immunoperoxidase staining were also carried out.

The influence of operational factors in the profile of monolesional leprosy cases in south India.

A comparison of the profile of monolesional cases among new PB cases detected in a Government Leprosy Control Unit (GLCU) and the field area of a Central Leprosy Teaching and Research Institute (CLTRI), both located in South India, demonstrates that the proportion of monolesional cases among new cases detected between 1987 and 1991 was higher in children than adults, higher in females than males (only in the CLTRI)--over 95% were the tuberculoid type. A significantly increasing trend in this proportion could be seen in the GLCU but not in the CLTRI; an explanation of this is based on the difference in operational aspects in case detection methodology adopted by the 2 areas--e.g.

Nerve abscess in leprosy: a retrospective study.

Nerve abscesses occur, both in tuberculoid and lepromatous leprosy. We studied 20 patients who had undergone surgery for nerve abscess in mixed peripheral and cutaneous nerves. Details of these cases and the controversial question as to how long the question PB regimen should be continued are discussed.

Serological response of leprosy patients to Mycobacterium leprae specific and mycobacteria specific antigens: possibility of using these assays in combinations.

The serological response of 147 leprosy patients to 3 mycobacterial antigens, PGL-I, 35 kDa (Mycobacterium leprae-specific) and LAM (which is a common mycobacterial antigen) were analysed. A stronger serological response was seen amongst the MB patients than the PB patients in all the assays. The 3 antibody levels correlated positively with each other in both MB and PB cases.

Mycobacterium leprae soluble antigen (Rees) skin test responses in an endemic population in India.

The response to intradermal administration of Rees soluble skin test antigen was studied in 12,142 randomly selected individuals living in a highly endemic area in South India. Taking a cut-off point of 12 mm induration as the criterion for 'positivity', 73% of PB cases, 45% of MB cases and 63% of noncase population (67% in contacts and 63% in non-contacts) were found to be positive. Age-specific positivity rates were higher in males than in females and in adults than in children.

Initial intensive therapy for multibacillary leprosy patients--in retrospect.

We analysed the results of 4845 multibacillary (MB) patients being treated with multidrug treatment (MDT) in the Srikakulam District of Andhra Pradesh, India. Of these, 2309 (47.7%) patients were given an initial 14-day intensive therapy with rifampicin, clofazimine and dapsone, followed by the WHO recommended pulse therapy.

Specificity of IgG subclass antibodies in different clinical manifestations of leprosy.

We analysed specific IgG subclasses levels to Mycobacterium leprae sonicate extract (MSE), lipoarabinomannan B (LAM) and phenolic glycolipid I (PGL-I) in the sera of leprosy patients with different clinical manifestations. IgG2 was found to be the predominant antibody to MSE regardless of clinical manifestations, and IgG1 response was mostly seen in lepromatous patients. IgG3 reacted only rarely but IgG4 reacted relatively more in certain clinical groups such as borderline lepromatous and lepromatous with erythema nodosum leprosum (ENL) reaction.

Time lag between case registration and commencement of treatment in a leprosy control unit.

Analysis of client-based data as a part of computerised management information system in a Government leprosy control unit in Tamil Nadu reveals that there was delay in initiating treatment of leprosy patients. The mean and standard deviation of the period of delay for cases registered before, within 6 months and after 6 months of start of MDT in the Unit were 6.80 +/- 6.

Surgical correction of claw fingers in Hansen's disease by palmar plate shortening and pulley advancement.

A simple technique has been used to correct the clawing of fingers in patients with Hansen's disease. The distal part of the palmar plate is excised and the remaining portion is advanced and sutured with a single horizontal mattress suture to prevent hyperextension of the metacarpophalangeal joint. A pulley advancement is also done.

Serum zinc/copper ratio in subtypes of leprosy and effect of oral zinc therapy on reactional states.

Serum zinc and copper levels and zinc/copper ratios were studied in 86 healthy controls, 45 cases of borderline tuberculoid (BT), 31 cases of borderline lepromatous (BL), 117 cases of lepromatous (LL) leprosy patients, 16 cases with severe erythema nodosum leprosum (ENL) reaction, and 16 cases with ENL reaction receiving oral zinc therapy. A significant reduction in serum zinc levels was noticed in all types of leprosy, the maximum decrease being seen in cases with ENL reaction. Conversely, the copper levels were significantly increased from BT to LL cases with ENL reaction in a progressive manner.

A computerized information system for evaluation of NLEP through monthly progress reports.

A computerized system for monitoring district-wise operational performance and epidemiological progress using existing regular and special monthly reports of the National Leprosy Eradication Programme (NLEP) is presented. The same system, with some minor modifications could be used for programme assessment at the Leprosy Control Unit level also. The advantage of the system is the speed with which it can generate output in the form of comparative tables and graphs for different regions for use by programme managers for making overall assessments in time and for sending feedback reports to workers at various levels, for self-assessment and for taking timely corrective action.

Observations on nerve tissue infected with M. leprae.

Nerve tissue from leprosy patients showed (i) small linear pinkish translucent crystalloid bodies, (ii) small round structures in relation to filamentous strands, (iii) short pieces of filaments with round spaces within them and (iv) miscellaneous structures like pink granules, brown bodies and dark masses. These structures are being studied for their relationship to leprosy.

Sub-clinical infection with Mycobacterium leprae in household contacts of leprosy.

870 household contacts of leprosy patients were examined for sub-clinical infection with M. leprae by smear (skin and nasal), lepromin and FLA-ABS tests. 0.

Screening of registered leprosy cases and its effects on prevalence rate.

Prevalence rates of leprosy in 6 endemic districts in Andhra Pradesh, India with a population of 168.71 lakhs (1981 census) were studied before and after screening of registered cases. The screening was carried out as part of multidrug treatment project implementation.

Bacteriological study of urine samples from leprosy patients: a preliminary communication.

A.F.B.

Effect of temperature, cholesterol and nerve tissue on multiplication of armadillo M. leprae.

The effect of temperature, nerve tissue and certain constituents of the medium on multiplication of armadillo M. leprae was studied using Hanks BSS. An equal or better growth was seen at 30 degrees C and 10 degrees C compared to 37 degrees C.

A study into bacteriological positivity and treatment of beggar leprosy patients.

Hundred beggar leprosy patients were medically examined and skin smears were taken for bacteriological positivity for A.F.B.

Morphology of M. leprae (?) in VS3E medium--a preliminary communication.

In a previous attempted culture of M. leprae in VS2M medium non-acid fast organisms were seen initially and acid fast organisms appeared later. A drop of a sonicated suspension from a subculture of this was inoculated in VS3E medium.

Observations on T-cell sub-populations in type II reactions.

15 cases each of Type II Reaction, LL and TT Leprosy and 50 endemic controls were studied for phenotypic markers T2, T4 and T8 by 2 step immunoperoxidase technique. There was statistically significant increase in T4 (helper) cells in Type II Reaction. There was also a decrease in T8 cells but this was not statistically significant.