Effectiveness of MDT in multibacillary leprosy.

The study on the use of World Health Organization multidrug therapy (WHO/MDT) under field conditions was initiated in December 1981, and included 1067 multibacillary (MB) patients treated with two MDT regimens. The first was a THELEP-recommended regimen which consisted of 600 mg of rifampin (RFP) and 600 mg of clofazimine (CLO) given under supervision on two consecutive days monthly and 225 mg of diacetyl diaminodiphenylsulfone (DADDS) bimonthly plus dapsone (DDS) 100 mg daily unsupervised. The second regimen was the conventional MDT: patients received RFP 600 mg and CLO 300 mg supervised once a month, daily 100 mg of DDS and 50 mg of CLO unsupervised.

Fixed-duration therapy (FDT) in multibacillary leprosy; efficacy and complications.

The World Health Organization (WHO) recommended a multidrug therapy (MDT) regimen for multibacillary (MB) leprosy patients in 1982 which was to be administered for a minimum period of 2 years or until a skin smear was negative for acid-fast bacilli, whichever was later. This regimen contains rifampin, dapsone and clofazimine. A single dose of rifampin was shown to effect a high degree of bacterial killing (99.

Long-term follow-up of joint stabilization procedures in the treatment of fixed deformities of feet in leprosy.

This retrospective study of 52 patients, who underwent joint stabilization procedures for static deformities of the feet in leprosy between 1971 and 1985, was undertaken to asses the long-term results of joint stabilization of feet for fixed deformities in leprosy. The main purpose of joint stabilization is to make the feet plantigrade for weight bearing and to make the wearing of footwear possible. Deformities corrected include varus, equinus and equinovarus.

A leprosy survey in a taluk headquarters town and the role of dermatological services and active health education in its success--a preliminary report.

A report of two general surveys done in 1984 and 1987 in Gudiyatham town, is presented. The first survey covered 89.2% and the second survey 82% of the population.

Climatic droplet keratopathy in leprosy.

An atypical gross form of climatic droplet keratopathy (CDK) occurring in the cornea of 24 eyes of 17 leprosy patients is described. The CDKs were situated in the lower outer quadrant of the cornea and were not associated with trauma, scars or vascularization. All patients, except one, belonged to the lepromatous group.

Pupil cycle time in leprosy patients without clinically apparent ocular pathology.

The pupil cycle time (PCT) was estimated in 384 leprosy patients whose eyes looked normal on clinical examination and in an equal number of healthy controls. A statistically significant increase in PCT (p < 0.05) was noticed in leprosy patients, and corroborates the view that the ocular autonomic system may be affected without any visible clinical pathology in the eye.

Professional freedom of government leprosy personnel.

Background: Government employment in India is known for its lack of flexibility. We studied whether this also involved professional freedom among health personnel working for the National Leprosy Eradication Programme.

Methods: The sample population consisted of National Leprosy Eradication Programme employees from Tamil Nadu and Andhra Pradesh and 8 health professional groups.

Incidence of late lepra reaction among multibacillary leprosy patients after MDT.

Multidrug therapy (MDT) recommended by the World Health Organization (WHO) had been administered in 1982 to a cohort of multibacillary (MB) leprosy patients. Treatment was administered for a minimum period of 2 years or until skin-smear negativity for acid-fast bacilli was achieved (whichever was later). Among 980 MB leprosy patients who completed treatment, 11 patients (1.

Quantitative assessment of the visibility of unmyelinated corneal nerves in leprosy.

Unmyelinated corneal nerves were counted in 383 leprosy patients whose eyes looked normal on clinical examination and in an equal number of healthy controls. Visibility of these nerves was decreased significantly (p < 0.01) in the nasal half of the cornea in both patients and controls.

Intraocular pressure in leprosy patients without clinically apparent anterior segment pathology.

A widely prevalent notion is that intraocular pressures are generally lower in leprosy patients than in normal individuals. Applanation intraocular pressures were recorded in one hundred sixty-six leprosy patients who had no clinically visible anterior segment pathology and in one hundred and eleven healthy controls. Mean (SD) intraocular pressures in leprosy patients (13.

Understanding the attitude of multidisciplinary teams working in leprosy.

This study investigated the attitude of health personnel who were working for the National Leprosy Eradication Programme (NLEP) in India to their leprosy patients. These personnel were studied individually and as homogeneous groups so that comparisons were possible within and among the groups, and between the groups in different regions who were conducting similar health programmes, with a difference in length of between 1 and 5 years. The sample population was the NLEP employees of 2 state governments, consisting of 8 health professional groups.

Impact of multidrug therapy on health personnel in their level of job satisfaction.

This study examines the "service" factors of the health professionals working in the National Leprosy Eradication Programme (NLEP) resulting from the introduction of multidrug therapy (MDT) technology, and their impact on their job satisfaction. The findings show that both among physicians and paramedicals, the significant chemotherapeutic dissatisfaction observed before the introduction of multidrug therapy has been replaced by a moderately positive satisfaction. This was much higher than the other incentives like pay, promotional prospect and job significance within NLEP and the community.

Relationship problems between doctors and paramedical professionals working in leprosy with reference to a possible solution.

An empirical investigation was conducted on the in-group dynamics of health personnel working in leprosy. The sample populations were taken from the National Leprosy Eradication Programme (NLEP) employees of two state governments in India. They consisted of 21 doctors and 335 paramedicals, the former constituting a formal group and the latter a semiformal group.

Transmission of health information on leprosy from children to their families: another approach to health education.

A controlled study was carried out in the North Arcot District of Tamil Nadu, South India to determine whether health information given to schoolchildren would influence the knowledge and attitudes of their families concerning leprosy. A total of 41 children and almost all of their household members participated in the study. The study, conducted by questionnaire, involved a pre-test of knowledge and attitude about leprosy of seventh standard students and their families.

Inter- and intra-laboratory variation in the reporting of skin smears in leprosy.

This paper defines the variations in the reporting of skin smears between a base and field laboratory in a leprosy control program. Ten percent of all slides read by the field laboratory in a control area were re-read by the base laboratory. There was almost no variation in the reporting of negative slides, but a variation of 1 + was present in approximately 92% of positive slides.

Rifampin in drug-incorporated diet: effect of duration and temperature of storage. Relevance to drug-susceptibility testing in mice inoculated with M. leprae.

This paper is in two parts. Plasma concentrations of rifampin were assayed at 11 time points in 24 hr in mice fed one of three dosages of rifampin, either by gavage or by dietary incorporation. The drug-mixed diets had been stored for a maximum of 3 weeks at 4 degrees C or at room temperature (30 degrees C-35 degrees C).

Foot soaks for callosities and fissures.

A study to assess the effect of soap soaks and plain water soaks on the dry anaesthetic sole of 15 leprosy patients bearing multiple fissures and callouses is reported. A callous scraper devised by us was found effective. It is recommended that a hypotonic keratolytic solution such as toilet soap or plain water be used for soaking which has the effect of softening the keratin.

Impact of MDT on incidence rates of leprosy among household contacts. Part 1. Baseline data.

This preliminary study from Gudiyatham Taluk, the leprosy control area of the Schieffelin Leprosy Research & Training Centre, investigated the incidence rates of leprosy among household contacts during the period 1970-1985. The incidence rates of leprosy among the household contacts prior to and during the initiation of multi-drug therapy are presented here. The overall incidence rate among the household contacts was 4 per 1000 person-years at risk.

Infectivity of secondary dapsone-resistant cases.

The incidence rate of leprosy among 517 household contacts of 113 cases of secondary dapsone resistance with 5074 person years at risk were studied. The incidence rate of leprosy was 4.3 per 1000 person years at risk, which is very similar to the incidence rate (4.

An evaluation of the Semmes-Weinstein 6.10 monofilament as compared with 6 nylon in leprosy patients.

In a previous study Birke and Sims (1986) identified the 5.07 (10 y) Semmes-Weinstein monofilament, as the most useful tool, in measuring protective sensation in the sole of the foot of leprosy patients. This study has demonstrated that the standard 6 Nylon being used in Karigiri, is as good as the monofilament, in assessing protective sensation in leprosy patients.

Cataract surgery on leprosy patients.

All patients who had cataract surgery at the Schieffelin Leprosy Research and Training Centre, Karigiri, India, between January 1979 and April 1985 were studied to find out the outcome of that surgery. These patients included 291 leprosy cases and 89 nonleprosy cases. Postoperative complications were slightly higher among leprosy patients compared to the nonleprosy cases.

Results of long-term domiciliary dapsone (DDS) monotherapy for lepromatous leprosy in Gudiyatham Taluk, South India.

At the Schieffelin Leprosy Research and Training Centre, Karigiri, India, data were assembled on all 58 living patients with lepromatous leprosy residing in Gudiyatham Taluk who had been registered in 1960 or earlier. They had received domiciliary oral DDS monotherapy for greater than 20 years. Fifty-one of the 58 patients were currently smear negative and clinically inactive.