Risk of relapse among non-lepromatous patients released from treatment after dapsone monotherapy

Abstract

Information on 14,625 non-lepromatous patients released from treatment after dapsone monotherapy and fo llowed up to a maximum of 15 years at the ILEP project, Dharmapuri, India, was analysed to study the pattern of relapses. The overall relapse rate was 5/1000 person years. Males had a higher relapse rate than fe males. The risk of relapse increased with age, number oflesions and duration of treatment. The risk for relapse remained constant over several years after release from treatment. Even though the absolute risk for relapse after MDT may be different, the pattern of relapses and the fa ctors affecting it may be similar to what has been shown in this study. With the introduction of multidrug therapy the prevalence of leprosy cases requiring treatment has reduced in many endemic districts of India. Paucibacillary cases are being maintained under surveillance for 2 years after treatment, for the early diagnosis of treatment fa ilures, relapses and reactions. There are also a large number of non lepromatous patients who have been released from treatment after dapsone mono therapy. At present there is very little information on their long term risk for relapse. Further, identification of factors which modify the risk for relapse fo llowing dapsone monotherapy, may facilitate the planning ' of fo llow-up procedures for patients released after MDT. With this in view a historical cohort study was carried out at the ILEP Leprosy Control project at Dharmapuri, Tamil Nadu, India, to measure the relapse rates among non-lepromatous patients treated with dapsone monotherapy and fa ctors affecting the risk for relapse.

Leprosy Classification, Clinical Features, Epidemiology, and Host Immunological Responses: Failure of Eradication in 2023

“…The first skin lesion to appear is usually a small- to medium-sized hypopigmented patch situated mostly on the thigh and face, having vague edges with some loss of sensation [ 52 , 53 ]. As the disease progresses, similar patches appear all over the body.…”