Croft R P, Richardus J H, Nicholls P G, Smith W C
Leprosy Mission, Danish Bangladesh Leprosy Mission, Nilphamari, Bangladesh.
Lepr Rev. 1999 Jun;70(2):140-59. doi: 10.5935/0305-7518.19990018.
The Bangladesh Acute Nerve Damage Study (BANDS) is a prospective cohort study designed to investigate epidemiological, diagnostic, therapeutic and operational aspects of acute nerve function impairment in leprosy. The study is based at a single centre in Bangladesh, in an area with a high prevalence of leprosy. The centre, Danish Bangladesh Leprosy Mission, has a well-established vertical leprosy control programme. In this paper, the study design and methodology are described, together with definitions of nerve function impairment (NFI) used in this and subsequent papers. The study recruited 2664 new leprosy cases in a 12-month period. The male:female ratio is 1.25:1, and 17.61% of the cohort are under 15 years of age. In all, 83.33% of the cohort are paucibacillary (PB), and 16.67% multibacillary (MB). However, the MB rate amongst males is 19.72%, and amongst females is 12.85%, despite an equal period of delay to diagnosis. 55% of patients presented for treatment within 12 months of developing symptoms 6.12% of the total number of cases were smear positive, and 36.71% of the MB cases were smear positive. 9.61% of the total number of cases were graded as having World Health Organisation (WHO) disability grade 1, and 5.97% had grade 2. Amongst MB cases, 27.48% had WHO grade 1 disability present, and 18.24% had grade 2 present, compared with 6.04% and 3.51%, respectively, amongst PB cases. A total of 11.90% of the cohort had sensory NFI of any kind, and 7.39% had motor NFI. Ninety patients presented with NFI needing treatment (3.38%), and of these, 61 (67.78%) had silent NFI. MB patients had a prevalence of reaction/NFI needing treatment nearly 7 times higher than PB cases (15.32% amongst MB; 2.30% amongst PB), and males nearly double that of females (5.67% amongst males, 2.96% amongst females). The most commonly affected nerve by function impairment was the posterior tibial (sensory) with 6.46% of nerves affected (9.38% of patients), followed by the ulnar nerve with 3.23% of nerves impaired (5.56% of patients). Future research and publications, building on this foundation, will focus on the following areas: the incidence of NFI and reactive events, the risk factors for developing NFI, and the response to treatment of patients developing acute NFI.
孟加拉国急性神经损伤研究（BANDS）是一项前瞻性队列研究，旨在调查麻风病急性神经功能损害的流行病学、诊断、治疗及操作方面的情况。该研究以孟加拉国的一个单一中心为基础，位于麻风病高流行地区。该中心，即丹麦孟加拉国麻风病防治团，拥有完善的垂直麻风病控制项目。本文描述了研究设计和方法，以及本论文和后续论文中使用的神经功能损害（NFI）的定义。该研究在12个月内招募了2664例新的麻风病病例。男女比例为1.25:1，队列中17.61%的患者年龄在15岁以下。总体而言，队列中83.33%为少菌型（PB），16.67%为多菌型（MB）。然而，尽管诊断延迟时间相同，但男性中的MB率为19.72%，女性中的MB率为12.85%。55%的患者在出现症状后的12个月内接受治疗。病例总数的6.12%涂片阳性，MB病例的36.71%涂片阳性。病例总数的9.61%被评为世界卫生组织（WHO）残疾等级1级，5.97%为2级。在MB病例中，27.48%存在WHO 1级残疾，18.24%存在2级残疾，而PB病例中这一比例分别为6.04%和3.51%。队列中共有11.90%的患者存在任何类型的感觉性NFI，7.39%存在运动性NFI。90例患者出现需要治疗的NFI（3.38%），其中61例（67.78%）为无症状性NFI。MB患者发生反应/NFI需要治疗的患病率几乎是PB病例的7倍（MB中为15.32%；PB中为2.30%），男性患病率几乎是女性的两倍（男性中为5.67%，女性中为2.96%）。功能损害最常累及的神经是胫后神经（感觉），6.46%的神经受累（9.38%的患者），其次是尺神经，3.23%的神经受损（5.56%的患者）。基于这一基础的未来研究和出版物将聚焦于以下领域：NFI和反应性事件的发生率、发生NFI的危险因素以及急性NFI患者的治疗反应。
