Cartel J L, Spiegel A, Nguyen Ngoc L, Moulia-Pelat J P, Martin P M, Grosset J H
Institut Territorial de Recherches Medicales Louis Malarde, Tahiti, Polynesie Française.
Lepr Rev. 1992 Sep;63(3):223-30. doi: 10.5935/0305-7518.19920027.
In 1982, following the recommendations of a WHO study group, multidrug therapy (MDT) was introduced into French Polynesia to treat all patients suffering from active leprosy, and--only on request--those still on dapsone monotherapy. After 5 years, a clear-cut decrease of prevalence and mean annual detection rates for leprosy (except for detection rates among children aged less than 15 years, many of such cases being detected early by increased household contact training) has been observed. There was also a decrease in the proportion of newly detected cases with disabilities. During the 21-year period preceding the introduction of MDT into the control programme, mean annual detection rates for leprosy had remained stable, and this led to the consideration that such a decrease was due neither to the natural decline of the disease nor to the economic improvement of the country. Our results, together with the fact that, to date, the relapse rate was nil in the Polynesian patients put on MDT, strongly suggest that the implementation of MDT has resulted in a decrease of detection rates for leprosy which may be a consequence of a decrease in the transmission of the disease.
1982年，根据世界卫生组织一个研究小组的建议，法属波利尼西亚采用了多药疗法（MDT）来治疗所有活动性麻风病患者，并应要求治疗那些仍在接受氨苯砜单药治疗的患者。5年后，观察到麻风病的患病率和平均年发现率明显下降（15岁以下儿童的发现率除外，其中许多病例是通过加强家庭接触培训而早期发现的）。新发现的有残疾病例的比例也有所下降。在将多药疗法引入控制项目之前的21年期间，麻风病的平均年发现率一直保持稳定，因此人们认为这种下降既不是由于疾病的自然衰退，也不是由于该国经济的改善。我们的研究结果，以及到目前为止接受多药疗法的波利尼西亚患者的复发率为零这一事实，有力地表明，实施多药疗法导致麻风病发现率下降，这可能是疾病传播减少的结果。
