Pandey A, Uddin M Jamal, Patel R
Regional Leprosy Training & Research Institute (RLTRI), Raipur.
Lepr Rev. 2005 Jun;76(2):112-8.
This study compares the epidemiological pattern of leprosy in pre- (April 1986 to March 1992) and post- (April 1992 to March 2002) multi-drug therapy (MDT) periods by retrospective analysis of 3274 registered leprosy cases in the rural field area of Regional Leprosy Training & Research Institute (RLTRI), situated in Raipur district of Chattisgarh province of Central India. The area has high endemicity for leprosy. In the post-MDT period, prevalence rate (PR) came down to less than 1 in 10, while New Case Detection Rate (NCDR) remained almost static during the two periods. Of the total new registered cases, 30.1% were registered during the pre-MDT period and the remaining 69.9% during the post-MDT period. Comparison of key leprosy variables among new registered cases showed a 2-fold rise in the proportion of MB cases (14.8 versus 27.6%), 3.0% increase in proportion of child cases (15.3 versus 18.6%) and cases with deformity grade II (3.1 versus 5.9%) and 4.0% increase in female proportion (41.4 versus 45.7%) during the post-MDT period. A decline was noted in mean age of registration for both MB (6.4 years) and PB (5.7 years) groups in the post-MDT period. While comparing treatment and outcome related variables, a marked fall of 25.8 months was recorded in treatment duration in the post-MDT period. The defaulter rate came down by 45.0% and relapse rate by more than 12.0% during the same period. The study shows that MDT is effective operationally, but continued ongoing transmission of infection and delayed diagnosis needs corrective action.
本研究通过对位于印度中部恰蒂斯加尔邦赖布尔地区的区域麻风病培训与研究机构（RLTRI）农村实地地区3274例登记麻风病病例进行回顾性分析，比较了多药联合治疗（MDT）前（1986年4月至1992年3月）和后（1992年4月至2002年3月）时期麻风病的流行病学模式。该地区麻风病流行率很高。在MDT后时期，患病率降至每10人中不到1例，而新病例发现率（NCDR）在两个时期几乎保持不变。在新登记的病例总数中，30.1%是在MDT前时期登记的，其余69.9%是在MDT后时期登记的。新登记病例中关键麻风病变量的比较显示，MDT后时期MB病例比例上升了2倍（14.8%对27.6%），儿童病例比例增加了3.0%（15.3%对18.6%），II级畸形病例比例增加了3.0%（3.1%对5.9%），女性比例增加了4.0%（41.4%对45.7%）。MDT后时期，MB组（6.4岁）和PB组（5.7岁）的平均登记年龄均有所下降。在比较治疗及与结局相关的变量时，MDT后时期的治疗时长显著缩短了25.8个月。同期，违约率下降了45.0%，复发率下降了超过12.0%。该研究表明，MDT在实际操作中是有效的，但感染的持续传播和诊断延迟需要采取纠正措施。
