Ali M K Showkath, Thorat D M, Subramanian M, Parthasarathy G, Selvaraj U, Prabhakar V
Division of Epidemiology and Statistics, Central Leprosy Teaching and Research Institute (CLTRI), Chengalpattu 603 001, Tamil Nadu.
Indian J Lepr. 2005 Apr-Jun;77(2):105-15.
A retrospective analysis of data pertaining to the rural field operation area of the Central Leprosy Teaching and Research Institute, Chengalpattu, Tamil Nadu, was carried out to determine the magnitude of relapse after MDT and its significance with other variables. The study included 3248 leprosy patients who have successfully completed treatment during 1987-2003, of whom 2892 were PB and 356 MB cases. A total of 58 cases of relapse was reported which gives a crude cumulative relapse rate of 1.78% for the 16-year period of follow-up and the rates for PB and MB were 1.9% and 0.84% respectively. With respect to PB cases, 68% of relapses were reported in the first 3 years of RFT. The person-year relapse rate was highly significant with regard to the number of skin lesions (p<0.0002) and nerve involvement (p<0.0002). The person-year relapse rate did not differ significantly between PB and MB leprosy, male and female, and child and adult cases. RFT year cohort relapse rate reveals that the introduction of MB-MDT regimen for PB leprosy had resulted in the reduction of relapses among PB cases after 1998. The relapse rate with reference to the time gap after RFT reveals that relapse declines with passage of time after RFT. The risk of relapse was very low in both PB and MB leprosy which fact emphasizes that proper counselling about signs and symptoms of relapse during RFT is adequate to combat the problem. A majority of relapses occurred in the first three years after RFT. The number of skin lesions and involvement of nerves were the main risk factors for relapse.
对位于泰米尔纳德邦金奈帕图的中央麻风病教学与研究所农村实地操作区域的数据进行了回顾性分析，以确定多药联合化疗（MDT）后复发的程度及其与其他变量的关系。该研究纳入了1987年至2003年期间成功完成治疗的3248例麻风病患者，其中2892例为结核样型（PB）麻风，356例为瘤型（MB）麻风。共报告了58例复发病例，在16年的随访期内，粗累积复发率为1.78%，PB和MB的复发率分别为1.9%和0.84%。对于PB病例，68%的复发发生在反应停治疗（RFT）的前3年。按人年计算的复发率在皮肤损害数量（p<0.0002）和神经受累方面（p<0.0002）具有高度显著性。PB和MB麻风、男性和女性以及儿童和成人病例之间按人年计算的复发率没有显著差异。RFT年份队列复发率显示，1998年后，将MB-MDT方案用于PB麻风导致PB病例复发率降低。根据RFT后的时间间隔计算的复发率显示，复发率随RFT后时间的推移而下降。PB和MB麻风的复发风险都非常低，这一事实强调了在RFT期间对复发的体征和症状进行适当咨询足以应对这一问题。大多数复发发生在RFT后的头三年。皮肤损害数量和神经受累是复发的主要危险因素。
