Global review of multidrug therapy (MDT) in leprosy.

Leprosy continues to be an important public health problem in most countries of Asia, Africa and Latin America. While there has been a steady increase in the number of registered leprosy cases from 1966 to 1985, since then there has been a substantial reduction of over 30% in the number of registered cases. This is mainly attributed to the introduction of multidrug therapy (MDT) as recommended by a WHO study group on chemotherapy of leprosy for control programmes in 1981. The coverage for MDT has steadily increased over the last 5 years, reaching a global figure of 55.7% of all registered cases by October 1990. Over 2 million leprosy patients are currently undergoing MDT and, in addition, over 1 million patients have completed MDT since 1985. MDT has been found to be generally well tolerated with a high level of acceptability leading to improved treatment compliance. MDT coverage shows wide variations among WHO regions and among individual countries. The prospects for further reductions in prevalence of registered cases in the next decade are very bright. However, problems such as early case detection, and prevention and management of disabilities after patients have been curred for several years, will continue to pose significant challenges.