Orege P A, Obura M, Okelo C, Okuku P, Makokha S, Nyawalo J
Alupe Leprosy and Skin Disease Research Centre, Busia, Kenya.
East Afr Med J. 1990 Sep;67(9):632-9.
A prospective study is being undertaken in Western Kenya to evaluate the effectiveness and tolerability of WHO-MDT, while at the same time comparing it to a modified multidrug regimen, which is rifampicin 1500mg at the onset supervised, and repeated after 3 months and dapsone 100mg daily for 6 months. Preliminary analysis done on 127 cases admitted into the study are presented. The inactivity index observed between 0-12 weeks was 20% for WHO-MDT and 47% for modified-MDT (p less than 0.01). The inactivity index observed between 0-24 weeks was 63.3% for WHO-MDT and 82.3% for modified-MDT (p less than 0.05). The inactivity index observed between 0-32 weeks was 83% for WHO-MDT, and 88% for modified-MDT. Type 1 reaction was noted in 23.3% on those on WHO-MDT, and 20.3% on those cases on modified-MDT (p greater than 0.1). Compliance rate was 93.8% for those on WHO-MDT and 95.2% on those on modified MDT. All regimens were well tolerated. These preliminary results indicate that MDT is effective in treatment of paucibacillary leprosy, and also that clinical cure can be achieved in much shorter duration, particularly with higher dosage of rifampicin.
在肯尼亚西部正在进行一项前瞻性研究，以评估世界卫生组织多药联合化疗方案（WHO-MDT）的有效性和耐受性，同时将其与一种改良的多药疗法进行比较，改良疗法为开始时监督服用利福平1500mg，并在3个月后重复给药，氨苯砜每日100mg，服用6个月。本文展示了对纳入该研究的127例病例进行的初步分析。观察到WHO-MDT在0至12周之间的无反应指数为20%，改良MDT为47%（p小于0.01）。WHO-MDT在0至24周之间观察到的无反应指数为63.3%，改良MDT为82.3%（p小于0.05）。WHO-MDT在0至32周之间观察到的无反应指数为83%，改良MDT为88%。WHO-MDT组有23.3%出现1型反应，改良MDT组有20.3%出现1型反应（p大于0.1）。WHO-MDT组的依从率为93.8%，改良MDT组为95.2%。所有治疗方案耐受性良好。这些初步结果表明，多药联合化疗方案对少菌型麻风病有效，而且可以在更短的时间内实现临床治愈，特别是使用更高剂量的利福平。
