Bechelli L M
Faculdade de Medicina, Ribeirão Preto, University of São Paulo, Brazil.
Acta Leprol. 1989;7(1):29-36.
The paper discusses various aspects of indeterminate (I) leprosy in the initial survey undertaken in the Burma BCG trial (69,242 inhabitants), and in the annual examinations of 28,220 children in the trial followed up over periods of five to eight years. Age-specific rates in the initial mass survey are presented. In total 1914 cases were detected (6.2% I, 76% T, 16% L and 1.8% B). Among the children in the BCG trial 768 cases were detected: 255 of them had the I form and their proportion (33%) was much higher than in the population survey. Of these 255 I cases only 4.3% had a negative or doubtful lepromin reaction. Two-thirds of these 255 cases evolved to the tuberculoid pole in less than one year. No L cases appeared in the trial population until ten and eleven years after the start of the trial. It is concluded that whereas a high proportion of indeterminate cases regress spontaneously or evolve towards the T pole, the indeterminate lepromin negative cases are important in the dynamics of the disease, because a proportion of them, if untreated, tend to envolve towards the L form. This stresses the importance of detection and treatment of I cases at an early stage in an effective strategy for controlling leprosy.
本文讨论了在缅甸卡介苗试验（69242名居民）的初始调查以及对试验中28220名儿童进行的为期五至八年的年度检查中，未定类（I）麻风病的各个方面。给出了初始大规模调查中的年龄别发病率。总共检测到1914例病例（6.2%为未定类，76%为结核样型，16%为瘤型，1.8%为界线类）。在卡介苗试验的儿童中检测到768例病例：其中255例为未定类，其比例（33%）远高于人群调查中的比例。在这255例未定类病例中，只有4.3%的麻风菌素反应为阴性或可疑。这255例病例中有三分之二在不到一年的时间里转变为结核样型极型。直到试验开始后的第十年和第十一年，试验人群中才出现瘤型病例。得出的结论是，虽然高比例的未定类病例会自发消退或向结核样型极型转变，但未定类麻风菌素阴性病例在疾病动态变化中很重要，因为其中一部分如果不治疗，往往会转变为瘤型。这强调了在控制麻风病的有效策略中早期发现和治疗未定类病例的重要性。
