Raju M S, Elkana M, Failbus P, Palla J P, Hembrom U K, Rao P S
Indian J Lepr. 2016 Sep;87(4):241-248.
In order to analyse the factors of demographic as well as disease related variables and their correlation with Rate of Defaulting (ROD) from Multi Drug Therapy (MDT) among leprosy patients, secondary data have been collected from 3,579 new cases registered for MDT, during a period of 4 years from 2007 to 2010 in four leprosy hospitals/ treatment centers across the four high endemic states viz. Uttar Pradesh, Chhattisgarh; Maharashtra and Andhra Pradesh. Year wise percentage of patients defaulted was calculated on aggregate as well as with reference to each centre and cross tabulated with demographic and disease related factors. Findings show that out of the total 3,579 new cases, 1944,(54.3%) defaulted with variation across centers ranged from 44 to 66 percent. Comparison of ROD against type of leprosy indicated that MB types defaulted (55.7%) more than PB (50.6%) types, (statistically significant difference, (p=0,04). ROD of male patients across the centers ranged from 45% to 67.7% in comparison with 42.4% to 61.5% of female patients. A-statistically significant difference (p=6.04) was found between the overall ROD of males (56.35%) and females (51.47%). The ROD among those with more severe disabilities (WHO Gr-2) ranged between 44% to 67.5% across the centers, while the same among those'with less severe disabilities (Gr-0&1) ranged from 42.6 to 72.7 percent. Comparison of ROD against severity of disability was found statistically significant only across 2 centers. No statistically significant variation was found when ROD of adult patients with refeince to each centr ranged between (43.6% to 65.4%) was compared with the same of children ranged beeIen (36.2% to 69.3%). Across each of these categories and centers,'the ROD remained consistent over the ,4 years. Based on the above findings'this may be concluded that male sex and MB types are significant correlates of default from treatment. Severity of disabilities plays significant role only in certain areas, probably due to other interfering factors, which needs to be further investiged.
为了分析麻风病患者的人口统计学因素、疾病相关变量及其与多药联合治疗（MDT）违约率（ROD）的相关性，我们收集了2007年至2010年这4年间，在北方邦、恰蒂斯加尔邦、马哈拉施特拉邦和安得拉邦这四个麻风病高发邦的四家麻风病医院/治疗中心登记接受MDT治疗的3579例新病例的二手数据。按年份计算了患者违约的总体百分比以及各中心的违约百分比，并与人口统计学和疾病相关因素进行交叉制表。研究结果显示，在总共3579例新病例中，有1944例（54.3%）违约，各中心的违约率在44%至66%之间。将ROD与麻风病类型进行比较表明，多菌型（MB）的违约率（55.7%）高于少菌型（PB）（50.6%），（差异具有统计学意义，（p = 0.04）。各中心男性患者的ROD在45%至67.7%之间，而女性患者的ROD在42.4%至61.5%之间。男性（56.35%）和女性（51.47%）的总体ROD之间存在统计学显著差异（p = 0.04）。残疾程度较重（世界卫生组织二级）的患者各中心的ROD在44%至67.5%之间，而残疾程度较轻（0级和1级）的患者的ROD在42.6%至72.7%之间。将ROD与残疾严重程度进行比较，仅在2个中心发现有统计学显著差异。将各中心成年患者（43.6%至65.4%）的ROD与儿童患者（36.2%至69.3%）的ROD进行比较时，未发现统计学显著差异。在这些类别和中心中，4年期间ROD保持一致。基于上述研究结果，可以得出结论，男性和多菌型是治疗违约的重要相关因素。残疾严重程度仅在某些地区起重要作用，可能是由于其他干扰因素，这需要进一步调查。
