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在进行4年半的多药联合治疗后,对麻风病隔离区的多菌型病例进行细菌学评估。

A bacteriological assessment of multibacillary cases in leprosy colonies after 4 1/2 years of multidrug therapy.

作者信息

Naik S S, Bhanage N D, Sawant K V, Ganapati R

机构信息

Acworth Leprosy Hospital Society for Research, Rehabilitation and Education in Leprosy, Wadala, Bombay.

出版信息

Indian J Lepr. 1988 Jul;60(3):393-9.

PMID:3058827
Abstract

In this presentation we have devised a novel way of calculating the total bacterial quantum in 100 (78 LL and 22 BL) multibacillary leprosy patients living in leprosy colonies. The calculation is based on Ridley's logarithmic scale. We have also attempted to assess the reduction in the bacterial quantum as a result of intervention through multidrug therapy (MDT). 53% of the patients rendered bacteriologically negative within two years of treatment of MDT and 94% at 54th pulse dose i.e. at 54th month. The bacterial quantum in human source as leprosy patients was calculated thus--Average BI of the group X Number of patients in each group X Multiplication factor devised as per Ridley's Bacterial Index (BI). By applying this purely arithmetic formula, it was found that 99.8% of the bacterial load is harboured in leprosy patients having BI more than 3. The introduction of MDT initiated the reduction in total bacterial quantum "based on above arithmetic scale" was achieved very fast i.e., from 100% to 5% at 12 months and to 0.4% at 24 months. We believe that if one wants to achieve leprosy control through a reduction in total bacterial quantum within a specific period, leprosy cases with BI more than 3 should be treated on priority basis.

摘要

在本报告中,我们设计了一种新颖的方法来计算生活在麻风病隔离区的100名(78名瘤型和22名界限类偏瘤型)多菌型麻风病患者体内的细菌总量。该计算基于里德利对数分级法。我们还试图评估通过多药联合化疗(MDT)进行干预后细菌总量的减少情况。53%的患者在接受MDT治疗两年内细菌学转为阴性,在第54个脉冲剂量时,即第54个月时,这一比例为94%。麻风病患者作为传染源的细菌总量计算方法如下——每组的平均细菌指数×每组患者人数×根据里德利细菌指数(BI)设计的相乘系数。通过应用这个纯算术公式,发现99.8%的细菌负荷存在于细菌指数大于3的麻风病患者体内。MDT的引入使基于上述算术分级法的细菌总量迅速减少,即在12个月时从100%降至5%,在24个月时降至0.4%。我们认为,如果想在特定时期内通过减少细菌总量来实现麻风病控制,应优先治疗细菌指数大于3的麻风病病例。

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