Mushtaq Sabha, Dogra Devraj, Faizi Nafis, Dogra Naina
Department of Dermatology, Venereology and Leprology, Government Medical College, Jammu, Jammu and Kashmir, India.
Department of Community Medicine, Jawahar Lal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India.
Indian Dermatol Online J. 2020 May 10;11(3):355-360. doi: 10.4103/idoj.IDOJ_393_19. eCollection 2020 May-Jun.
The focus of leprosy control programs worldwide today is the WHO multidrug therapy which adequately cures the disease. Incomplete treatment puts not only the patient but the entire community at risk which may further jeopardize the leprosy control program.
To study the magnitude of treatment default among leprosy patients, its trend in the last 10 years, and association with clinicodemographic variables.
This was a retrospective study conducted at the urban leprosy center (ULC) attached to the dermatology department of a tertiary care centre. Data were obtained from the standard leprosy cards maintained at ULC from 2005-14. The following data were collected from the preformatted cards: age, gender, residence, occupation, type of leprosy, treatment, time of default, and so on and analyzed to see the association of defaulter status with sociodemographic and disease-related variables.
In a total of 743 cases, the rate of treatment default was 39.3%. The default status was found to have decreased significantly over the years from 2005-14 ( = 0.03). Majority of the treatment defaulters were migrants (47.9%) as compared with natives (29.7%) ( < 0.001). Regardless of the residential status, treatment default was more in pure neuritic (58.5%) and tuberculoid type (40.7%) as compared with others ( < 0.001). Smear negative cases (40.0%) were more likely to default than smear-positive cases (31.4%) ( < 0.001). Rate of defaulting was more among patients in the district where ULC was located than in the districts away from ULC ( = 0.017).
Though the study period witnessed an overall decreasing trend over the 10-year period, treatment default remains a major concern in leprosy. Adherence to treatment is central to the success of leprosy control programs and therefore the factors associated with defaulting from treatment need to be addressed.
当今全球麻风病防治项目的重点是世界卫生组织的多药疗法，该疗法能有效治愈该病。治疗不彻底不仅会使患者，还会使整个社区面临风险，这可能会进一步危及麻风病防治项目。
研究麻风病患者中治疗中断的程度、过去10年的趋势以及与临床人口统计学变量的关联。
这是一项在一家三级医疗中心皮肤科附属的城市麻风病中心（ULC）进行的回顾性研究。数据来自2005年至2014年ULC保存的标准麻风病卡片。从预先格式化的卡片中收集了以下数据：年龄、性别、居住地、职业、麻风病类型、治疗情况、中断时间等，并进行分析以观察治疗中断状态与社会人口统计学和疾病相关变量的关联。
在总共743例病例中，治疗中断率为39.3%。发现2005年至2014年期间，治疗中断状态显著下降（P = 0.03）。与本地人（29.7%）相比，大多数治疗中断者是移民（47.9%）（P < 0.001）。无论居住状况如何，与其他类型相比，纯神经炎型（占58.5%）和结核样型（占40.7%）的治疗中断情况更多（P < 0.001）。涂片阴性病例（占40.0%）比涂片阳性病例（占31.4%）更有可能中断治疗（P < 0.001）。ULC所在地区的患者中断治疗率高于远离ULC的地区（P = 0.017）。
尽管在研究期间的10年里总体呈下降趋势，但治疗中断仍是麻风病防治中的一个主要问题。坚持治疗是麻风病防治项目成功的关键，因此需要解决与治疗中断相关的因素。
