Boerrigter G, Ponnighaus J M, Fine P E
LEPRA Control Project, Lilongwe, Malawi.
Int J Lepr Other Mycobact Dis. 1988 Sep;56(3):408-17.
A study was undertaken within the framework of the LEPRA Evaluation Project and the LEPRA Control Project in Malawi (Central Africa) to study the incidence rates of type 1 reactions and of relapses in paucibacillary leprosy patients treated with the current World Health Organization-recommended multiple drug regimen (WHO/MDT). Of 503 patients recruited into the study, 488 were reviewed at the end of treatment and 480 have now been followed for 1 year after completion of treatment. At the end of treatment the skin lesions had completely disappeared in 27.4%, but were judged to be still active in 4.3%. During the follow-up period two patients were found with new active skin lesions, giving a relapse rate of 4.17 (2 of 480) per 1000 person years during the first year after completion of WHO/MDT (95% confidence interval 1.14 to 15.06 per 1000 person years). The incidence rate of marked type 1 reaction (renewed inflammation in previously inactive lesions) during the first year after completion of WHO/MDT was 47.8 per 1000 person years in self-reporting patients but zero in patients identified by active case finding. Data are presented which suggest that the incidence rate of late type 1 reactions is closely related to the classification and stage of the disease at detection.
在非洲中部马拉维的麻风病评估项目和麻风病防治项目框架内开展了一项研究，以调查采用世界卫生组织目前推荐的多药联合化疗方案（WHO/MDT）治疗的少菌型麻风病患者中1型反应和复发的发生率。在纳入该研究的503例患者中，488例在治疗结束时接受了复查，480例在治疗完成后已随访1年。治疗结束时，27.4%的患者皮肤损害完全消失，但4.3%的患者被判定仍有活动性损害。在随访期间，发现2例患者出现新的活动性皮肤损害，在世卫组织多药联合化疗完成后的第一年，复发率为每1000人年4.17例（480例中有2例）（95%可信区间为每1000人年1.14至15.06例）。在完成WHO/MDT后的第一年，自我报告患者中明显1型反应（先前无活动性损害处再次出现炎症）的发生率为每1000人年47.8例，而主动病例发现所识别的患者中发生率为零。所提供的数据表明，迟发性1型反应的发生率与疾病发现时的分类和阶段密切相关。
