Courtright P, Hu L F, Li H Y, Lewallen S
International Centre for Eye Health, London.
Int J Epidemiol. 1994 Aug;23(4):835-42. doi: 10.1093/ije/23.4.835.
Factors associated with leprosy-related eye disease in a multidrug therapy (MDT) treated population in China were assessed to determine if status prior to inclusion in the MDT programme (newly diagnosed leprosy patient or leprosy patient on prior dapsone monotherapy) contributed to the prevalence of ocular pathology.
Trained leprosy paramedical workers in Sichuan Province examined 974 leprosy patients in a standardized fashion. Univariate analyses and multiple logistic regression were used to assess the contribution of demographic and clinical parameters to leprosy-related eye disease.
In both groups (prior dapsone and new MDT) leprosy-related eye disease was associated with a longer distance to leprosy health worker or health centre. Among patients with a history of prior dapsone monotherapy, age and duration on dapsone monotherapy were also associated with leprosy-related ocular morbidity. Among newly diagnosed leprosy patients the prevalence of ocular morbidity remained between 8% and 11% regardless of when the patient started MDT.
Our findings suggest that, even when case detection is good, ocular pathology will still occur in MDT treated leprosy patients. There remains an important role for health workers in the prevention of ocular morbidity. Our data also demonstrated that pooling of results from all patients (newly diagnosed and on prior dapsone monotherapy) in a leprosy control programme will likely give rise to inadequate estimates of risk of ocular disease due to variable clinical disease histories in these groups.
对中国接受多药联合化疗（MDT）治疗的麻风病患者人群中与麻风病相关眼病的影响因素进行评估，以确定纳入MDT项目之前的状态（新诊断的麻风病患者或先前接受氨苯砜单药治疗的麻风病患者）是否会导致眼部病变的发生率。
四川省经过培训的麻风病辅助医务人员以标准化方式对974名麻风病患者进行了检查。采用单因素分析和多因素逻辑回归来评估人口统计学和临床参数对麻风病相关眼病的影响。
在两组患者（先前接受氨苯砜治疗组和新接受MDT组）中，与麻风病相关的眼病均与到麻风病防治人员或防治中心的距离较远有关。在有氨苯砜单药治疗史的患者中，年龄和氨苯砜单药治疗的持续时间也与麻风病相关的眼部发病率有关。在新诊断的麻风病患者中，无论患者何时开始接受MDT治疗，眼部发病率均保持在8%至11%之间。
我们的研究结果表明，即使病例发现情况良好，接受MDT治疗的麻风病患者仍会出现眼部病变。卫生工作者在预防眼部疾病方面仍发挥着重要作用。我们的数据还表明，在麻风病控制项目中汇总所有患者（新诊断患者和先前接受氨苯砜单药治疗的患者）的结果，可能会因这些组中临床疾病史的差异而导致对眼部疾病风险的估计不足。
