Does the introduction of WHO-MDT influence trends in the incidence of leprosy?--the Malaŵian experience.

There has been an average annual decline in detection rates of all types of leprosy in Malaŵi of around 11.6% between 1977 and 1991. There was no obvious acceleration or slowing down of this decline following the introduction of WHO/MDT in 1983-84. Disability ratios stayed at the same level of about 11% during the 15 years covered by this paper suggesting that patients did not self-report earlier after 1983-84 which might have masked an underlying accelerated decline in detection rates. Thus it is concluded that the influence of WHO/MDT on the pattern of leprosy over a period of time, in a country like Malaŵi, is so far not noticeably different from any influence dapsone monotherapy might have had.