Vijayakumaran P, Jesudasan K, Mozhi N M, Samuel J D
Branch of Epidemiology and Leprosy Control, Schieffelin Leprosy Research & Training Centre, Karigiri, South India.
Int J Lepr Other Mycobact Dis. 1998 Jun;66(2):125-30.
The multidrug therapy program with the World Health Organization (WHO)-recommended treatment (WHO/MDT) regimens has given the hope of early case detection and rendering a leprosy patient, especially a multibacillary (MB) patient, noninfectious within a short period of time. Hence, the duration of exposure for household contacts to infection is expected to be remarkably less when compared to exposure to MB leprosy patients on dapsone monotherapy. A total of 1661 household contacts of skin-smear-positive leprosy patients were recorded from 1984 to 1994. Follow up of these individuals [8403 person-years at risk (PYR)] revealed that the incidence of leprosy was 7.7 per 1000 PYR, which was 8 times more than that of the general population. The risk was more if there was a coprevalent case in the family. The incidence of leprosy declines from the third year of surveillance onward, and declines more so in children. Although disease transmission should have been arrested as soon as the index case was started on MDT, the incidence of leprosy among the household contacts was still high when compared to that of the total population. Effective intervention needs to be introduced to reduce the risk of contacts developing leprosy.
采用世界卫生组织（WHO）推荐治疗方案（WHO/MDT）的多药联合治疗计划带来了早期病例发现的希望，并有望使麻风病患者，尤其是多菌型（MB）患者在短时间内不再具有传染性。因此，与接触接受氨苯砜单药治疗的MB麻风病患者相比，家庭接触者感染的暴露时间预计会显著缩短。1984年至1994年期间，共记录了1661名皮肤涂片阳性麻风病患者的家庭接触者。对这些个体的随访[8403人年风险（PYR）]显示，麻风病发病率为每1000人年7.7例，是普通人群的8倍。如果家庭中有共同流行病例，风险会更高。麻风病发病率从监测的第三年起开始下降，在儿童中下降得更多。尽管一旦索引病例开始接受MDT治疗，疾病传播就应该被阻断，但与总人口相比，家庭接触者中的麻风病发病率仍然很高。需要引入有效的干预措施来降低接触者患麻风病的风险。
