• Volume 70 , Number 1
  • Page: 37–8
CORRESPONDENCE

Single-dose ROM treatment tor multilesion paucibacillary leprosy-further observations

C. R. Revankar; H. O. Bulchand; V. V. Pai; R. Ganapati






To the Editor:

A single dose treatment with ROM in the single skin lesion-paucibacillary (SSL-PB) leprosy group has been well received by the leprosy control programs. A small proportion of relapses and other clinical problems have been reported (2-3). ROM single dose (ROM-1) treatment in paucibacillary patients with two to five lesions (PB 2-5) is currently under trial and the initial observations including relapses have been reported (2,3). It is necessary to record longterm follow-up of such cases before this regimen can be considered for leprosy control programs.

A treatment period cohort analysis of ROM-1-treated 335 PB (2-5) leprosy patients followed up for a period ranging from 6 months to 70 months is reported. The mean period of follow up was 2.8 years. All the clinical problems other than reactions were recorded. The reactions were noted separately. The clinical problems were mainly in the nature of new lesions, persistence of lesions and an increase in the size of the patches. All these problem cases were given steroids before they were labeled as relapses. The rate of relapse observed in this study is compared with already published relapse rates after PB-MDT. The confidence interval (CI) is calculated for all the values at 95%. Table 1 shows that 10.4% (95% CI 7.03, 13.78) of the patients presented with various clinical problems other than reactions. The relapse rate is 1.4% (95% CI 012, 2.68) or 5.3 relapses (95% CI 0.26. 1.32) per 1000 person years of follow up. The annual rate is 0.5%. Two of them were bacteriologically positive when they relapsed. One of these bacteriologically-positive patients relapsed after 26 months and the other one after 70 months. All these 5 relapses have been retreated.

 

 

The annual relapse rate (0.5%) in the ROM-1 treated PB (2-5) leprosy group is more or less comparable to the already reported annual relapse rate in the PB-MDT treated group (Table 2). This follow-up study indicated that ROM-1 dose in PB (2-5 lesion group) appears to be adequate because the relapse rate is well within acceptable limits and comparable to the PB-MDT treated group.

 

 

- C. R. Revankar
H. O. Bulchand
V. V. Pai
R. Ganapati

Bombay Leprosy Project
11, VN Purav Marg, Chunabhatti
Bombay-400022. India

 

REFERENCES

1. LI HUAN-YING, HU LU-FANG, HUANG WAN-BIAO. LIU GUP-CAI, YUAN LIAN-CHAO, JIN ZHENG, LI XIOM:. LI JIN-LAN and YANG ZMONG-MIN. Risk of relapses in leprosy after fixed duration multidrug therapy. Int. J. Lepr. 65(1997)238-245.

2. REVANKAR. C. R.. BULCHAND. H. O., P.M. V. V. and GANAPATI. R. Relapse rate in paucibacillary leprosy treated with single dose. Int. J. Lepr. 69(Supplement)(2001)S131.

3. REVANKAR, C. R., PAI, V. V., SAMY, M. S. and GANAPATI, R. Single-dose treatment for paucibacillary leprosy: Field Implications. Int. .1. Lepr. (1999) 312-314.

4. WHO LEPROSY UNIT. Risk of relapse in leprosy. Indian J. Lepr. 67(1995) 13-26.

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