Leprosy Mailing List – February 2, 2015
Ref.: (LML) How efficacious is MDT?
From: CR Revankar, New Jersey, USA
Dear Dr.Pieter,
Thanks for continuing discussion on Relapse and efficacy of MDT in leprosy.
I am trying to analyse this interesting topic in the following ways ultimately to (i) interrupt transmission (ii) no morbidity and disability
1) Public health perspective: Evidence so far reported in terms of curing more than 13 million leprosy cases (PB and MB) with MDT indicates the efficacy of MDT. Relapses are being reported by the programmes though the reporting may not be complete.
2) Clinical perspective: Careful and intensive field surveillance of all treated cases with MDT is identifying relapses ( both MB and PB) wherever it is being practiced. Or where treated cases report themselves with new lesions/reactivation of the old lesions. Such cases are investigated/retreated.
3) Research perspective: Clinical and laboratory research centers are investigating carefully and reporting relapses with drug resistance/sensitivity to MDT drugs.
In any given public health programme( whether treatment based / vaccine based/combined one/ environmental based) , a certain percentage of failure rate( in terms of deaths/relapse/disability) is accepted until we reach a final stage : eradicating the disease.
What is needed is that public health programme experts, clinicians and research scientists join hands to address the remaining challenges in leprosy so that we will be able to move forward.
By joining hands, we have achieved smallpox eradication. Polio and guinea worm are on the way of eradication globally. Yaws is the next one.
Dr.CR Revankar
Independent Consultant
Leprosy and other Neglected Tropical Diseases
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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