Leprosy Mailing Leprosy Mailing List – September 16, 2016
Ref.: (LML) A Dual Crisis: The Chemotherapy of MB Leprosy and Leprosy Control
From: Tarun Narang, Chandigarh, India
Dear Pieter,
I agree with Robert Gelber (LML, September 15, 2016). We are facing the same problem. We are getting patients who relapse within 1-2 years of completing MDT.
We are also seeing a subset of patients who are non-responsive to MDT. They continue to develop new lesions, while on MDT, HAVE RECURRENT or chronic Type 2 reactions, and have high Morphological index despite 12-24 months of MDT. However, these patients respond very well to the alternative regime of Rifampicin, ofloxacine and minocycline. And their morphological index becomes zero within 3 months of alternative regime. The recurrent ENL or persistent ENL also responds and they are off steroids by 1st year of treatment.
I quote the lines from your paper that instead of Chemotherapy of Leprosy for Control Programmes we require as a tool to eliminate leprosy a more robust chemo-therapy regime because these patients are a serious threat to the elimination of leprosy.
Regards
Tarun Narang M.D
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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