Leprosy Mailing List – September 18, 2016
Ref.: (LML) A Dual Crisis: The Chemotherapy of MB Leprosy and Leprosy Control
From: Grace Warren, Sidney, Australia
Dear Pieter,
Very interested in the letters you have been showing recently. It is the same old problems - recurrent reactions and a return of clinical lesions several years after the cessation of official MB or PB therapy. I am afraid but think that the 6 and 12 month total dosage is not adequate, as I was very disturbed by those who returned after many years with obvious relapse (or was it reinfection?). I am glad surveys are now being made, in areas where very little real survey work had been done before. I was visiting and working in some areas for over 40 years!!
I have experienced that for many years, and just wish to say that I found that clofazamine is an excellent drug for these problem patients. Many patients referred to me had already had the official WHO routine treatments but who knows how regular they were?? I am aware that many patients do not like clofazamine especially if they are light skinned and have face patches but if they are serious about recovering they will usually comply. I found that many or the problem patients did very well on clofazamine, alone till I got them controlled – if they had definite ENL I would even give 300mgms daily for a short period and then slowly grade it off. Of course ensured treating associated problems like malaria, anemia, intestinal parasites and TB. In some areas I found that routine MDT 3 drugs initially did produce problems of reaction so often we started with Clofazamine alone and then added the others after a few months.,
This became my practice about the 1980s - but continued to be effective till early this century. I no longer travel overseas so have little idea of what is happening now. May be I am biased as I was part of the initial drug trials for clofazamine in the mid-1960s, when I worked with Dr Stanley Browne.! But am surprised how little I hear of the use of clofazamine today. But as I suspect this will be in the discussions at the conference I wished to throw out what could be a forgotten method of care. Of coursed one of the advantages is the fact that we rarely see resistance to clofazamine (or maybe I ought to say we rarely saw the resistance - does it occur today?)
I would love to be at the conference - but no matter - I can still help the problem, via this computer.
Greetings to everyone and especially those I have worked with over the years past.
Yours sincerely,
Grace Warren
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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