Leprosy Mailing List – December 1, 2015
Ref.: (LML) Draft WHO Leprosy Strategy 2016-2020
From: Diana Lockwood, London, UK
Dear Pieter,
I am replying to agree with the posting of Wim Van Brakel on Nov 19 in which he noted the probl ems that may be caused by giving all patients clofazimine.
A significant number of patients will develop in generally both pigmentation in their lesions and in their skin in generally. We don’t know quite how many because it has not been measured in any of the MDT trials. However, I have treated patients in India, Ethiopia and London, who have complained about the problem. One solution is to use the single monthly rifampin in combination with ofloxacin and minocycline. We have previously highlighted the need for these combinations to be tested in randomised controlled trials, and this would be a good opportunity to do so.
I also agree with Wim that a new strategy for improving care after MDT is needed and this should be developed whatever drug treatment is being given because many patients will present with reactions even after the current drug regimens.
Diana Lockwood
Prof Tropical Medicine
London School of Hygiene & Tropical Medicine.
- SIngle monthly ROM for all. Lep Rev 2012. Lockwood, da Cunha.
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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