World Health Organization : Technical Report Series, No. 675: Chemolherapy of Leprosy for Control Programmes

By R. B. Adiga

Book Id: WPLBN0000175893
Format Type: PDF eBook:
File Size: 1.38 MB
Reproduction Date: 2005

Title:	World Health Organization : Technical Report Series, No. 675: Chemolherapy of Leprosy for Control Programmes
Author:	R. B. Adiga
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago B. Adig, B. R. (n.d.). World Health Organization : Technical Report Series, No. 675. Retrieved from http://gutenberg.cc/

Description
Medical Reference Publication

Excerpt
A WHO Study Group on Chemotherapy of Leprosy for Control Programmes met in Geneva from 12 to 16 October 1981. The objectives of the meeting were: (1) to review information collected since 1976 (the year when the WHO Expert Committee on Leprosy last met) on the problems related to chemotherapy and chemotherapeutic regimens of leprosy; (2) to recommend, for use in leprosy control programmes, appropriate multidrug regimens for multibacillary cases including new, treated, and drug-resistant cases, whether clinically suspected or proved; (3) to recommend regimens for paucibacillary cases; and (4) to identify further research needs in the clinical and operational aspects of chemotherapy of leprosy. The meeting was opened by Dr A. Zahra, Director, Division of Communicable Diseases, on behalf of the Director-General. He noted that leprosy control programmes were at an important cross-road in the containment of leprosy: particularly in the context of attaining the objective of health for all by the year 2000. There had recently been a revival of interest in leprosy control and a definite commitment had been made by governments, through resolutions they had adopted in the World Health Assembly, to contain this ancient scourge. While progress had been made in expanding leprosy control programmes, the twin constraints of dapsone resistance and bacterial persistence were causing serious operational problems and a feeling of uncertainty regarding the future of leprosy control programmes. There was therefore an urgent and imperative need for recommendations on globally applicable therapeutic regmens based on research efforts from all over the world and on the operational and logistic constraints in the field.

Table of Contents
CONTENTS Page Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 1 . Theproblem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 1.1 Dapsone resistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 1.2 Secondary dapsone resistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 1.3 Primary dapsone resistance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1.4 Secondary resistance to other bactericidal antileprosy drugs . . . . . . . . . . . 14 1.5 Persistence of M. . leprae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 1.6 Difficulties in implementing the therapy recommended in the fifth report of the \IrHO Expert Committee on Leprosy . . . . . . . . . . . . . . . . . . . . . . . . . 16 1.7 The present situation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 2 . Drugs for multidrug regimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 2.1 Dapsone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 2.2 Rifampicin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 2.3 Clofazimine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 2.4 Ethionamide and protionamide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 3 . Recommended chemotherapeutic regimens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 3.1 Treatment of multibacillary leprosy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 3.2 Treatment of paucibacillary leprosy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24 4 . Operational aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.1 Case detection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2 Laboratory facilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.3 Drug delivery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.4 Medicalcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.5 Records and follow-up . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.6 Health education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.7 Equipment and drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.8 Manpower and financial resources .................... 4.9 Planning and evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.10 Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 . Research needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32