Treatment compliance by leprosy out-patients and its monitoring under field condition

The widely experienced poor treatment compliance by leprosy out-patients has interfered with effective leprosy control and contributed to the problem of drug (dapsone) resistance. This paper summarises (1) the pattern of treatment compliance by rural and urban patients in a leprosy hyperendemic area, and (2) various methods to monitor the treatment compliance, especially under field conditions. Two simple methods of monitoring the dapsone intake by patients viz. "Physical verification of DDS tablets with patients" and "paper spot test", when applied together, by a field worker in the field, were found to be operationally very feasible, economical and acceptable; and had good correlation with each other. Thus these methods are recommended to be used on large scale in leprosy control programme. The paper spot test was found to be 98% reliable, when compared with DDS/Cr. ratio estimation. In addition, communities and patients be continuously educated about leprosy and its control; and for the optimal utilization of medical care services by patients, they should be organized in background of the consumers.