Dapsone compliance in an urban field project

Available reports both from rural and urban leprosy centres prove beyond any doubt that dapsone is not being consumed regularly by all those who show regular clinic attendance. No reports are available from urban field projects where SET programme is being operated. In this study surprise urine samples of 294 patients of all types (smear positive 53%) mainly on dapsone monotherapy attending (1) leprosy treatment centres in slum clinics situated in the field areas adopted for SET work by Bombay Leprosy Project and (2) general hospital clinics situated predominantly outside the project area were analysed for dapsone/creatinine ratio to judge the extent of drug compliance. 201 out of 294 (68%) were regular and 82 out of 294 (28%) were irregular in consuming DDS as judged by urine examination. 67% of smear positive cases were regular. No difference was found in regularity between patients living within the project area (intensive follow up is done in this group to remind about treatment) and outside project area patients (no reminder followup is done). Similarly no difference was observed in regularity amongst the patients attending slum clinics and general hospital clinics. It could be stated that facilities for treatment offered at general hospitals or dispensaries and encouraging voluntary reporting could be quite fruitful and economical for obtaining better drug compliance in urban areas.