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Problems of leprosy relapse in China
1Leprosy Unit, Beijing Tropical Medicine Research Institute, China.
Summary
Leprosy relapses increased in China despite control programs. A short multidrug therapy (MDT) course is recommended for previously treated patients to prevent future leprosy relapses.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Leprosy control in China began in 1955 using dapsone monotherapy.
- Rising relapse rates, reaching 18%-24% in endemic coastal provinces, have been observed.
- Relapses have occurred even in patients previously treated with rifampin-plus-dapsone.
Purpose of the Study:
- To analyze the trend of leprosy relapses in China.
- To evaluate the effectiveness of past treatment regimens.
- To propose strategies for preventing future leprosy relapses.
Main Methods:
- Analysis of national leprosy control program data.
- Review of reported relapse cases, including those after multidrug therapy (MDT).
- Assessment of treatment histories and diagnostic classifications.
Main Results:
- A steady increase in the proportion of leprosy relapses since 1955.
- Significant relapse rates (18%-24%) in highly endemic coastal areas.
- Limited reports of paucibacillary relapses post-MDT, often linked to initial misclassification.
Conclusions:
- Previous treatment regimens may not fully prevent relapses.
- A short course of multidrug therapy (MDT) is advised for all previously dapsone- or rifampin-plus-dapsone-treated patients.
- Regular screening for early detection and timely MDT is crucial for those not receiving prophylactic MDT.