Summary This study was carried out to assess the role PGL-l antibodies may have to play in assisting with early diagnosis in close contacts of leprosy patients. Blood samples were collected from patients and contacts. It was found that 6·9% of index cases and 1 % of healthy contacts were positive for PGL-l antibody. None of the healthy contacts developed clinical leprosy and all had become seronegative at fo llow-up. We conclude that screening for PGL-l antibodies has a limited role in the screening of healthy contacts and may not be of use in low endemic areas.

The serological responses to 2 Mycobacterium leprae specific epitopes and one common mycobacterial antigen were examined in 46 untreated patients with primary neuritic (PN) leprosy. M. leprae specific antibodies to the terminal disaccharide of phenolic glycolipid and/or the ML-04 defined epitope on the 35 kDa protein were detected in 41% of PN patients and 47% responded to one of the 3 antigens. This serological response mirrored that observed in paucibacillary leprosy patients. There was a significant increase in the level of antibody response when more nerve trunks were involved. Changes in antibody levels in seropositive PN patients may prove useful in monitoring the response to chemotherapy.

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The self administration of dapsone by Nepali leprosy patients receiving multidrug therapy was assessed by a colorimetric and a filter paper spot test. Overall 45 out of 337 (13.3%) patients were found to be non-compliant. The relation of non-compliance to sex, age, leprosy classification, therapy type and length of therapy was investigated. The spot test was compared with the colorimetric assay and found to have a relative sensitivity of 99.3% and specificity of 95.4%. Follow up of patients was successful in that two-thirds of non-compliant patients were compliant on their follow-up test.