Since the World Health Organization (WHO) set the global goal of leprosy elimination in 2000, many countries have successfully achieved elimination. Indonesia has achieved elimination at a national level, but several provinces and areas still have a high prevalence rate. South Sulawesi is one of 6 provinces on Sulawesi Island, and 5 of these provinces still have many leprosy patients with a prevalence rate of more than 1.1 per 10,000 population and new cases are detected every year. The leprosy control program has not been successful in reducing the prevalence of this disease and 22 out of 27 regencies have, on average, a prevalence rate of 2.3 cases per 10,000 population, of which child cases account for more than 5%, indicating that there are many more leprosy cases in the community. The leprosy control program has been helped by the multi drug therapy (MDT) regimen based on the WHO recommendation and several research studies carried out in the area. However, we as yet do not have a clear idea how to eliminate leprosy in South Sulawesi and further research is required.

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Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.

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