Relapses in multibacillary leprosy patients: A retrospective cohort of 11 years in Colombia

Guerrero-Guerrero, Martha; Muvdi-Arenas, Sandra; León-Franco, Clara Inés

doi:10.47276/lr.83.3.247

Cited by 18 publications

(22 citation statements)

References 19 publications

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“…The probability of relapse in the first five years of follow-up observed in our study was much lower than a retrospective cohort study conducted in Columbia. The higher probability of relapse reported in that study could be due to retrospective study design, target patients (MB), higher exclusion (70.4%) and relapse (67 per 1000 PY) rates [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Low risk of relapse and deformity among leprosy patients who completed multi-drug therapy regimen from 2005 to 2010: A cohort study from four districts in South India

et al. 2021

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Introduction Relapse of leprosy among patients released from treatment (RFT) is an indicator of the success of anti-leprosy treatment. Due to inadequate follow-up, relapse in leprosy patients after RFT is not systematically documented in India. Relapsed leprosy patients pose a risk in the transmission of leprosy bacilli. We determined the incidence of relapse and deformity among the patients RFT from the leprosy control programme in four districts in South India. Methods We conducted two follow-up surveys in 2012 and 2014 among the leprosy patients RFT between 2005 and 2010. We assessed them for any symptoms or signs of relapse, persistence and deformity. We collected slit skin samples (SSS) for smear examination. We calculated overall incidence of relapse and deformity per 1000 person-years (PY) with 95% confidence intervals (CI) and cumulative risk of relapse. Results Overall, we identified 69 relapse events, 58 and 11, during the first and second follow-up surveys, respectively. The incidence of relapse was 5.42 per 1000 PY, which declined over the years after RFT. The cumulative risk of relapse was 2.24%. The rate of deformity among the relapsed patients was 30.9%. The overall incidence of deformity was 1.65 per 1000 person years. The duration of M. leprae detection in smears ranged between 2.38 and 7.67 years. Conclusions Low relapse and deformity rates in leprosy RFT patients are indicative of treatment effectiveness. However, a higher proportion of detection of deformity among relapsed cases is a cause for concern. Periodic follow-up of RFT patients for up to 3 years to detect relapses early and ensure appropriate treatment will minimize the development of deformity among relapsed patients.

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Section: Discussionmentioning

confidence: 99%

Low risk of relapse and deformity among leprosy patients who completed multi-drug therapy regimen from 2005 to 2010: A cohort study from four districts in South India

et al. 2021

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“…However, there has been much debate about the real impact of this reduction, given that the numbers of new cases continue to be high in endemic countries (Guerrero-Guerrero et al, 2012;Balagon et al, 2009) and that many studies have found high relapse rates (Girdhar et al, 2000;Gelber et al, 2004;Cellona et al, 2003). These data place doubt on the real effectiveness of the disease control program and MDT regimen.…”

Section: Introductionmentioning

confidence: 99%

Leprosy Relapse: A Retrospective Study on Epidemiologic, Clinical, and Therapeutic Aspects at a Brazilian Referral Center

Nascimento

Santos

Antunes

et al. 2022

International Journal of Infectious Diseases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Estas diferenças poderão ser justificadas por diversos factores como: localização geográfica, esquema terapêutico efectuado e respectiva duração, adesão à terapêutica, formas clínicas estudadas, índice bacilar prévio, variações na definição de recidiva e tempo de seguimento. 4,9,11,14 No nosso estudo, apesar do número limitado de doentes, concordante com uma maioria de casos importados e com ausência de casos autóctones, a frequência calculada foi de 4,5%, superior à reportada pela maioria dos estudos. [28][29][30][31] Todos os casos corresponderam a recidiva da forma borderline lepromatosa, num período inferior a 24 meses após interrupção da terapêutica.…”

Section: Discussionunclassified

“…1,2,5,6 A eficácia da terapêutica com múltiplos fármacos, de acordo com o esquema proposto pela OMS, em 1982 é inegável. [7][8][9][10] A taxa de recidiva na doença de Hansen diminuiu consideravelmente, comparando com o observado em doentes sob monoterapia crónica com dapsona, esquema igualmente associado a maior frequência de resistências. 1,4,11 Com as actuais recomendações terapêuticas (Tabela 1), a taxa de recidiva, da doença de Hansen é baixa: 0,77% para as formas multibacilares e 1,07% para as formas paucibacilares, segundo a OMS.…”

Section: Introductionunclassified

Recidiva Na Doença De Hansen - Estudo Retrospectivo E Descritivo De 5 Anos

Pires

Oliveira

Cardoso

2016

SPDV

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Introdução: A recidiva na doença de Hansen refere-se ao aparecimento de novos sinais e sintomas em doentes com diagnóstico prévio e que completaram o esquema de tratamento proposto pela OMS.Objectivos: Determinar e caracterizar os casos de recidiva da doença de Hansen num período de 5 anos (2008-2012), na consulta de doença de Hansen do Hospital Curry Cabral.Material e Métodos: Realizou-se um estudo retrospectivo e descritivo, através da consulta dos processos clínicos, com identificação dos casos num total de 89 doentes observados na consulta no referido período. O tempo mínimo de seguimento foi de 6 meses. Em todos os casos, a suspeita clínica de recidiva foi confirmada por baciloscopias e exame histopatológico.Resultados: Foram identificados 4 casos de recidiva, o que correspondeu a 4,5% do total dos doentes observados, todos com diagnóstico prévio da forma clínica borderline lepromatosa, de acordo com a classificação de Ridley-Jopling. Foi instituída terapêutica para as formas multibacilares de acordo com esquema OMS em todos os casos. As recidivas ocorreram num período de seguimento entre 7 e 16 meses após interrupção do tratamento.Discussão: A frequência da recidiva da doença na população de doentes foi superior à observada na maioria dos estudos. Verificou-se incumprimento da terapêutica em todos os doentes, admitida como causa de recidiva, excluídos outros factores. Destacamos a importância do acompanhamento regular dos doentes em tratamento, permitindo assegurar a adesão à terapêutica e a sua eficácia.

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Relapses in multibacillary leprosy patients: A retrospective cohort of 11 years in Colombia

Cited by 18 publications

References 19 publications

Low risk of relapse and deformity among leprosy patients who completed multi-drug therapy regimen from 2005 to 2010: A cohort study from four districts in South India

Low risk of relapse and deformity among leprosy patients who completed multi-drug therapy regimen from 2005 to 2010: A cohort study from four districts in South India

Leprosy Relapse: A Retrospective Study on Epidemiologic, Clinical, and Therapeutic Aspects at a Brazilian Referral Center

Recidiva Na Doença De Hansen - Estudo Retrospectivo E Descritivo De 5 Anos

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