Should Large Lesions of Leprosy Be Considered As “Multibacillary” for Treatment Purposes Even If the Total Number of Lesions Is Less Than Five?

Sp, Kumarasinghe; Mp, Kumarasinghe

doi:10.1489/1544-581x(2004)072<0173:sllolb>2.0.co;2

Cited by 5 publications

(2 citation statements)

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“…According to this system, which was primarily for operational use, patients with 4 5 lesions are classified as multibacillary, whereas if there are 5 lesions the classification is paucibacillary. However, counting the skin lesions has several shortcomings (Groenen et al, 1995;Talhari, 1996;Croft et al, 1998;Kumarasinghe & Kumarasinghe, 2004). First, well-trained leprosy workers (particularly in the view of integration of leprosy into general health services) are needed to conduct the clinical examination.…”

Section: Lesion Counting Systemmentioning

confidence: 99%

Classification of leprosy into multibacillary and paucibacillary groups: an analysis

Parkash

2009

FEMS Immunol Med Microbiol

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Classification of leprosy patients into multibacillary and paucibacillary determines the duration of their treatment. Misclassification leads to increased risk of relapse due to insufficient treatment if a multibacillary patient is classified as paucibacillary. This also prolongs the time the patient is infective. Over the years, the criteria used for classification (for treatment purpose) of leprosy patients have changed significantly from bacterial index measuring approach through number of skin lesions. The reliability of both of these criteria has been questioned. Several studies have shown that the presence of antibodies to the Mycobacterium leprae-specific antigens correlates with the bacterial load of a leprosy patient. Further, there are reports where results of serology and bacteriological approaches have been found to agree substantially. Thus, serology seems to be a worthwhile convenient alternative tool for classification of leprosy into multibacillary or paucibacillary. Nevertheless, in view of the limitations of various classification criteria, follow-up studies are called for to understand the efficiency of various approaches in preventing relapse after treatment. The method ensuring the lowest rate of relapse could be adopted for future use in classifying these patients.

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Section: Lesion Counting Systemmentioning

confidence: 99%

Classification of leprosy into multibacillary and paucibacillary groups: an analysis

Parkash

2009

FEMS Immunol Med Microbiol

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“…Initially treatment was recommended on the basis of slit‐skin‐smear (SSS); later, a WHO study group on chemotherapy of leprosy recommended clinical criteria based on the number of skin lesions (NSL) . Thereafter, various clinical criteria were introduced by other researchers to classify leprosy, including number of body areas affected (NBAA)and size of largest skin lesion (SLSL) in order to further simplify leprosy identification at field level. These three clinical criteria are utilized individually to help field workers in management of leprosy patients.…”

Section: Introductionmentioning

confidence: 99%