Treatment of leprosy in India

Abstract

Introduction of multi-drug therapy (MDT) into the National Leprosy Eradication Program (NLEP) of India has brought a decline in both the burden of the disease and the detection of new cases in the country. Despite this success, MDT has had many problems like remarkable relapse rate, non-adherence to the MDT and the emergence of drug resistance associated with it. Moreover, there is no new MDT regimen at present, which could solve all these problems. The current situation suggests that we should look for alternative solutions in the delivery of leprosy-related services. With the introduction of Accredited Social Health Activists under the National Rural Health Mission, there is an opportunity to control some of these problems associated with MDT. Besides, District Nucleus should take initiatives and actively participate in establishment of coordination between departments of Health, Social welfare and justice, education and various non-governmental agencies working in the field of leprosy and disability in order to deliver the best of services to the persons affected by leprosy.

Effect of Ofloxacin and Norfloxacin on Rifampicin Pharmacokinetics in Man

“…Dapsone monotherapy was replaced by multidrug. [8][9][10] However, poor compliance (related to long duration and other socioeconomic factors), drug resistance, and relapses have been reported. 8 Thus, there has been a renewed effort to find newer regimens that may shorten the duration of therapy and improve compliance while simultaneously maintaining or improving the therapeutic advantages of previous regimens.…”

“…[8][9][10] However, poor compliance (related to long duration and other socioeconomic factors), drug resistance, and relapses have been reported. 8 Thus, there has been a renewed effort to find newer regimens that may shorten the duration of therapy and improve compliance while simultaneously maintaining or improving the therapeutic advantages of previous regimens. 11 In 1997, a combination of rifampicin (600 mg), ofloxacin (400 mg), and minocycline (100 mg) known as ROM therapy was approved for single-lesion paucibacillary leprosy.…”

A very common case become rare: Anesthetic considerations of lepromatous leprosy

“…As of 31 st March 2009, 32 States in India have achieved the level of elimination and but still some states like Bihar and Chhattisgarh have PR between 2 and 3 per 10,000 population. [3] So still one can encounter leprosy patient as us, from nearby states or country, because India and some other Asian country was just about to declared leprosy free.…”

Pharmacokinetics of isoniazid with or without ofloxacin

“…Due to the resistance of most strains of M. leprosy and M. tuberculosis, the treatment of leprosy has changed in the past three decades. Dapsone monotherapy was replaced by multidrug therapy (with dapsone, rifampicin and clofazimine) in 1982 (WHO, 1982;Gautam, 2009). Since its introduction, multidrug therapy has been an important tool in leprosy elimination; not only has it helped to reduce the duration of treatment but it has also been useful in addressing problems related to resistance to dapsone and relapses (Gautam, 2009;Visschedijk et al, 2000;Meima et al, 2004).…”

“…Dapsone monotherapy was replaced by multidrug therapy (with dapsone, rifampicin and clofazimine) in 1982 (WHO, 1982;Gautam, 2009). Since its introduction, multidrug therapy has been an important tool in leprosy elimination; not only has it helped to reduce the duration of treatment but it has also been useful in addressing problems related to resistance to dapsone and relapses (Gautam, 2009;Visschedijk et al, 2000;Meima et al, 2004). Thus, there has been a renewed effort to find newer regimens that may shorten the duration of therapy and improve compliance while simultaneously maintaining or improving the therapeutic advantages of previous regimens (Sehgal et al, 2008;Maninder et al, 2011).…”