Relapses in multibacillary leprosy patients after Multidrug therapy

OBJECTIVESTo determine the magnitude of relapses in multibacillary leprosy patients after multi-drug therapy and to determine the factors influencing the relapse.DESIGNA retrospective study pertaining to multibacillary leprosy patients treated with MBMDT as per WHO guidelines was carried out. The study included 300 MB patients who had successfully completed treatment during 1986-2002, of whom 163 patients were available for follow-up. Patients were examined clinically and bacteriologically to asses the present status of disease.RESULTSA total of three cases relapsed at 2, 4 and 11 years after being released from treatment which gives a crude cumulative relapse rate of 1.84% for the 18 year period of follow-up with mean duration of follow-up 7.13 +/- 1.25 years. It also gives the total follow-up period of 1163 person-years with the relapse rate of 0.26/100 person-years of follow-up (95% confidence interval is 0.235-0.285).CONCLUSIONRelapse rate after WHO recommended MDT leprosy is low. High bacterial load before initiation of therapy is an important factor which determines the relapse.