Non-adherence to steroid therapy in leprosy reaction and neuritis

Nerve Function Impairment has been a prime hallmark of Type 1 Reaction in leprosy, which often leads to deformities and disability if not treated effectively. Steroid has been a drug of choice to treat severe reactions and nerve damage since the mid-20th century. The recommended therapy regimen starts with 40mg per day for 2 weeks, followed by subsequent tapering for 12 weeks. Although the optimal dose and duration of therapy are still being studied, steroid is generally accepted as the standard treatment. It is evident from published articles that oral steroid therapy may reverse nerve function impairment up to 50 – 70%. – 5 Therefore completing appropriate courses of steroid therapy may improve the function of involved peripheral nerves, and prevent the development of secondary deformity. For many therapeutic regimes in chronic disease like hansen’s and tuberculosis (Multi-drug therapy and WHO oral steroid therapy), poor adherence affects the clinical outcome and results in a considerable financial burden on society and modern health care system. Non-adherence to steroids may affect the recovery of the involved nerves and lead to secondary deformities. Early detection and treatment for nerve function impairment is the fundamental concept in leprosy. A previous study reported that 10% of patients with leprosy showed signs of motor, sensory and autonomic neuropathy at the time of registration for MDT. Nerve function impairment in the diagnosis has been found to be a stronger risk in the development of reaction and sensory and motor neuropathy. Each patient undergoes regular nerve function assessment such as voluntary muscle test (VMT) and monofilament test