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Ideally, when introducing a new and supposedly improved treatment, this new regimen should first be tried out in a study group. The results in this study group should be compared with the results in a control group which continued to receive the old treatment . However WHO-MDT was generally introduced without waiting for the results of any such controlled trial on the assumption that (a) multi drug treatment would be superior to dapsone monotherapy, and that (b) there was no time for a controlled trial because resistance of Mycobacterium leprae to dapsone was globally reported to be developing into a serious threat to the effectiveness of leprosy control projects . I Thus unfortunately it is now only possible to evaluate WHO-MDT using historical controls treated with dapsone monotherapy. WHO-MDT in paucibacilliferous patients should be evaluated in terms of: a, adverse drug reactions (including death attributable to the regimen); b, development or regression of disabilities ; c, Type I reactions; d , relapses; and e, acceptability (compliance and operational feasibility) . All clinical parameters being equal , the cost per patient treated with WHO­ MDT should also be compared with the cost per patient treated with dapsone monotherapy. In this short paper we present a preliminary evaluation of WHO-MDT in paucibacilliferous patients in Malawi in terms of the development or regression of disabilities during and after treatment.

Preliminary evaluation of the effect of WHO-MDT on disabilities in leprosy patients in Malaŵi, Central Africa