Dapsone-induced haemolysis among leprosy patients on MDT from an endemic area of central India.

Abstract

Background and aim: Haemolysis due to dapsone as a part of MDT in leprosy patients has been long recognized. However, the frequency and severity of this side effect and factors associated with it have not been well documented. We planned to determine the frequency of dapsone-induced haemolysis in leprosy patients on MDT and various risk factors associated with it.

Materials and methods: This was a hospital-based retrospective analysis, conducted on 36 treatment completed or partially treated or on treatment leprosy patients in a tertiary care centre in Chhattisgarh.

Results: Out of 36 patients, 83.3% showed a fall in haemoglobin from the baseline value (pre-treatment values). Dapsone was stopped in 33.3% of patients with a significant fall in haemoglobin. We found that the mean haemoglobin concentration for all patients fell from 13.05(+/-1.8) g/dl to 11.8(+/-1.9) g/dl (P < 0.05) which was statistically significant. A total of 25% of patients were labelled as confirmed cases of dapsone-induced haemolysis as per our definition.

Conclusion: Our results underline the need to incorporate haematological investigations in leprosy management protocol, especially in primary care settings where the majority of leprosy patients are managed.