[The frequency of the appearance of perforating foot ulcers in patients with Hansen's disease as a function of treatment with disulone alone or with polychemotherapy].

Acta leprologica Pub Date : 1995-01-01
I Mane, M Y Grauwin, J L Cartel
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Abstract

Between 1986 and 1989, in 5 departments of Senegal, 436 new cases of leprosy were detected, of whom 225 were put under dapsone monotherapy and 211 under multidrug therapy (MDT). Of them, 190 could be followed-up during 2 years by means of annual bacteriological and clinical examination, including neurological assessment. In 2 years, the onset of 10 (5.3%) chronic plantar ulcers (CPU) was observed: 4 (4%) among the 99 patients under dapsone monotherapy and 6 (6.6%) among the 91 under MDT (no significant difference). Of the 10 CPU, 3 (2%) appeared among the 149 patients without any disability at detection while 7 (17%) were observed among the 41 others who presented a grade 1 disability at detection (p < 0.01). Of the 6 CPU appeared in the patients under MDT, 5 (22%) were observed among the 23 who presented a grade 1 disability at detection and 1 (1.5%) among the 68 who did not (p < 0.01). This difference was not noted in the patients under dapsone monotherapy. Our results need to be confirmed by other studies including a higher number of patients followed-up during a longer period of time. Nevertheless, they suggest that MDT could prevent the onset of CPU, but only in patients without any disability at detection. Therefore, they reemphasize the importance of early detection of the disease in leprosy control programmes.

【汉森氏病患者出现穿孔性足溃疡的频率与单用二磺龙或联合化疗的作用】。
1986年至1989年期间,在塞内加尔的5个省发现了436例新发麻风病例,其中225例接受氨苯砜单药治疗,211例接受多药治疗。其中190例可随访2年,每年进行细菌学和临床检查,包括神经学评估。2年内观察到慢性足底溃疡(CPU)发病10例(5.3%):99例单药治疗4例(4%),91例MDT治疗6例(6.6%)(差异无统计学意义)。149例无残疾患者中出现3例(2%),41例1级残疾患者中出现7例(17%)(p < 0.01)。在MDT下出现的6例CPU中,检出1级残疾的23例中出现5例(22%),未检出1级残疾的68例中出现1例(1.5%)(p < 0.01)。在氨苯砜单药治疗的患者中没有发现这种差异。我们的结果需要其他研究的证实,包括在更长的时间内对更多的患者进行随访。然而,他们认为MDT可以预防CPU的发作,但仅限于在检测时没有任何残疾的患者。因此,他们再次强调在麻风控制规划中早期发现该病的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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