Pattern of bacillary clearance in multibacillary leprosy patients with multidrug therapy.

Acta leprologica Pub Date : 2003-01-01
A Kumar, A Girdhar, B K Girdhar
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Abstract

The bacteriological index (BI) of the skin smears is traditionally one of the important parameters of assessment of severity and of progress of leprosy under multidrug therapy. The present study reports on BI clearance among 578 multibacillary treated leprosy patients and the factors that influence this clearance. The patients were treated till smear negativity or for 2 years fixed duration and their skin smears periodically examined every 6 to 12 months till negativity (and even afterwards). We confirm that bacterial clearance is a slow process. The time taken for each log-unit decline in BI is between 13.6 to 24 months probably depending on initial BI level. The rate of smear negativity appears to be dependent on immune competence of the patients as reflected by a rapid BI decline in borderline BT-BB patients vis-à-vis BL-LL lepromatous patients both in the low and high BI group. Patients who had several episodes of ENL, took significantly longer time (63.7 months versus 53.5 months, p<0.0001) to become smear negative than those without ENL.

多菌性麻风患者接受多药治疗后的细菌清除模式。
皮肤涂片的细菌学指数(BI)历来是评估麻风病严重程度和多药治疗进展的重要参数之一。本研究报告了578例接受多菌治疗的麻风病患者BI清除率及其影响因素。患者接受治疗至涂片阴性或2年固定疗程,每6 - 12个月定期检查皮肤涂片,直至涂片阴性(甚至之后)。我们确认细菌清除是一个缓慢的过程。每个对数单位的BI下降所需的时间在13.6到24个月之间,这可能取决于初始BI水平。涂片阴性率似乎取决于患者的免疫能力,这反映在低和高BI组中边缘性BT-BB患者对-à-vis BL-LL麻风病患者的BI快速下降。有几次ENL发作的患者花费的时间明显更长(63.7个月对53.5个月,p
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