RESUMO
PIP: There are currently an estimated 10-12 million cases of leprosy in the world. Until relatively recently, dapsone was the mainstay of drug therapy against this disease, but it had to be administered for very long periods of time and began to lose effectiveness in the face of growing disease resistance. New standard, multi-drug regimens were therefore recommended by WHO in 1982 and have since become the standard minimum necessary treatment in leprosy control programs. Multiple drug therapy (MDT), if administered early enough, can cure leprosy before deformity develops. Its cost and complexity, however, impede its widespread dissemination where needed. Much of rural Africa especially suffers from a lack of MDT due to financial constraints, geographic isolation, transport difficulties, and poor healthcare infrastructure. Dr, William Philip of the United Kingdom Aberdeen Royal Infirmary describes the introduction of MDT into and throughout rural northwestern Uganda over the period 1986-90. The introduction of MDT in West Nile has made a positive impact against leprosy. Most patients have been released from treatment or will be released soon after completing their regimes, so that only new cases will be receiving drug therapy. This large drop in case load will allow greater effort to be placed upon early case detection and treatment. MDT over time will reduce the number of patients needing drug therapy and leave only few disabled patients after a few decades. In so doing, MDT seems to be the approach needed to control and eventually eradicate leprosy. It is hoped that this program experience will help guide program implementation in other areas where MDT has yet to be introduced.^ieng