Causes of death among active leprosy patients in China.

We analyzed the causes of death among active leprosy patients in China, to better understand the disease and improve the quality of services, by performing a retrospective study involving 24 provinces of China. Information about patients with active leprosy who were not clinically cured and died between January 1, 2000, and December 31, 2005, was collected by professionals at county levels. A total of 524 deaths were analyzed. The leading cause of death was suicide. There were 86 patients (16%) who died at a mean of 21 ± 19 months after starting multi-drug therapy (MDT). The second and third leading causes of death were cardiovascular disease and organ failure associated with advanced age, respectively. Two hundred and twenty-one patients (42%) died within one year of beginning MDT. The second month of MDT was the riskiest for newly treated patients; approximately 20% of patients succumbed to liver failure, 33% to dapsone (diaminodiphenylsulfone/DDS) allergy, and 27% to renal insufficiency during this period. Among 143 deaths related to leprosy, 37 (26%) occurred within three months of starting MDT. We recommend that newly diagnosed patients should be provided with no more than two months of MDT blister packs.

Occurrence and management of leprosy reaction in China in 2005.

BACKGROUND: Leprosy reactions are a major cause of disability before, during and after anti-bacterial treatment. Prompt diagnosis and correct management of reaction is a crucial matter for improving the quality of leprosy health services. OBJECTIVES: To describe the pattern of leprosy reaction and its management in China during 2005. METHODS: A retrospective survey using a questionnaire was carried out in all the provinces of China at the beginning of 2006. Patients included were those presenting with leprosy reaction between 1 January and 31 December 2005. RESULTS: 452 questionnaires from 25 provinces were analysed. There were 313 male and 139 female patients who had 159 Type I reactions, 273 Type II reactions and 20 Type I and II mixed reaction. 72.4% of reactions occurred in the first year of MDT and 27.6% of patients during the second year of MDT. The highest frequency of reaction was during the first 6 months of MDT; 57.3% of patients developed new nerve impairment during and after MDT. CONCLUSIONS: New nerve function impairment and disability still occurs among patients during and after MDT. The early detection and management of leprosy reaction remains important.

Current situation of leprosy colonies/leprosaria and their future in P.R. China.

OBJECTIVE: To identify the current situation of leprosy colonies/leprosaria and make some recommendations for improving the quality of life of people affected by leprosy in China. METHODS: A national survey using designed forms was carried out in 2004. The forms were filled in by local heads responsible for the management of leprosy colonies/leprosaria and sent to Provincial and National Centres for analysis. RESULTS: China had 605 leprosy colonies/leprosaria with 555 active leprosy patients (on treatment) and 18,175 ex-patients (people affected by leprosy) living in them at the end of 2004. Among 18,730 patients and people affected by leprosy, 13,430 (71.7%) had grade 2 disabilities. Among those with visible disability, 6392 (47.6%) lost the ability to take care of themselves due to serious deformity. Because of a decrease in health workers working at leprosy colonies and a shortage of medical materials, the health care quality of these people was neglected. Most colonies/leprosaria were located at remote and isolateS places with difficult transportation, and most buildings/houses were in danger of collapse because the colonies/leprosaria were built in the 1950's. Those affected by leprosy were in great need of help. CONCLUSION: The authors recommend that small, remote and isolated leprosy colonies should be closed. New leprosaria at District, Provincial or National levels should be established or some old leprosaria with good transportation should be reconstructed to house those affected by leprosy from closed leprosy colonies/leprosaria. The newly established or reconstructed leprosaria could act as centres for reference, training, rehabilitation and research on leprosy.

Relapse in MB leprosy patients treated with 24 months of MDT in south west China: a short report.

This study investigates the relapse rate among multibacillary leprosy patients treated with 24 months of MDT in south west China. A retrospective relapse survey was conducted in the southwest of China. A detailed questionnaire was designed to collect the data on relapse among MB patients who completed 2 years of the WHO/MB regimen, from 1989 to 2000. The data about 2517 multibacillary leprosy patients in 27 counties in the southwest of China were collected. Among 2517 MB patients, 235 patients died or were lost to follow-up and 2374 were followed up for more than 3 years after completion of MDT. The total duration of follow-up was 20,825 person-years, with a mean duration of 8.27 years per patient. Five patients with relapse were identified with an accumulated relapse rate of 0.21/1000 person-years. Their initial BIs ranged from 1.8 to 5. The patients with relapse occurred 48-158 months after the completion of MDT. The relapse rate of MB patients treated with 24 months of the WHO/MB regimen was observed to be very low after long-term follow-up.

Recidivas en pacientes de Lepra MB tratados con 24 meses de MDT en el suroeste de China: Un informe breve / No disponible

Este estudio evalúa el índice de recidivas entre los pacientes de lepra tratados con 24 meses de MDT en el suroeste de China. Para ello se llevó a cabo un estudio retrospectivo de recidivas en esta parte del país. Se diseñó un cuestionario muy detallado para recoger los datos sobre las recidivas entre pacientes MB que habían completado 2 años de tratamiento OMS/MB desde 1989 a 2000. Los datos se obtuvieron sobre 2.517 pacientes multibacilares en 27 países del suroeste de China. Entre los 2.517 pacientes MB, 235 pacientes fallecieron o se dieron de baja durante el seguimiento y 2.374 fueron controlados durante más de 3 años después de completar la MDT. La duración total del seguimiento fue de 20,825 personas-año, con una duración media de 8.27 años por paciente. Se identificaron cinco pacientes con recidivas con un índice acumulado de recidivas de 0-21/1.000 personas-año. Los IB iníciales variaron entre 1.8 a 5. Las recidivas se presentaron entre 48-158 mese después de completar la MDT. El índice de recidivas de los pacientes MB tratados con 24 meses con una pauta OMS/MB se consideró muy bajo después de un largo período de seguimiento

This study investigates the relapse rate among multibacillary leprosy patients treated with 24 months of MDT in south west China. A retrospective relapse survey was conducted in the southwest of China. A detailed questionnaire was designed to collect the data on relapse among MB patients who completed 2 years of the WHO/MB regimen, from 1989 to 2000. The data about 2.517 multibacillary leprosy patients in 27 counties in the southwest of China were collected. Among 2.517 MB patients, 235 patients died or were lost to follow-up and 2.374 were followed up for more than 3 years after completion of MDT. The total duration of follow-up was 20,825 person-years, with a mean duration of 8.27 years per patient. Five patients with relapse were identified with an accumulated relapse rate of 0.21-/1.000 person-years. Their initial Bls ranged from 1.8 to 5. The patients with relapse occurred 48-158 months after the completion of MDT. The relapse rate of MB patients treated with 24 months of the WHO/MB regimen was observed to be very low after long-term follow-up

Recidivas en pacientes de Lepra MB tratados con 24 meses de MDT en el suroeste de China: Un informe breve / No disponible

Este estudio evalúa el índice de recidivas entre los pacientes de lepra tratados con 24 meses de MDT en el suroeste de China. Para ello se llevó a cabo un estudio retrospectivo de recidivas en esta parte del país. Se diseñó un cuestionario muy detallado para recoger los datos sobre las recidivas entre pacientes MB que habían completado 2 años de tratamiento OMS/MB desde 1989 a 2000. Los datos se obtuvieron sobre 2.517 pacientes multibacilares en 27 países del suroeste de China. Entre los 2.517 pacientes MB, 235 pacientes fallecieron o se dieron de baja durante el seguimiento y 2.374 fueron controlados durante más de 3 años después de completar la MDT. La duración total del seguimiento fue de 20,825 personas-año, con una duración media de 8.27 años por paciente. Se identificaron cinco pacientes con recidivas con un índice acumulado de recidivas de 0-21/1.000 personas-año. Los IB iníciales variaron entre 1.8 a 5. Las recidivas se presentaron entre 48-158 mese después de completar la MDT. El índice de recidivas de los pacientes MB tratados con 24 meses con una pauta OMS/MB se consideró muy bajo después de un largo período de seguimiento (AU)

This study investigates the relapse rate among multibacillary leprosy patients treated with 24 months of MDT in south west China. A retrospective relapse survey was conducted in the southwest of China. A detailed questionnaire was designed to collect the data on relapse among MB patients who completed 2 years of the WHO/MB regimen, from 1989 to 2000. The data about 2.517 multibacillary leprosy patients in 27 counties in the southwest of China were collected. Among 2.517 MB patients, 235 patients died or were lost to follow-up and 2.374 were followed up for more than 3 years after completion of MDT. The total duration of follow-up was 20,825 person-years, with a mean duration of 8.27 years per patient. Five patients with relapse were identified with an accumulated relapse rate of 0.21-/1.000 person-years. Their initial Bls ranged from 1.8 to 5. The patients with relapse occurred 48-158 months after the completion of MDT. The relapse rate of MB patients treated with 24 months of the WHO/MB regimen was observed to be very low after long-term follow-up (AU)