@article{2221,
  keywords = {Adult, Aged, Analysis of Variance, Cohort Studies, Comorbidity, Confidence Intervals, Disease Progression, Ethiopia, Female, Humans, Leprostatic Agents, leprosy, Male, Middle Aged, Multivariate Analysis, Prevalence, Prognosis, Prospective Studies, Risk Factors, Severity of Illness Index, Skin Diseases},
  author = {Saunderson P and Gebre S and Byass P},
  title = {Reversal reactions in the skin lesions of AMFES patients: incidence and risk factors.},
  abstract = {<p>Reversal reactions affect the skin and/or nerves of leprosy patients. This paper looks at reversal reactions involving the skin in 594 new patients in central Ethiopia, followed for between 6 and 11 years after the start of treatment. The incidence of reversal reaction declines steadily after the start of treatment, but the first episode may occur as long as 5 years after diagnosis in both paucibacillary (PB) and multibacillary (MB) patients. Recurrent episodes occurred up to 6 years after diagnosis. PB patients were at greatest risk for reversal reaction in the first year after diagnosis and MB patients in the first 4 years. The highest incidence rate was 18 episodes per 100 person years in MB patients during the first year after diagnosis. The ratio of the incidence rates for the first 3 years in MB versus PB patients is 2.4 (95% CI 1.6-3.8). This study confirms that starting effective treatment and borderline classification are risk factors for reversal reactions. Pregnancy/delivery in the 6 months prior to diagnosis was a significant risk factor for presenting with a reversal reaction [relative risk (RR) 5.9 (95% CI 2.1-16.5)], but later pregnancies were not associated with an increased risk. Being female was a significant risk factor for the late appearance of the first episode of reversal reaction. Having a reversal reaction in the first year after diagnosis was a highly significant risk factor for the development of later reactions [RR in PB cases 11.9 (95% CI 3.4-41.7); in MB cases 6.4 (95% CI 3.8-10.6)]. Being HIV positive was a risk factor for developing recurrent reversal reactions, although only three out of 29 recurrent cases were HIV positive [RR 2.7 (95% CI 1.4-5.1)].</p>},
  year = {2000},
  journal = {Leprosy review},
  volume = {71},
  pages = {309-17},
  month = {2000 Sep},
  issn = {0305-7518},
  url = {http://leprev.ilsl.br/pdfs/2000/v71n3/pdf/v71n3a10.pdf},
  doi = {10.5935/0305-7518.20000034},
  language = {eng},
}