02422nas a2200361   4500000000100000008004100001260001300042653001000055653002500065653002800090653002700118653003000145653002100175653001100196653001400207653001100221653001400232653002300246653001200269653002600281653000900307653002500316653003000341653003200371100001100403245017600414856006100590300001000651490000700661050001400668520136400682022001402046       2004                            d  c2004 Jun10aAdult10aCase-Control Studies10aColony Count, Microbial10aDisease Susceptibility10aDrug Therapy, Combination10aEndemic Diseases10aFemale10aGeography10aHumans10aIndonesia10aLeprostatic Agents10aleprosy10aMacrophage Activation10aMale10aMycobacterium leprae10aResidence Characteristics10aTumor Necrosis Factor-alpha1 aNawi R00aComparison of multidrug therapy treatment results between multibacillary leprosy patients in hyperendemic and hypoendemic areas in Gowa Regency, South Sulawesi, Indonesia.  uhttp://www.tm.mahidol.ac.th/seameo/2004_35_2/17-3148.pdf  a340-50 v35  aNAWI 20043 a<p>We studied 88 multibacillary (MB) leprosy patients, who received multidrug therapy (MDT) treatment in hyperendemic (44 persons) and hypoendemic (44 persons) areas in Gowa Regency, South Sulawesi, Indonesia. Bacteriological examinations were carried out (bacteria index and morphology index), immunological examinations (MLPA and TNF-alpha) and genetic variation in blood and ear lobe slit skin smears of MB leprosy patients, which had been treated by MDT, were performed. The collected data were analyzed with the chi-square test and discriminant analysis. Eight persons (9.1%) had a positive bacteria index and 2 persons (2.4%) had a morphology index. All patients (100%) increased their TNF-alpha concentration. All the samples (100%) showed an increase in the TNF-alpha concentration, compared to controls. MLPA positive conversion was found in 4 persons (47.7% samples) and TNF-alpha gene genetic variation at the position of -308, occurred in 12 persons (13.6% samples). Statistic test results showed a significant difference (p<0.01) in the TNF-alpha concentration between hyperendemic and hypoendemic areas. On the basis of a positive conversion by bacteriological results and its association with immunological results, it can be concluded that multibacillary leprosy patients with MDT treatment did not become a source of leprosy transmission.</p>  a0125-1562