02120nas a2200277 4500000000100000008004100001260001300042653002900055653003000084653001100114653001400125653002300139653001200162653002200174653001500196653002600211100001600237700001600253245010700269856005900376300001100435490000700446050001600453520135900469022001401828 1997 d c1997 Sep10aAnti-Inflammatory Agents10aDrug Therapy, Combination10aHumans10aIndonesia10aLeprostatic Agents10aleprosy10aPeripheral nerves10aPrednisone10aRetrospective Studies1 aBernink E H1 aVoskens J E00aStudy on the detection of leprosy reactions and the effect of prednisone on various nerves, Indonesia. uhttp://leprev.ilsl.br/pdfs/1997/v68n3/pdf/v68n3a07.pdf a225-320 v68 aBERNINK19973 a

This paper presents a retrospective study on the detection of the treatment of leprosy reactions in a field situation, and the effect of prednisone on the various affected nerves. Two patient cohorts were analysed. The leprosy control programme in the testing area is not backed up by a specialized referral leprosy hospital, but patients are treated on an ambulatory basis at peripheral health centres by trained multipurpose health workers supervised by the health centre doctors. For operational purposes the guidelines and procedures for reaction management in the field were adjusted and partially simplified. In both studies it appeared that the time of the occurrence of severe reactions was the same: 80% or more of the severe reactions occurred in the first year of treatment, the majority in the first few months after the start of the multidrug (MDT) treatment. One third of all reaction patients suffered from a silent neuritis. Well-instructed fieldworkers proved to be competent in detecting and treating leprosy reactions. Treatment of severe reactions with prednisone in the field situation can preserve or considerably improve the functions of the affected nerves. It is interesting that often the motor function of a nerve was found to be impaired without any loss in sensibility, which was tested using the ballpoint pen method.

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