02465nas a2200397   4500000000100000008004100001260001300042653001500055653001000070653000900080653002600089653001200115653003000127653001100157653002200168653001100190653002300201653001200224653000900236653001600245653002300261653001500284653002200299653001600321100001100337700001200348700001100360700001100371245013800382856005100520300001000571490000700581050001400588520145100602022001402053       2009                            d  c2009 Jun10aAdolescent10aAdult10aAged10aAnti-Bacterial Agents10aDapsone10aDrug Therapy, Combination10aFemale10aFollow-Up Studies10aHumans10aLeprostatic Agents10aleprosy10aMale10aMiddle Aged10aPatient Compliance10aRecurrence10aTreatment Outcome10aYoung Adult1 aJing Z1 aZhang R1 aZhou D1 aChen J00aTwenty five years follow up of MB leprosy patients retreated with a modified MDT regimen after a full course of dapsone mono-therapy.  uhttps://leprosyreview.org/article/80/2/17-0176  a170-60 v80  aJING 20093 a<p><b>BACKGROUND: </b>The relentless emergence of dapsone resistance amongst M. leprae threatened leprosy control programmes, and increased the relapse rate of patients cured with dapsone monotherapy.</p><p><b>OBJECTIVE: </b>The study aimed to analyse the effect on the relapse rate of dapsone-cured multibacillary (MB) leprosy patients, of re-treatment, using a multidrug therapy (MDT) regimen which differed from the WHO recommended regimen.</p><p><b>DESIGN: </b>794 MB leprosy patients who had been released from treatment after dapsone monotherapy were selected, amongst them 657 were re-treated for 1 year using the modified multidrug therapy regimen (mMDT) including rifampicin, clofazimine and dapsone, and 137 patients were observed as control cases.</p><p><b>RESULTS: </b>The regimen was well tolerated with good compliance: 620 patients completed re-treatment with mild side effects and a low incidence of leprosy reactions. There was a statistically significant difference between the relapse rates of re-treated and control groups (chi squaredf = 57.44, P < 0.001). Furthermore, the relapses in the re-treated group were significantly more likely to be later than those in the control group (t = 25.62, P < 0.001).</p><p><b>CONCLUSIONS: </b>Re-treatment with this modified regimen is acceptable and can reduce the risk of early relapse in dapsone-cured patients. The problem of persisters causing late relapse is likely to remain.</p>  a0305-7518