Delay in presentation, an indicator for nerve function status at registration and for treatment outcome--the experience of the Bangladesh Acute Nerve Damage Study cohort.

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TitleDelay in presentation, an indicator for nerve function status at registration and for treatment outcome--the experience of the Bangladesh Acute Nerve Damage Study cohort.
Publication TypeJournal Article
AuthorsNicholls PG, Croft RP, Richardus JH, Withington SG, Smith WCS
Abbrev. JournalLepr Rev
JournalLeprosy review
Year of Publication2003
Volume74
Issue4
Pagination349-56
Publication Languageeng
KeywordsAdolescent, Adult, Age Factors, Aged, Cohort Studies, Communicable Disease Control, Confidence Intervals, Disability Evaluation, Drug Therapy, Combination, Female, Follow-Up Studies, Health Education, Health Knowledge, Attitudes, Practice, Humans, Leprostatic Agents, Leprosy, Male, Middle Aged, Nepal, Peripheral Nervous System Diseases, Prednisolone, Probability, Proportional Hazards Models, Risk Factors, Severity of Illness Index, Socioeconomic Factors, Time Factors, Treatment Outcome
Abstract

The objective of our research was to relate delay in presentation in the Bangladesh Acute Nerve Damage Study cohort to intake status and to treatment outcome. The Bangladesh Acute Nerve Damage Study (BANDS) is a prospective cohort study of 2664 consecutive newly registered patients at clinics run by the Danish-Bangladesh Mission Leprosy (DBLM) project in Nilphamari, northern Bangladesh. The 1-year intake began in April 1995. Three-year follow-up for PB cases and 5 years for MB cases was completed in 2001. Delay in presentation in the BANDS cohort is associated with increased signs of nerve function impairment at registration. Individuals presenting with no nerve impairment and maintaining nerve function to the end of follow-up had the shortest mean delays. Individuals presenting with impairment that did not improve during follow-up had the longest mean delays. Discussion focuses on the value of setting a threshold value defining early presentation. Since the WHO Grade 2 disability rate effectively sanctions lengthy delays where there is no impairment, an indicator relating directly to delay is preferred as an indicator for good practice in leprosy control.

PubMed URL

http://www.ncbi.nlm.nih.gov/pubmed/14750580?dopt=Abstract

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