PERFIL CLÍNICO DE LA RECIDIVA EN LA LEPRA Y CORRELACIÓN CON EL LABORATORIO, INCLUYENDO LA INOCULACIÓN EN ALMOHADILLA PLANTAR Y TÉCNICAS MOLECULARES EN UNA INSTITUCIÓN ESPECIALIZADA EN LEPRA

Introduction: According to many studies, the relapse rate in leprosy has come down to negligible levels after the introduction of multi-drug therapy (MDT) by WHO. However, a small number of patients have been known to relapse after release from treatment, even when there has been good compliance.
Methods and findings: During 2009–2017 (8 years), 23 multibacillary relapse cases were diagnosed clinically at SIHR&LC, and investigated further to confirm relapse; 95.6% of cases were positive by slit skin smear, 78.3% on histopathology and 63.2% through growth in the mouse foot pad (MFP).
Conclusion: The positive slit skin smear and the presence of active Hansen’s disease with solid stained M. leprae on histopathology are suggestive of relapse. Positive mouse footpad inoculation indicated the presence of viable M. leprae. Relapse was confirmed in 12 patients, but negative mouse footpad results cannot exclude relapse. Where there are no facilities for such investigations, we must develop awareness about possible relapse in all treated
patients, especially in field conditions, for early self-reporting, referral, and retreatment (with alternative drugs in cases of drug resistance) as needed.