Selection of MDT strategies through epidemiometric modeling.

The epidemiometric model of leprosy, built on Polambakkam, India, data, is used to compare the impact on incidence of dapsone and different multidrug therapy (MDT) strategies. The simulations show that generalization of MDT could have a dramatic impact on transmission of the disease. Relapses after MDT, although important from an individual point of view, have a negligible influence on the incidence. Introduction of MDT requires investments that, during the first few years of the program, are much greater than for dapsone monotherapy. These are, however, rapidly absorbed due to the rapidly declining number of new cases, particularly when MDT is not limited to multibacillary cases but is administered to all patients.