MDT: management of "burnt-out" cases FAQ
Is it necessary to give MDT to patients who were on dapsone monotherapy and are now bacteriologically and clinically inactive?
The reports available from routine control programmes suggest that a small proportion of patients who had several years of dapsone monotherapy are relapsing, especially MB leprosy patients. Wherever resources permit, such patients should be treated with WHO MDT for 12 months but they should not be re-registered as new cases.
Does MDT help to bring about skin smear negativity earlier than with dapsone monotherapy?
The main function of MDT is to kill all viable organisms, which can be achieved in a relatively short period. The clearance of dead bacilli depends largely on the individual's immune response which, especially in individuals suffering from MB leprosy, is defective. The results of several large-scale, long-term field trials show that the rate of clearance of dead bacilli is about 0.6 to 1.0 logs per year and is not enhanced by MDT.