Leprosy elimination

MDT: duration of treatment FAQ

How should we deal with MB leprosy patients who are currently on treatment and have completed 12 or more monthly doses of MDT?

According to the recommendation all MB (multibacillary) patients who have completed 12 or more doses of WHO MDT for multibacillary leprosy should be regarded as cured and removed from the registers. However, as usual, all patients should be educated about the signs/symptoms of reactions and relapse and asked to report immediately to the nearest health centre when such problems arise.

In some control programmes, after completion of MDT, patients continue with a single drug, usually dapsone, for various lengths of time. Is this necessary?

The continuation of dapsone monotherapy after a course of MDT is totally unnecessary. Some control programmes may be using this to ensure regular follow-up; to satisfy patients who are not willing to discontinue treatment; or in situations where the physician may not be convinced of the efficacy of MDT. Whatever the reason, this approach puts an unnecessary burden on the patient and on the field workers and is not recommended.

Is post-MDT surveillance of patients essential?

Because the risk of relapses after completion of the WHO MDT regimens has been negligible, it is no longer necessary to continue active post-MDT surveillance. Instead, patients should be taught at the time of release from treatment to recognize early signs of possible relapses or reactions and to report promptly for treatment.

Is it necessary to keep the single lesion PB patient treated with ROM on active surveillance?

No, after receiving a single dose of ROM, it is enough to advise the person to report immediately if he/she notices any new lesion.