Objectives If leprosy is a public health problem, it is due to the disabilities it causes. Surprisingly little is known about the risk of disabilities. Even now, mainly cross-sectional studies report disability prevalence. The present study aims to report the risk of disability in pre and post-WHO multidrug therapy (MDT) in multibacillary leprosy patients and to assess the extent of the incidence of disability.
Methods The study design is prospective and the setting is an institutional field area. Patients were detected during 2001–6 field surveys. Of the 289 multibacillary patients, 146 completed the study. Both sexes were involved. The primary outcome planned was to study cure of disease, relapses and disability in patients receiving MDT. The secondary outcome was to measure reaction and default. Assessment was done clinically. Data have been analysed using SPSS software, logistic, survival analysis was performed and the χ2 test of significance was used.
Results An important risk factor was found to be three or more nerves involved with odds of 3.73 (1.24–11.2), and delay in treatment; 2.27 (1.04–4.96) at the pre-MDT stage and three or more nerves involved with odds of 2.81 (1.0–7.9) at the post-MDT stage. The incidence of disability was found to be 2.74/100 person-years; 2.69 in the MDT arm and 2.84 in defaulters, with slightly higher disability among early defaulters (3.08) than among late defaulters (2.30). The study suggests that the incidence of disability could be slightly higher if treatment is not completed.
Conclusion Early treatment for leprosy is a must for reducing the risk of disability, and treatment delay would increase the risk of disability. It is important to note that the incidence of disability between defaulters and those completing treatment was not found to be significantly different.
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To cite: Kumar A, Girdhar A, Girdhar BK. Risk of developing disability in pre and post-multidrug therapy treatment among multibacillary leprosy: Agra MB Cohort study. BMJ Open 2012;2:e000361. doi::10.1136/bmjopen-2011-000361
Contributors Although all authors were responsible for the conception, design and acquisition of data, drafting, revising and final approval of the article, AK played the lead role in planning, conducting the field study, analysis, writing revision and submission; AG was responsible for clinical evaluation and BKG for clinical monitoring and report preparation.
Funding This study was supported by an institutional grant from the National JALMA Institute for Leprosy, Taj Ganj, Agra. No specific funding from external agencies was asked for.
Competing interests None.
Patient consent Obtained.
Ethics approval Ethics approval was granted by the institutional ethical committee, which was being informed periodically about the progress of the work.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No extra data.
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