ARE 18 DOSES OF WHO MDT SUFFICIENT FOR MULTIBACILLARY LEPROSY - RESULTS OF A TRIAL IN MALAWI

A trial comparing 18 monthly and 30 monthly doses of the World Health Organization-recommended multidrug therapy (WHO/MDT) in 305 multibacil lary leprosy patients in Malawi is described. Patients were randomly a llocated to one of the two regimens at the time of taking the 18th sup ervised dose of WHO/MDT. The mean follow-up period was 3 years (maximu m 6 years). No relapse was observed in either group. The cumulative pr obabilities of remaining slit-skin smear positive were significantly h igher among patients receiving only the 18 monthly doses of WHO/MDT, b ut reached zero at month 60 of follow up. The percentage of patients w ho developed new disabilities during the trial period was similar in b oth groups. However, the overall percentage of patients who developed new disabilities (50/305, 16.4%) remains disturbingly high. On the who le, the results of the trial argue in favor of 18 monthly doses of WHO /MDT taken within 24 months as being sufficient for the treatment of m ultibacillary leprosy.