FIELD TREATMENT OF ACUTE NERVE FUNCTION IMPAIRMENT IN LEPROSY USING ASTANDARDIZED CORTICOSTEROID REGIMEN - FIRST YEARS EXPERIENCE WITH 100PATIENTS

In this study, a fixed regimen of prednisolone for the treatment of ac ute nerve function impairment (NFI) in leprosy patients was developed and introduced at field level in one area (Thakurgaon) of the Danish-B angladesh Leprosy Mission's field in NW Bangladesh. The assessment, ma nagement and follow-up of patients was undertaken by leprosy control s upervisors and physiotechnicians. One hundred patients were treated an d followed up 6-8 months after completion of a 4-month course of predn isolone. At a level of change of 2 points (where a change of at least 2 points in the motor/sensory score was taken to indicate a change of status, i.e. full or partial recovery, or deterioration), 42/65 (64.6% ) patients with sensory loss experienced some sensory recovery at comp letion of prednisolone treatment, and 40/! (61.5%) at 6-8 months' foll ow-up. 41/85: (48.3%) of patients with motor loss experienced improvem ent, and 42/85 (49.4%) at follow-up. Analysis of the mean scores at st art of prednisolone treatment, completion and at follow-up using Stude nt's t-test showed highly significant (p<0.001) differences between sc ores before and after treatment. The benefit is maintained as seen aft er a period of 6-8 months follow-up. It was concluded that treatment o f acute nerve function impairment at field level by paramedical worker s, using a standardized regimen of prednisolone Is feasible, practical and effective.