THE IMPACT OF MULTIPLE-DRUG THERAPY ON LEPROSY DISABILITIES

In an overview of controlled trials, it is shown that bactericidal dru gs increase the short-term risk of Type I reactions, but prevent the l ong-term development of new impairments caused by bacterial proliferat ion. Clinical experience suggests that the clofazimine component of mu ltiple drug therapy (MDT) has reduced the incidence of Type II reactio ns or erythema nodosum leprosum (ENL). The principal impact of MDT, co mpared with monotherapy, has been to reduce the duration of active dis ease, thus preventing the deterioration of disability scores. Reductio n of population disability rates is mainly achieved by earlier detecti on and treatment. MDT has a number of indirect benefits such as improv ed compliance, decreased cost, and increased motivation and availabili ty of leprosy workers. However, MDT must be supplemented by other meas ures to prevent and treat disabilities.