DOES MDT ARREST TRANSMISSION OF LEPROSY TO HOUSEHOLD CONTACTS

The multidrug therapy program with the World Health Organization (WHO) -recommended treatment (WHO/MDT) regimens has given the hope of early case detection and rendering a leprosy patient, especially a multibaci llary (MB) patient, noninfectious within a short period of time. Hence , the duration of exposure for household contacts to infection is expe cted to be remarkably less when compared to exposure to MB leprosy pat ients on dapsone monotherapy. A total of 1661 household contacts of sk in-smear-positive leprosy patients were recorded from 1984 to 1994. Fo llow up of these individuals [8403 person-years at risk (PYR)] reveale d that the incidence of leprosy was 7.7 per 1000 PYR, which was 8 time s more than that of the general population. The risk was more if there was a co-prevalent case in the family. The incidence of leprosy decli nes from the third year of surveillance onward, and declines more so i n children. Although disease transmission should have been arrested as soon as the index case was started on MDT, the incidence of leprosy a mong the household contacts was still high when compared to that of th e total population. Effective intervention needs to be introduced to r educe the risk of contacts developing leprosy.