220 chapter 26
TREATMENT AND MANAGEMENT OF LEPROSY
Treatment and management of leprosy should include 4 areas:
1. Long-term medical treatment to control the leprosy infection should begin as early as
possible.
2. Emergency treatment when necessary to control and prevent further damage from
leprosy reactions.
3. Safety measures, aids, exercises, and education to prevent deformities (sores, burns,
injuries, contractures).
4. Social rehabilitation: Work with the individual, parents, schools, and the community
to create a better understanding of leprosy, to lessen people’s fears, and to increase
acceptance, so the child or adult with leprosy can lead a full, happy, meaningful life.
Medical Treatment
Multi-drug treatment (MDT) consisting of rifampin, DDS and clofazimine, is now
recommended by the World Health Organization. MDT is usually supplied free. The treatment
varies according to whether the patient is a child or an adult, and whether the patient has PB or
MB leprosy.
For years, DDS (dapsone) was the main drug used. Unfortunately, in some areas the leprosy
bacilli became ‘resistant’ to DDS (were not harmed by it).
Rifampin works much faster against leprosy. To prevent development of resistance, it is
given in combination with other anti-leprosy medicines. Rifampin needs to be given only once a
month. This reduces cost and side effects.
Clofazimine, although less effective in killing leprosy bacilli than rifampin, has the advantage
that it also helps control leprosy Type 2 reaction.
Medicine for PB leprosy
(Tre atm ent is for 6 months.)
children
children
under 10 years 10 to 14 years
monthly dose rifampicin 300 mg.
450 mg.
monthly dose dapsone 25 mg. 50 mg.
adults Take the monthly dose on
the first day of treatment
600
100
mg.
mg.
(day 1) and then every
28 days for 6 months. Take
the daily dose every day for
daily dose dapsone
Medicine for MB leprosy
(Tr eatm ent is for 12 months.)
25 mg.
50
mg. 1 00 mg.
6 months. Treatment must be
completed within 9 months.
children
children
under 10 years 10 to 14 years
adults
Take the monthly dose on the
first day of treatment (day 1)
monthly dose rifampicin
monthly dose clofazimine
monthly dose dapsone
300 mg.
100 mg.
25 mg.
450 mg.
150 mg.
50 mg.
600 mg.
300 mg.
100 mg.
and then every 28 days for
12 months. Take the daily
dose every day, or as noted,
for 12 months. Treatment
daily dose dapsone
daily dose clofazimine
25 mg.
50 mg twice
50 mg.
50 mg. every
100 mg.
50 mg.
must be completed within
18 months.
a week
other day
Check with your Ministry of Health and WHO for information about leprosy treatment.
Importance of long-term treatment
Treatment to cure leprosy takes a long time: from 6 months to 1 year or more depending on
the type of leprosy. If treatment is stopped too soon or if the medicine is not taken at the right
time, not only can leprosy return, but a sometimes a leprosy reaction may result which can
cause even more nerve damage and paralysis or blindness.
It is therefore essential that health and rehabilitation workers make sure the person with
leprosy and her family understand the importance of taking the medicine regularly. It is
helpful if a health worker can be present when the child’s monthly dose is taken. This way, he
can check her for any complications of leprosy.
TREATED EARLY, LEPROSY NEED NOT BE A DEFORMING OR DISABLING DISEASE.
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