© 1994 Oxford University Press
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Multidrug Therapy and Eye Disease in Leprosy: A Cross-Sectional Study in the People's Republic of China
* International Centre for Eye Health Bath Street, London, EC1V 9EL, UK
** International Eye Foundation PO Box 2273, Blantyre, Malawi
Sichuan Provincial Institute of Dermatology 12 Si Dao Jie, Chengdu, Sichuan Province, PR China
Beijing Tropical Medicine Research Institute, Friendsip Hospital 95 Yun An Lu, Beijing, PR China
BackgroundFactors associated with leprosy-related eye disease in a multidrug therapy (MDT) treated population in China were assessed to determine if status prior to inclusion in the MDT programme (newly diagnosed leprosy patient or leprosy patient on prior dapsone monotherapy) contributed to the prevalence of ocular pathology.
MethodsTrained Leprosy paramedical workers in Sichuan Province examined 974 leprosy patients in a standardized fashion. Univariate analyses and multiple logistic regression were used to assess the contribution of demographic and clinical parameters to leprosy-related eye disease.
ResultsIn both groups (prior dapsone and new MDT) leprosy-related eye disease was associated with a longer distance to leprosy health worker or health centre. Among patients with a history of prior dapsone monotherapy, age and duration on dapsone monotherapy were elso associated with leprosy-related ocular morbidity. Among newly diagnosed leprosy patients the prevalence of ocular morbidity remained between 8% and 11% regardless of when the patient started MDT.
ConclusionsOur findings suggest that, even when case detection is good, ocular pathology will still occur in MDT treated leprosy patients. There remains an important role for health workers in the prevention of ocular morbidity. Our data also demonstrated that pooling of results from all patients (newly diagnosed and on prior dapsone monotherapy) in a leprosy control programme will likely give rise to inadequate estimates of risk of ocular disease due to variable clinical disease histories in these groups.
Received 1 January 1994
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