Introduction Multiple drug therapy (MDT) was utilized for the treatment of Hansen’s disease in Sarawak since 1989. MDT Sungai Buloh and MDT Sarawak were the 2 major MDT regimens used. Hence, we aim to compare the outcomes of MDT Sungai Buloh and MDT Sarawak. Materials and Methods A retrospective review of 40 cases receiving MDT Sungai Buloh and MDT Sarawak from 1993 to 2006 was performed. Data regarding demographics and outcomes were collected and analysed. Primary outcome was cure and secondary outcomes were relapse, reactivation, death, leprosy reactions and deformities. Results There were no statistically significant differences in the primary outcome among patients on MDT Sungai Buloh and MDT Sarawak (p=0.41) after adjustment for surveillance rate. We noted that significantly more patients on MDT Sarawak (40.9%) were still under surveillance compared to MDT Sungai Buloh (5.6%, p=0.01). We also noted a higher rate of erythema nodosum leprosum (ENL) (16.7%) and deformities (22.2%) in patients receiving MDT Sungai Buloh compared to 9.1% ENL and 9.1% deformity rate among those on MDT Sarawak. However, this did not reach statistical significance. Other secondary outcomes were not significantly different between the two regimens. No recurrence was reported with the two treatment regimens. Subanalysis for multibacillary patients did not reveal any significant differences between the two regimens in the primary outcome of cure after adjustment for surveillance rate (p=0.35). Both ENL and deformity rates of 25% each for MDT Sungai Buloh were higher than the rate of 13.3% each for MDT Sarawak although they did not reach statistical significance. Analysis for paucibacillary patients did not show superiority of any one regimen. Conclusion Both the MDT Sungai Buloh and MDT Sarawak were effective in leprosy treatment. Selection of the best treatment regimens will depend on the cost effectiveness, ease of administration and duration of treatment that patients can tolerate.

Chronic

A series of new 2,5-disubstituted-1,3,4-oxadiazole derivatives (5a-j and 6a-j) have been designed and synthesized in four-steps. Sixteen compounds among the twenty compounds are reported for the first time. The compounds were characterized and confirmed by the FTIR, 1D- and 2D-NMR and HRMS analyses, and were tested against Mycobacterium smegmatis and Mycobacterium tuberculosis H37Ra. Compound 5d was the most active against M. smegmatis with MIC value of 25 µM, and exhibited cidal activity with MBC of 68 µM, respectively. The time-kill assay showed the good killing rate at 77% with the combination of isoniazid (INH). In addition, checkboard assay confirmed the interaction of compound 5d was categorised as additive. Docking simulation has been performed to position 5d into the pantothenate synthetase active site with binding free energy value –8.6 kcal mol-1. It also occupied the same active site as that of standard native ligand with similar interactions, which clearly indicate their potential as pantothenate synthetase inhibitor.