D.D.S.(Diamino-Diphenyl-Sulfone) has been accepted as the first choice in the treatment of leprosy. This compound is relatively toxic but effective in all types of leprosy, and can be used for prolonged periods of time with almost negligible drug resistance and at very low cost. Leprosy is an extraordinarily chronic disease with an exceptionally prolonged incubation period. It is a well accepted practice to use chloroquine for malaria, penicillin for syphilis, and INH for tuberculosis as an agent of chemoprophylaxis. Leprosy is a disease that occurs chiefly among the poorer people in poverty stricken countries. Contacts with leprosy patients, particulary household contacts in such countries, are inevitable. An effective measure of prevention, if any, is greatly to be desired. Lew and Lee(1960) reported the results of the chemoprophylaxis of leprosy contacts with D.D.S. Seven hundred and sixty children born to leprous individuals were divided into two groups, the first group, 325 children, were given D.D.S. 50 - 300 mg. weekly for a period of 7 months to 5 years and the second group, 435 children, were not given any prophylactic measures but observed as controls for a similar period of time. Among the experimental group, the first group of 325 children developed no leprosy, while in the second group 31 children(7.1%) out of 435 developed leprosy. Nine suspicious cases of leprosy with hypopigmented skin patches were identified among the first group of 325 children while they were under preventive medication but those lesions gradually disappeared. Two cases of leprosy, indeterminate group, were identified about two years after stopping medication among the first group of 325 children. Another experiment on chemoprophylaxis is being conducted. In the first group, (experimental group); there were 778 household contacts from 156 bacteriologically positive leprosy patients who have been medicated only with D.D.S. at the leprosy center. The dosage of D.D.S. was paralleled to the dosage of leprosy patients whose maximum dosage was fixed to 400 mg. per week. At present these contacts have been followed for a period of one to seven years. None of leprosy incidences were identified during this observation period among those 778 D.D.S.-medicated contacts. In the second group, (control group); there were 749 individuals who were the household contacts of 160 leprosy patients in Kangwondo province. These contacts were not protected by D.D.S., nor by B.C.G. This group have been followed for the past one to seven year period during which time only the index cases (leprosy patients among the families) were me dicated with D.D.S. Fourty-four cases of leprosy (5.9%) among 749 household contacts were identified from the past 1 to 30 year period. Thirteen (1.7%)out of 44 cases (5.9%) of leprosy among the 749 household contacts were identified during the period of 1 to 7 years observation while there was no leprosy incidence among the D.D.S.-medicated 778 contacts in the first group experiment.
Adolescent ; Child ; Dapsone/*therapeutic use ; Human ; Leprosy/*prevention & control

BACKGROUND: Although incidence of leprosy in Korea has declined steadily over the years, the increase in immigration since the turn of the century-much of it from countries where leprosy is still prevalent-has been linked to an uptick in registered cases. OBJECTIVE: To describe the epidemiologic trends of incident leprosy cases detected in Spain among Korea-and foreign-born population groups METHODS: Observational, retrospective study of suspected leprosy cases in Korea, as reviewed leprosy records from the Korea Centers for Disease Control & Prevention from 2001 to 2015, with results disaggregated by country of birth. Author collected statistical data on leprosy burden for other countries from WHO(World Health Organization) to estimate the expected number of imported cases. RESULTS: Of the 198 leprosy cases registered during the study period, 172(86.9%) were in Korea patients, while 26(13.1%) were detected in resident immigrants. Author identified a significantly higher number of imported leprosy cases during the 2004~2006, 2007~2009, 2010~2012 and 2013~2015 trienniums compared to the reference triennium 2001~2003 (OR 2.66, 95% CI 0.607–11.65; OR 8.33, 95% CI 2.05–33.94; OR 10.00, 95% CI 2.25–44.49; and OR 10.00, 95% CI 1.99–1.34; respectively). Most imported cases were diagnosed in Indonesia(23%) and Sri Lanka(23.8%). However, registered incidence was lower than expected for each year from 2007 to 2015. For example, in 2007, the expected new cases in immigrants were 8, compared to only one case that were actually detected (a 87.3% difference). Likewise, the author expected to find 24 incident cases among immigrants in 2014 and 2015, but only one new case were reported (95.7% fewer than expected). CONCLUSION: Imported cases of leprosy are low than expected cases in Korea, and the author cannot rule out some under-diagnosis. Clinicians should be made more aware of the potential for leprosy incidence among patients from countries where the disease is endemic.
Centers for Disease Control and Prevention (U.S.) ; Emigrants and Immigrants ; Emigration and Immigration* ; Humans ; Incidence ; Korea* ; Leprosy* ; Parturition ; Population Groups ; Retrospective Studies ; Spain

Drug Resistance, Bacterial ; Humans ; India ; epidemiology ; Leprosy ; epidemiology ; prevention & control ; National Health Programs ; Population Surveillance ; Prevalence ; World Health Organization

OBJECTIVETo analyze the trends of case detection and other indicators of leprosy in China during 1985-2002.

METHODSData reported by each province were collected by China National Leprosy Database in Nanjing P.R. China. All data about registered cases were put into computer for analysis.

RESULTSFrom 1985 to 2002, a total of 49,477 new leprosy cases had been detected. Among them, 69.5% were multibacillary cases and 25.4% had grade 2 disability. The child cases aged below 15 years accounted for 3.74% of total cases. Totally, 5824 cases and 303 cases relapsed after dapsone (DDS) mono-therapy and multidrug therapy (MDT), respectively. Case detection showed a marked reduction from 0.47/100,000 in 1985 to 0.18/100,000 in 1993 although there were several spurts due to operational factors. From 1994, case detection showed no significant decline. The grade 2 disability among new patients decreased from 31.4% in 1985 to 23.4% in 2002. The child case detection rate among new cases fluctuated between 2.70%-3.56% from 1999 to 2002. The incidence of relapse declined after the introduction of DDS mono-therapy. However, it increased after the introduction of MDT.

CONCLUSIONChina experiences in leprosy control show that it will take a long time with continuing present leprosy control activities to bring down the case detection and other indicators to a very low level even after reaching the elimination goal of leprosy.

Adolescent ; Adult ; Age Factors ; Child ; China ; epidemiology ; Communicable Disease Control ; trends ; Dapsone ; administration & dosage ; therapeutic use ; Disability Evaluation ; Drug Therapy, Combination ; Humans ; Incidence ; Leprostatic Agents ; administration & dosage ; therapeutic use ; Leprosy ; drug therapy ; epidemiology ; prevention & control ; Recurrence