Treatment of Leprosy

MODULE II

Treatment of
Leprosy
MULTI-DRUG THERAPY =

MDT
accepted standard treatment for leprosy
combination of 2 or more anti-leprosy drugs

1.

several
advantages;
Highly
effective
cure for leprosy

2.

Fixed duration of treatment

3.

Cuts down transmission of the disease

4.

Prevents the emergence of drug resistant

bacilli

5.

Reduces risk of relapse

6.

Treatment is home-based

Multidrug Therapy for adults

Multidrug Therapy for children

Single dose regimen for

single lesion PB case (Not
Dosage: Single dose ROM
Available)

Adult
Rifampicin 600 mg (2 x 300 mg)
Ofloxacin 400 mg (2 x 200 mg)
Minocycline 100 mg (2 x 50 mg)

Child (10 14 years old)

Rifampicin 300 mg (1 x 300 mg)
Ofloxacin 200 mg (1 x 200 mg)
Minocycline 50 mg (1 x 50 mg)

MDT sideRed coloured urine

effects

Darkening of skin

Severe itching of
skin

This is due to Rifampicin.

Lasts only for few hours
Reassure the patient that
this is harmless
Due to Clofazimine.
Reassure patient that this
will disappear few months
after treatment is
completed
This is due to allergy to
Dapsone. Stop all
medicines and refer to
hospital

In case any of the above conditions occur, refer the patient to

nearest health facility (Rural Health Unit or Sanitarium) for
appropriate treatment.

CONTRA-INDICATIONS TO
MDT
a.

Cases with severe liver or/and kidney disease

b.

Known severe drug hypersensitivity to any of the

MDT Drugs

c.

Severe anemia

d.

Ofloxacin and Minocycline are not recommended

for use in pregnant women and children below
five (5) years old

I mportant Messages about MDT

Health Advise/ I nstruction

1. Regular and continuous intake of MDT Take your monthly and daily doses of MDT
drugs will cure leprosy and if the prescribed
drugs regularly, continuously and adequately
number of blister packs are consumed
to make sure that you get cured of the
within the prescribed period of 12 to 18
disease.
months for MB and 6 to 9 months for PB.
2. A leprosy patient becomes non-infectious Patient becomes non-infectious one-month
after taking MDT drugs.
after taking the initial dose of MDT drugs.
3. MDT drugs are available in all government Collect monthly supply of MDT blister pack(BP)
rural health units, free of charge.
at the rural health unit until all the prescribed
number of blister packs are completed.
4. Leprosy reactions may occur during the Patient must report immediately to the rural
course of treatment.
health unit or to the health worker for
appropriate intervention of any case of leprosy
reaction
Advise the patients to continue drug intake
during reactions.
5. Impairments and disabilities of eyes, hands Advise patients to take care of their
and feet are preventable.
anaesthetic hands and feet by using protective
devices such as; gloves, shoes and shades for
the eyes.

When is Treatment
Completed ?
A PB patient has taken 6 blister packs MDT
drugs within 6-9 months;
A MB patient has taken 12 blister packs MDT
drugs within 12 to 18 months; and
SLPB patient has taken the single doses of
ROM.
A LEPROSY CASE WHO HAS COMPLETED A FULL COURSE OF
TREATMENT SHOULD NO LONGER BE REGARDED AS
LEPROSY PATIENT.

When is a leprosy patient

considered a defaulter?
Patient who has started treatment
and
not collected MDT drugs for six (6)
consecutive months
It is important that adequate efforts are made to trace these
patients and persuade them to return for
assessment and treatment.
A defaulter who returns to the rural health unit for treatment
should be given a new course of MDT.

Patients with Special

Needs
Designed
to address the problem ofMDT
compliance
Accompanied
1. For patients who live in geographically inaccessible areas
2. For patients whose life style does not permit regular visit to the
rural health unit ; e.g. NOMADS
3. For patients who cannot attend clinics at certain times;
e.g. rainy season

Designed to ensure that patients receive the full course of

treatment.

Sufficient supply of drug to cover the period of absence

should be advised to report to the nearest rural health unit if they

have any complications.
FIRST DOSE TO BE TAKEN IN THE RURAL HEALTH UNIT

Patients with Special

Needs
Accompanied MDT
Reasons for the interruption of treatment:
(cont.)
Poor access to the health service
No one is at the rural health unit when they come
to collect their blister packs
Nature of work (e.g. fisherman)
I nsurgency

Patients with Special

Needs

Patients with Special

Needs
Tuberculosis (TB)
Patients suffering from both tuberculosis and leprosy
require appropriate anti-tuberculosis therapy in addition
to MDT.
Since Rifampicin doses for tuberculosis are larger than
for the leprosy MDT regimen, remove the Rifampicin
capsules from the MDT blister packs for the duration of
tuberculosis therapy, and give Clofazimine and Dapsone
together with TB regimen.
When the TB treatment
prescribed MDT regimen.

is completed, resume the

Patients with Special

Needs
HI V I nfection
Management of leprosy patient infected with HI V
is the same as with any other patient.
The information available so far indicates that the
patients response is similar to any other leprosy
patient.
The management including the treatment of
reactions do not require modifications.