Diabetic status in leprosy

The diabetic status of the local Jhansi patients (120 cases) was established before and after antileprosy treatment. Control studies were performed in normal healthy subjects (50 persons) without family history of diabetes mellitus. Random normals showed an incidence of diabetes only 2%, while leprosy patients (94 males and 26 females) had incidence of diabetic status of 14.2%. The highest incidence (19.3%) of diabetes was in lepromatous leprosy and lowest incidence (6.4%) in tuberculoid leprosy patients. Repeated studies in leprosy after treatment showed not only clinical improvement for leprosy but also disappearance of the chemical and latent diabetes mellitus and lowering of blood sugar levels in manifest diabetes mellitus. Incidentally it was noted that 'diabetic status' was worse among males (82.3%) and with advancing age. Association and improvement of diabetic status with specific treatment would tentatively suggest that Mycobacterium leprae lesions are not confined to skin alone but somehow also related to carbohydrate metabolism. A careful management of the chemical and latent diabetes may help in clinical management of leprosy too.

Evaluation of treatment of lepromatous leprosy patients in the Netherlands

The results of treatment of the group of leprosy patients at the lepromatous side of the leprosy spectrum registered at the Department of Dermatology of the University of Amsterdam in the years 1950-1976 were studied. The average duration of treatment to obtain bacteriologically negative skin biopsies in patients who were untreated at the time of registration, was 5 years. A substantial number of patients suffered a relapse; the main reasons for these relapses were discontinuation of treatment and DDS treatment in low dosage.

Combined therapy in leprosy. Background and findings

This report is based on data obtained from 64 lepromatous cases. Despite many years of DDS monotherapy, the homogenates from biopsies of these patients revealed 10(4) or more bacteria. From the beginning of combination therapy with synergistic-acting substances (rifampicin + isoprodian (INH + PTH + DDS) the logarithms of the number of bacteria in the homogenates decreased, both during treatment period and during treatment-free observation period (Figs. 3--8). During the whole time biopsies were taken almost monthly. A considerable regression of the bacterial mass or even "negativity" could be observed within a relatively short time. Once started, the process of reduction of bacteria continued also after termination of therapy. To be able to evaluate a medication, therapy-free observation periods (for a minimum of 5 years) are indispensable.

Experimental chemotherapy in leprosy

The Memorandum reviews the considerable progress that has been made in research on the chemotherapy of leprosy during the last 10-15 years, as a result of which it is now possible to study the same topics in leprosy as are studied in other bacterial diseases. Thus drugs have been screened in mice for their activity against Mycobacterium leprae. Those that have been found to have the greatest activity against M. leprae at acceptable dosages-dapsone, rifampicin, and clofazimine-have been characterized in terms of the minimal effective dosage and rate of bacterial kill. Similarly, their pharmacokinetics in man and in certain animals have been defined. The theoretical basis for drug trials in leprosy patients is discussed in terms of the number of viable and the number of dead M. leprae that remain at various stages of therapy.

Leprosy in Louisiana, 1855-1970. An epidemiologic study of long-term trends

Study of a well known focus of leprosy in Louisiana in 1855-1970 showed a decrease in incidence which began before the use of chemotherapy. Many of the cases had onset in a limited area of Louisiana, French Louisiana, where there was a high incidence of multiple family cases. Overall incidence rates were found to be decreasing for each cohort of birth, and within cohorts after 1920, the highest incidence rates were in the age group 10-19. A high incidence rate was found for cases with onset in the years 1900-1929; rather than an epidemic, this was probably related to bias in the recording of year of onset. Although persistent for a long period, the focus remained limited in geographic extent and seems to be disappearing.