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Chemoprophylaxis of Leprosy Contacts with D.D.S.

Yonsei Medical Journal 1966년 7권 1호 p.47 ~ 51
 ( Lew Joon ) - 연세대학교 의과대학 미생물학교실

 ( Kim Young-Soo ) - World Vision Special Skin Clinic Leprosy Center

Abstract


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.

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