Browsing by Author "Christian, M"
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Item A 20-year study of the leprosy control programme at the Government Leprosy Treatment and Study Centre at Tirukoilur in south India.(1982-07-01) Radhakrishna, S; Christian, M; Nair, N GItem A 20-year study of the Leprosy Control Programme at the Hemerijckx Leprosy Centre in Polambakkam in South India.(1985-07-01) Nair, N G; Radhakrishna, S; Christian, M; Ramakrishnan, R; Gopi, P GThe Hemerijckx leprosy centre at Polambakkam in South India covers a rural population of about 800,000 and has treated over 40,000 cases of leprosy during the period 1955-75. Based on a stratified random sample of 25% of the case records, information was obtained about the profile of newly-detected cases in various cohorts (1955-57, 1958-60, 1961-64, 1965-69, 1970-75), regularity in drug collection and response to treatment. In newly-detected cases, the ratio of males to females was stable (3:2), but the proportion of adults aged 45 years or more increased from 15% in 1958-60 to 20% in 1970-75 and the lepromatous rate decreased from 9% to 6%; the proportion deformed at the time of diagnosis ranged from 11% to 15%. Regularity in drug collection was unsatisfactory even in the first year of treatment, with less than half the patients making 6 (or more) of the 12 monthly drug collections. The clinical status at 4-6 years was known for 70-75% of the patients who started treatment and of those approximately 60% had inactive or arrested disease. Data from population surveys was sparse; about 60% of the expected numbers were initiated and less than 30% of these had a coverage of 75% or more. The limited evidence, however, showed a decline in the prevalence of about 2 per thousand per annum. Field studies to evolve strategies for better motivation of patients, introduction of short-course regimens, and continuous monitoring of the programme are urgently needed.Item Are defaulters with paucibacillary leprosy a problem?(1985-04-01) Jesudasan, K; Bradley, D; Christian, MThis study examined the risk of relapse in 421 paucibacillary patients who had defaulted after varying periods of dapsone monotherapy; short of the recommended course. The 421 patients contributed a total of 2,162 person years of risk; 10 patients relapsed, giving a relapse rate of 4.6 per 1000 persons years of risk, or a crude relapse rate (RR) of 2.4%. This paper discusses the issue of defaulters with paucibacillary leprosy and the findings of the study suggest that defaulters with paucibacillary leprosy are not a serious problem in terms of leprosy control.Item Incidence rates of leprosy among household contacts of "primary cases".(1984-07-01) Jesudasan, K; Bradley, D; Smith, P G; Christian, MThe data consisted of information from 1,564 "Primary cases" of leprosy of all classification and 9,162 of their household contacts. Household contacts of Indeterminate (Ind), Borderline (BL) and Lepromatous (LL), "Primary case" (PC) had an incidence rate (IR) of 5 per 1000 person years of risk (PYR). Household contacts of Tuberculoid (TT) and borderline tuberculoid (BT) patients had an IR of 3.2 and 3.8 per 1000 PYR respectively. Compared with an incidence rate of leprosy of 1.6 per 1000 PYR among individuals not exposed to leprosy in the same area, household contacts of Non-lepromatous patients had a relative risk of twice as high and contacts of lepromatous and borderline lepromatous patients a relative risk of 3 times as high. The incidence rate was higher among household contacts of bacteriologically positive patients, among contacts closely related and in households with multiple cases. The peak age specific incidence rate among household contacts was between the ages 5-9 years of age. The significance of these findings are discussed.Item Spontaneous healing in paucibacillary leprosy.(1985-02-01) Jesudasan, K; Christian, MItem Surveillance in leprosy.(1985-01-01) Jesudasan, K; Christian, MSurveillance in leprosy forms an integral part of leprosy control activities. Usually contact and school surveys are done annually and general population surveys are done once every 3-5 years. Data is presented which suggest that frequently done surveys may not be cost effective as a means of case detection. Carefully done general surveys once every 3 years, covering contacts as well as school children may be adequate and more cost effective in endemic areas, whereas contact surveys, surveys of high risk groups and contact tracing, may be more relevent in low endemic areas.Item Time trends in the analysis of incidence rate of leprosy among household contacts.(1984-10-01) Jesudasan, K; Bradley, D; Smith, P G; Christian, MAnalysis of time trends in the Incidence Rates among 9.598 household contacts of 1,614 primary cases of leprosy, showed that the incidence rates (IR) remained high even 10 years after treatment was started in the Primary Case. The IR during the 1st year of follow-up was 3.8 per 1000 person years of risk (PYR) and the IR was 3 per 1000 PYR after 10 or more years of follow-up. The significance of these findings in relationship to the Epidemiology of leprosy among household contacts in an endemic area for leprosy is discussed.