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Biomedical subjects

K Jesudasan

Publications and source records attributed to K Jesudasan.

At least 37 records · Page 2Linked to original sources

Transmission of health information on leprosy from children to their families: another approach to health education.

A controlled study was carried out in the North Arcot District of Tamil Nadu, South India to determine whether health information given to schoolchildren would influence the knowledge and attitudes of their families concerning leprosy. A total of 41 children and almost all of their household members participated in the study. The study, conducted by questionnaire, involved a pre-test of knowledge and attitude about leprosy of seventh standard students and their families. After one group of children received health education about leprosy and the other received information about tuberculosis, an identical post-test questionnaire was administered to all participants. Although significant improvement in knowledge about leprosy was detected in the leprosy educated group of children compared with controls, no transmission of information on leprosy was detected in the family members of either group. The attitudes of the children who had been educated about leprosy may have been adversely affected by the health education session. The reasons for our failure to detect significant transfer of information about leprosy in this setting are discussed, as well as the need for additional research in this area.

Adolescent↗

Impact of MDT on incidence rates of leprosy among household contacts. Part 1. Baseline data.

This preliminary study from Gudiyatham Taluk, the leprosy control area of the Schieffelin Leprosy Research & Training Centre, investigated the incidence rates of leprosy among household contacts during the period 1970-1985. The incidence rates of leprosy among the household contacts prior to and during the initiation of multi-drug therapy are presented here. The overall incidence rate among the household contacts was 4 per 1000 person-years at risk. Contacts of multibacillary and paucibacillary cases had a relative risk of 3-6 times and 2-4 times the risk of leprosy in the general population, respectively. The incidence rates among children were higher than adults; the peak age-specific incidence rate was between 5-9 years, and nearly one third of the primary cases were children. These findings are presented and the methodological issues discussed.

Age Factors↗

Infectivity of secondary dapsone-resistant cases.

The incidence rate of leprosy among 517 household contacts of 113 cases of secondary dapsone resistance with 5074 person years at risk were studied. The incidence rate of leprosy was 4.3 per 1000 person years at risk, which is very similar to the incidence rate (4.8) among household contacts of lepromatous cases. Two, possibly three, cases of primary dapsone resistance were detected among the 27 contacts who developed multibacillary leprosy. There was no evidence of dapsone resistance among 48 paucibacillary leprosy cases assessed when treated with dapsone monotherapy. The possibility that secondary dapsone-resistant cases will infect and will result in an increase in the number of primary dapsone-resistant cases needs to be investigated further.

Adult↗

An evaluation of the Semmes-Weinstein 6.10 monofilament as compared with 6 nylon in leprosy patients.

In a previous study Birke and Sims (1986) identified the 5.07 (10 y) Semmes-Weinstein monofilament, as the most useful tool, in measuring protective sensation in the sole of the foot of leprosy patients. This study has demonstrated that the standard 6 Nylon being used in Karigiri, is as good as the monofilament, in assessing protective sensation in leprosy patients. However there is a need for standardising procedures for measuring sensory loss in leprosy patients.

Azepines↗

Relapse rates in lepromatous leprosy according to treatment regularity.

In Gudiyatham Taluk, South India, 1008 lepromatous (LL) and borderline lepromatous (BL) patients were studied. They had previously been smear positive, had attained smear negativity, and continued on DDS monotherapy. "Relapse" was defined as the reappearance of Mycobacterium leprae in skin smears. The area is endemic for leprosy. The lower relapse rates in the first three years of smear negativity alone were associated with more-regular treatment during both past smear positivity and smear negativity. From the fourth year of smear negativity onward, only the more-regular treatment during smear negativity was associated with lower relapse rates; whereas patients with more-regular treatment during past smear positivity had no lower risk of relapse than those with less-regular treatment. The finding that regularity of treatment during smear positivity seems to have no effect on relapse rates beyond the third year of smear negativity is discussed. In a leprosy-endemic area, it is argued that beyond the first three years of smear negativity in an LL or BL patient, sources of M. leprae outside the patient may be more responsible for relapse than the patient's own bacilli.

Dapsone↗

Relapse rates among nonlepromatous patients released from control.

A total of 1701 nonlepromatous patients treated with dapsone monotherapy for at least 4 1/2 years and released from control were followed up and examined for evidence of relapse. They contributed a total of 5254 person years of risk, and there were 51 relapses (3%), giving an overall relapse rate of 9.7/1000 person years of risk. This paper examines the effect of various factors on the risk of relapses, such as age, sex, and classification of the disease; duration and regularity of treatment; percentage of attendance; deformity grade; number of patches and lepromin status. Some of the factors studied, such as age, sex, classification, percentage of attendance, and the number of patches in association with the lepromin status, were found to significantly influence the risk of relapse in these patients. Therapy in nonlepromatous leprosy is discussed in light of these findings.

Adolescent↗

An analysis into the trends of reconstructive surgery in Gudiyatham Taluk, a leprosy control area.

The trends in Reconstructive Surgery in Gudiyatham Taluk, an area where an effective Leprosy Control Programme has been in progress since 1963, were analysed. Over the years 1962-79, it is shown that there is a decline in the number of Reconstructive surgical operations in Karigiri, on patients from the Control area, even though the new case detection rate and the total number of operations from both control and non-control areas remained high. The decline in the number of Reconstructive Surgery on patients from a Control area, provides a reliable index to judge the efficacy of a Leprosy Control Programme.

Adolescent↗

Prevalence of secondary dapsone resistance in Gudiyattam Taluk, the leprosy control area of the Schieffelin Leprosy Research and Training Centre, Karigiri. 1. Preliminary report.

A preliminary study of the prevalence rate of secondary dapsone resistance among leprosy patients in Gudiyattam Taluk, Tamil Nadu, was undertaken. During the period March 1978 to February 1979, there were 1580 lepromatous and borderline lepromatous patients considered to be at risk of developing secondary resistance. Of them, 1431 were examined clinically, and reactivation and/or relapse was found in 114 patients. Of these, 46 had a bacteriological index of 2,000 and more. Skin biopsies were taken from 26 patients for mouse foot pad studies. Resistance to dapsone at the highest drug concentration was found in 22 and partial resistance in two patients. The organisms from two patients were sensitive to dapsone. Twenty patients were not biopsied because they had been absent from treatment for significant periods of time. These patients are now under observation. Prior to this study, nine patients had been confirmed to have dapsone resistance in the control area, and during the present study 24 additional patients with secondary resistance have so far been detected. Thus 33 patients with dapsone resistance among the 1431 patients examined yields a crude prevalence rate of 2.3% in Gudiyattam Taluk.

Dapsone↗