Treatment of falciparum malaria with a single dose combination of dapsone and pyrimethamine (Maloprim).
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The Dapsone/creatinine ratio in random samples of urine was determined in 910 infectious leprosy patients attending the outpatient department of the Acworth Leprosy Hospital, Bombay during the period 20-9-76 to 20-11-1976. It was found that 48.7% of them were not taking regular treatment. The patients who were detected to be irregular in treatment were interviewed when they next attended the clinic to find the reason behind their irregularity. It was noticed that the majority of them (63%) attended the clinic for DDS treatment but could not come regularly for valid reasons, e.g. no time to attend, no money to travel to the clinic and absence from Bombay to go to native village.
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Effect of DDS was studied using the mouse model. It was observed that DDS did not have any neurotoxic effect. On the contrary it showed a protective action towards the nerve, when administered in the early stages following definite establishment of nerve lesions.
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A modified tile reaction test for monitoring self administration of DDS by leprosy patients is described. 385 Urine samples collected at 24 hours after a single dose and at 24, 48 and 72 hours after daily doses of 25, 50, 100 mg were screened for the presence of DDS by this test and the corresponding DDS/C ratios were studied for comparison. Patients compliance was assessed on 268 urine specimens collected on surprise visits. The feasibility of application of this test in field situations is discussed.
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At the Schieffelin Leprosy Research and Training Centre, Karigiri, India, data were assembled on all 58 living patients with lepromatous leprosy residing in Gudiyatham Taluk who had been registered in 1960 or earlier. They had received domiciliary oral DDS monotherapy for greater than 20 years. Fifty-one of the 58 patients were currently smear negative and clinically inactive. Patients with a Bacterial Index that had at some time been greater than or equal to 2+ were currently found smear positive more frequently than the remaining patients.
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