Drug resistance surveillance in leprosy : Report of the WHO-ILEP joint meeting 4-6 February 2014, Cebu City, Philippines
AbstractDescription: Anti-microbial resistance is an important factor to reckon in communicable disease control and leprosy is no exception. Rifampicin is a strong constituent antibiotic in the multidrug therapy (MDT) besides dapsone and clofazimine. Even after 30 years since its introduction, MDT remains the only WHO recommended regimen for treating leprosy. Surveillance of drug resistance is a necessary particularly in the absence of new drug regimens as effective as MDT. In 2009, WHO published 'Guidelines for Global Surveillance of Drug Resistance in Leprosy'. Currently drug resistance surveillance (DRS) is carried out by screening all multi-bacillary (MB) patients who have relapsed after completing the prescribed WHO MB-MDT, on a sentinel centre basis. Currently 17 countries are participating in surveillance activities by collecting patient samples for testing drug resistance: Benin, Burkina Faso, Brazil, Colombia, China, India Indonesia, Madagascar, Mali, Mozambique, Myanmar, Nepal, Niger, Pakistan, Philippines, Viet Nam and Yemen. There are ten reference laboratories which facilitate processing of these samples for 'leprosy drug resistance DNA mutation' detection in Brazil, France, India, Japan, Nepal, South Korea, Switzerland and USA. Because drug resistance in leprosy remains a concern, surveillance should be continued and expanded to maintain the integrity of MDT. Networks of sentinel centres should be developed for the eastern African region covering Tanzania, Ethiopia and other endemic countries, similar to the western African region. The meeting on drug resistance surveillance was organized to review the progress on drug resistance surveillance in leprosy through the network of sentinel centre. Currently rifampicin resistance does not seem to be a serious problem among relapse cases. Longitudinal observation need to be continued since the situation in leprosy control is not the same situation as in TB or other disease control programmes and vigilance has to be maintained to prevent the occurrence and spread of drug resistance and thus maintain the effectiveness of MDT.
World Health Organization, Regional Office for South-East Asia. (2014). Drug resistance surveillance in leprosy : Report of the WHO-ILEP joint meeting 4-6 February 2014, Cebu City, Philippines. WHO Regional Office for South-East Asia. http://www.who.int/iris/handle/10665/204980