MCQ MAHE 2000 PSM Answer 02

The Correct Answer is A

Evolution and current status of WHO MDT regimens

The World Health Organization (WHO) introduced MDT in 1982, and advocated short-course treatment regimens . According to WHO guidelines, PB patients were to be treated with two drugs [rifampicin (600 mg, once a month, supervised) and dapsone (100 mg, daily, unsupervised, for 6 months)]. As most of these patients are lepromin-positive, it was thought that any residual organisms remaining after stoppage of therapy would be taken care of by the immunity of the host. Treatment for MB patients comprised three drugs [rifampicin (600 mg, once a month, supervised), clofazimine (300 mg, once a month, supervised; along with 50 mg, daily, unsupervised) and dapsone (100 mg, daily, unsupervised)]. The treatment was to be given for 2 years or until the attainment of smear negativity – whichever was earlier.

In the early 1990s, the concept of fixed-duration treatment (FDT) was introduced for control programmes. It was advocated that treatment in PB cases should be stopped after completion of six supervised doses taken in a maximum of 9 months, and treatment in MB cases be stopped after completion of 24 supervised doses in 36 months, irrespective of whether the smears were positive or negative . This duration has been further reduced to 12 months for MB cases, and a single-dose regimen comprising rifampicin (600 mg), ofloxacin (400 mg) and minocycline (100mg) (ROM) has been recommended for mono-lesion cases . These regimens have already been implemented by control programmes in some countries, such as India .

Note:
Currently none of the options is correct
In 1998 the WHO technical advisory group noted that multibacillary patients could probably be treated with only 12 months of multidrug therapy. However, no long term relapse data are currently available for this regimen, and many healthcare providers prefer to continue with the evidence based 24 month regimen.

Category: MAHE 2000 MCQs