Clinical outcome, Morphologic Index and Associated Factors in Multibacillary Leprosy Patients
No Thumbnail Available
Date
2025
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa Universtity
Abstract
Although Ethiopia has substantially reduced its leprosy burden, new cases
persist, and management challenges, such as poor patient adherence, limited education, and inadequate healthcare training, continue to impact treatment outcomes. However, clinical outcomes and morphologic indices in multibacillary leprosy patients upon multidrug therapy completion remain undocumented in the Ethiopian context.
Objective: To assess clinical outcome morphological indices and associated factors in multibacillary leprosy patients at completion of multidrug therapy (MDT) at ALERT Hospital, in Addis Ababa, Ethiopia
Methods: The study was a facility based cross-sectional study conducted in ALERT Hospital. All patients diagnosed with multibacillary leprosy and given the advised MDT in ALERT Hospital between November 1, 2020, and November 30, 2025, were followed up. The data were analyzed and inputted in SPSS version 26. The demographic and clinical characteristics were summarized by descriptive analysis. BI/MI change was tested using
Wilcoxon signed-rank, bivariate (p[?]0.25) and multivariate logistic regression determined the outcome poor predictors. The outcome of the development of new and progressive lesions, active lesions or a continuance of active lesions, the BI persistence and a severe reaction after 12 months of MDT are considered poor outcome. The p-value of less than 0.05 was counted as significant. Results were presented using texts, tables and figures.
Results: In total, 107 MB leprosy patients were included. The median (IQR) age was 30 (25–36) years. Young adults (25–44 years: 67.2%) and males (65.4%, n=70) predominated. One third 33.6% had poor clinical outcomes and three-fourths, 83.2%, had persistent MI at the end of MDT. BI (z = -7.85, p < 0.001) and MI (z = 7.01, p < 0.001) were significantly reduced at end of MDT. End MDT- MI (1–10%) in 86.0%. High BI at diagnosis [AOR=11.7 (95% CI
1.44- 93.66)] and High MI at diagnosis [AOR = 5.13(95% CI: 1.94-13.57), p=0.001] were independently associated with poor clinical outcome. High BI at diagnosis was associated persistent MI at end of MDT [AOR=12 (95% CI: 3.53–42.28), p=0.001].
Conclusions: One third of the patients had poor clinical outcome, and more than three fourths had persistent MI at the end of Fixed 12-month MDT. We found discordance between achieved dermatological cure and suboptimal bacteriological clearance in the high-BI Ethiopian cohort. Post-MDT smear monitoring is recommended for lepromatous cases.
Description
Keywords
s: Multibacillary leprosy, MDT, bacteriologic index, morphological index, ALERT Hospital