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World Health Organization (WHO) Antibiotic Regimen Against Other Regimens for the Treatment of Leprosy: A Systematic Review and Meta-Analysis
35 Pages Posted: 14 Feb 2019
More...Abstract
Objective: To evaluate the effectiveness and safety of the WHO antibiotic regimen for the treatment of paucibacillary (PB) and multibacillary (MB) leprosy compared to other available regimens.
Methods: We performed a search from 1982 to July 2018 without language restriction. We included randomized controlled trials, quasi-randomized trials, and comparative observational studies (cohorts and case-control studies) that enrolled patients of any age with PB or MB leprosy that were treated with any of the leprosy antibiotic regimens established by the WHO in 1982 and used any other antimicrobial regimen as a controller. Primary efficacy outcomes included: complete clinical cure, clinical improvement of the lesions, relapse rate, treatment failure. Data were pooled using a random effects model to estimate the treatment effects reported as relative risk (RR) with 95% confidence intervals (CI).
Results: We found 24 eligible studies, 11 evaluated patients with paucibacillary leprosy, while 13 evaluated patients with MB leprosy. Diverse regimen treatments and outcomes were studied. Complete cure at 6 months of Multidrug Therapy (MDT) in comparison to Rifampin-Ofloxacin-Minocycline (ROM) found RR of 1.02 (95% CI 0.92 - 1.15) in four studies. Whereas six studies compare the same outcome at different follow up periods between 6 months and 5 years, according to the analysis a significant difference was found with a RR of 1.10 (95% CI 1.01 - 1.20).
Conclusion: Not better treatment than the implemented by the World Health Organization was found. Diverse outcome and treatment regimens were studied, more statements to standardized the measurements of outcomes are needed.
Funding Statement: We have not received any fund to carry it out and it has been subsidized by the researchers.
Declaration of Interests: "None"
Ethics Approval Statement: This review was reported following the Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Keywords: leprosy, treatment, systematic review, world health organization
Suggested Citation: Suggested Citation