Efficacy of BCG vaccine against leprosy and tuberculosis in northern Malawi

Protection afforded BCG vaccines against tuberculosis and leprosy varies widely between different populations. In the only controlled trial which assessed protective efficacy of BCG (Danish and Pasteur strains) against both diseases; there was slightly more protection against leprosy than against tuberculosis. Protection was estimated at 50 percent or greater against leprosy; and there was no evidence for lower protection against multibacillary than against paucibacillary disease. There was no statistically significant protection by BCG against tuberculosis in this population

Four-year follow-up results of a WHO-recommended multiple-drug regimen in paucibacillary leprosy patients in Malawi

An evaluation of a World Health Organization-recommended multidrug therapy (WHO/MDT) in 499 paucibacillary leprosy patients is described. Patients were followed for 48 months after completion of treatment. Overall relapse rates after treatment were found to be 6.5 per 1000 person years (95 percent confidence interval 3.4-11.4). There were 12 relapses. A relative lack of cell-mediated immunity; as suggested by number of lesions; clinical classification and lepromin test results; and poor compliance with the dapsone component of WHO/MDT; appeared to be associated with a marginally increased risk of relapse. Severe type 1 reactions after completion of treatment occurred in 17 (3.5 percent ) patients; 15/17 during the first 12 months of follow-up. Overall; 12 (2.5 percent ) patients developed new disabilities during or after WHO/MDT