"Outside project area" leprosy cases in 'A' ward of Mumbai.

Analysis of newly registered smear-positive cases in a ward of the metropolitan city of Mumbai, which has a railway terminus during 1990-97 revealed that 72% of the patients came from outside the project area, most of them arising from the States of Uttar Pradesh, Bihar and Orissa. They had unstable and temporary residences in the area and were employed in low income hard labour jobs. Nevertheless, it was found that their treatment completion rate was high. Using different approaches, e.g. through the community leaders of footpath dwellers and railway platform dwellers, and those of different state language groups' colonies, the new entrants were examined periodically and simultaneously proper rapport was maintained with the medical practitioners of the ward for more referrals to leprosy clinic. Such special approach may have to be developed to tackle such situation in other metropolis in the country.

Pattern of drug compliance in leprosy patients attending urban centres--a longitudinal study.

The pattern of drug compliance in 485 leprosy patients attending urban leprosy centres in Bombay was studied for 2 years. The study subjects included 113 patients with paucibacillary leprosy under dapsone monotherapy, 241 patients with paucibacillary leprosy under multidrug therapy and 131 patients with multibacillary leprosy under multidrug therapy. Their urine samples had been checked at least 6 times during the 2 years by DDS tile test at the time of their clinic attendance. The urine test results were not disclosed to the patients, but patients showing negative results were counselled about the need for regular drug intake. 35% of the patients were "Regular through out", 13% were "Irregular through out" and the other 52% who "Tended to be irregular" in their drug intake became "Regular" after counselling. Regularity in drug compliance was better in patients on multidrug therapy than in those on monotherapy. It is suggested that periodic testing of urine for checking for regularity of drug intake and subsequent counselling of patients should be made a routine practice to maintain drug compliance at a high level.