[Evaluation of 7 years of systematic surveys of leprosy in Morocco]. / Bilan de sept années d'enquêtes systématiques sur la lèpre au Maroc.

Between 1980 and 1987, 12 systematic surveys were made on a population of 254,979 people, of whom 236,868 were actually examined (92.61%). 422 suspected cases were identified i.e. a global detection rate of 1.66% of which only 241 reported to Aïn-Chock Hospital for further tests (55%). Out of these 241 suspected cases, 217 proved as having leprosy, i.e. a 90% correlation between the clinical suspicion and the biological identification. The 181 suspected cases who never reported to the hospital and the 16 leprosy patients whom we lost sight of constitute as a whole 46.68% of the suspected cases first identified. This shows an obvious lack of coordination between the local Authority and the medical service. The 185 confirmed cases of leprosy are shown in the table below and compared with those of the Central Statistical Office.

[Histopathology of leprosy. Study of more than 2300 biopsies]. / Réflexions sur l'histopathologie de la lèpre. Etude sur plus de 2,300 biopsies.

2,326 biopsies on Moroccan subjects suffering of leprosy had been studied in 4 years. After a critical study of histopathologic diagnosis and the classifications, the authors studied especially the lepromatous granuloma, its evolution during treatment and the lepromatous reactions. Defining histologically a reactional background, they make a certain generalisation among all the types of reactions observed in lepromatous patients.

[Sensitivity to dapsone, sulfamethoxypyridazine and ethionamide of mycobacterium leprae taken from patients treated by the drugs]. / Sensibilité envers la dapsone, la sulfamethoxypyridazine et l'éthionamide, de Mycobacterium leprae provenant de malades traités par ces substances

Suspensions of M. leprae from skin biopsies of patients treated with dapsone (DDS) (four cases), sulfamethoxypyridazine (SMP) (six cases), and ethionamide (ETH) (seven cases), were inoculated into mouse foot pads and their sensitivity for the different drugs determined. Two strains were DDS resistant. Resistance appeared after 13 and 14 years respectively after the start of treatment. Five strains were isolated from patients treated with SMP. Relapses during sulfonamide treatment are considered to be due to the low effective serum concentrations reached by SMP, a situation which is aggravated by irregularities in drug intake. Fortunately all strains were sensitive to SMP and DDS as well. Four strains were ETH resistant. ETH resistance at the present moment reaches 4% and appeared in two cases six years after the start of treatment. It is concluded that SMP is not indicated for the treatment of multibacillary leprosy and that ETH can be used only in association with other drugs during the introductory phase of treatment of multibacillary forms of leprosy.