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Biomedical subjects

H Sansarricq

Publications and source records attributed to H Sansarricq.

At least 19 recordsLinked to original sources
PubMed1991

A case of relapse with drug-susceptible M. leprae after multidrug therapy.

A male born in 1930 was diagnosed as smear-positive borderline leprosy in 1971, and was treated with dapsone and/or sulfamethoxypyridazine from 1972 to 1980 with clinical improvement. However, new skin lesions with smears strongly positive appeared in August 1980, and he was diagnosed as having downgraded to lepromatous (LL) leprosy, but the bacilli recovered from the skin biopsy were fully susceptible to both dapsone and rifampin by mouse foot pad technique. Between 1981 and 1983, the patient was treated with 24 months of rifampin 600 mg and dapsone 100 mg daily, supplemented with prothionamide 500 mg daily during the initial 3 months, and his skin lesions gradually improved during treatment with the combined regimen. Afterward, the patient was kept under surveillance without treatment. From 1984 to 1986, his skin smears were negative, and no bacilli could be found from a skin biopsy taken in 1985. Then in 1987, 52 months after stopping treatment, new skin lesions appeared with a high concentration of Mycobacterium leprae (2 x 10(6)/mg tissue). The drug-susceptibility test again demonstrated that the organisms were fully susceptible to both dapsone and rifampin. Apparently the relapse was due to remultiplication of drug-susceptible persisters.

Adult↗
PubMed1989

Technical problems related to multidrug therapy in leprosy control.

About 40% of registered leprosy patients worldwide have been, or are being, treated with multidrug therapy (MDT) in accordance with the standard regimens recommended by WHO in 1981. The conclusions that can be drawn from such an extensive experience are discussed. The most significant of these are: (i) the MDT regimens recommended by WHO are non-toxic and well-accepted by patients; (ii) as regards the efficacy of these regimens, post-therapeutic relapses, in both multibacillary and paucibacillary patients, have been negligible when observed over periods of one to three years. The overall conclusion that at present emerges is that the MDT regimens for leprosy control, as recommended by WHO in 1981, should continue to be applied without any modification.

Drug Therapy, Combination↗
PubMed1985

BCG vaccination of children against leprosy: fourteen-year findings of the trial in Burma.

The value of BCG vaccination in preventing leprosy among children was studied in an area of high leprosy endemicity in Burma through a controlled trial; one group of 13 066 children received BCG and another group of 13 176 served as controls. The overall protective effect of BCG, which was only about 20% over the 14-year period, was found to vary with the batch of vaccine, as well as age, sex, and contact status of the children. BCG protection was found to be independent of the initial tuberculin status of the children. The protective effect of BCG against the lepromatous type of leprosy could not be measured because of the low incidence. Protection was observed throughout the fourteen years of the study except for the first year. The results are compared with those of three other major BCG trials in leprosy. The trial has shown that BCG provides only a very modest level of protection and that BCG vaccination is not likely to be an important solution for leprosy control.

Adolescent↗
PubMed1984

Immunization against leprosy: progress and prospects.

The limitations of the current approach to leprosy control through mass treatment of patients are well recognized. The long incubation period of the disease, the insidious onset, the chronic course, and the need for prolonged treatment have made control a formidable task. The recent years have seen tremendous progress in the field of immunology of leprosy, and the availability of large quantities of Mycobacterium leprae, grown in the nine-banded armadillo, has given impetus to the search for a vaccine specific for leprosy. Methods for production and purification of M. leprae have now been developed and the resulting preparation has been shown to produce good delayed-type hypersensitivity in mice and guinea pigs.Small-scale studies in human subjects have shown that preparations of M. leprae and BCG can induce cell-mediated immunity in Mitsuda-negative patients and contacts. It is now appropriate to consider field trials of vaccine preparations in selected groups before moving on to large-scale trials in different populations.

BCG Vaccine↗
PubMed1981

[Problems in designing a protocol for a leprosy vaccine trial. (author's transl)].

Investigations carried out by the Scientific Working Group on Immunology of Leprosy (IMMLEP) have led to the planning of field trials of an experimental vaccine preparation to be carried out in few years' time. The objectives of these trials have been defined as follows: 1) The main objective should be the assessment of the protective effect of the vaccine against leprosy, its various forms and more particularly the lepromatous form. 2) Another important objective will be to determine the value and significance of the greatest possible number of immunological tests as indicators of sensitization and as preliminary indicators of protection against leprosy, its various forms and more particularly the lepromatous form. The protocol of the trials should take into account the following points: 1) In view of the uneven distribution of leprosy, the variations in the distribution of its various forms, as well as the unknown epidemiological factors, several trials should be planned with at least one in a country in Asia or Africa and one in a country in Latin America. 2) Because of the long incubation of leprosy and its occurrence at any age, all age groups should be included in the trials. 3) To take into account the low incidence of leprosy, the trials should involve a large population and the observation period should last about ten years. 4) In view of the low incidence of leprosy and its uneven distribution, the random sampling for allocation to vaccinated and control groups should be based on individuals. 5) Because of the absence of objective criteria for the diagnosis of leprosy, provision should be made in the protocol to minimize over- and under-diagnosis. 6) When the immunological tests to ber studied within the protocol itself may affect the results of the trial, special groups should be planned for these investigations.

Adolescent↗
PubMed1980

Epidemiological information on leprosy in the Singu area of Upper Burma.

In the course of a WHO trial designed to evaluate the possible protective action of BCG vaccine against leprosy, a longitudinal epidemiological study of the whole population was carried out in an area of very high endemicity in Burma from 1964 to 1976. Two mass surveys of the whole population with an interval of 4 years and annual re-examination of the 28 000 children (0-14 years) in the BCG trial were carried out. The data collected yielded important information about general prevalence and yearly incidence of the disease as well as on sex, age, and classification of cases. The general prevalence rate declined from 32.6 per 1000 in the first survey to 25.2 per 1000 in the second. The number of cases among males was significantly higher than among females. Incidence rate among contacts of already known cases was 9.8 per 1000 person-years. The estimated yearly incidence among non-contacts was 5.9 per 1000. Prevalence rates reached a peak in the 20-39-year age group. The prevalence rate of multibacillary patients also reached a peak in the same age bracket. It is stressed that a further period of epidemiological surveillance will be essential in order to have a correct estimate of the expected number of new infections, especially multibacillary cases, in the 20-39-year group. The value of this information is considered unique for planning and programming of future control activities.

Adolescent↗
PubMed1980

An information system for leprosy control (OMSLEP Recording and Reporting System).

This study reports the various steps involved in the design of a simplified information system for leprosy (OMSLEP), developed in cooperation between the Unit of Epidemiology, University of Louvain, Belgium, and WHO. The objective of the system is to permit the evaluation of a) the efficiency of programs within the context of established strategies and norms; b) the effectiveness of leprosy control methods from an epidemiological point of view; c) the efficacy and productivity of certain program components. Prior to designing the system, the relevant epidemiological and operational indices have been reviewed. A survey was also made of the forms used by some 78 leprosy control schemes throughout the world in order to analyze the current information now being collected. The proposed system is described. It includes individual record form to be filled at registration and once yearly in subsequent years of follow-up, a detection form, and an annual statistics form for the tabulation of total patients. The system is presently being tested in some 15 countries.

Data Collection↗
PubMed1974

BCG vaccination of children against leprosy: nine-year findings of the controlled WHO trial in Burma.

The leprosy incidence rates so far in the vaccinated and unvaccinated children aged 5-9 and 10-14 years are similar. The BCG-vaccinated children aged 0-4 years at intake had an incidence rate lower than that of children in the control group. BCG vaccination did not protect household contacts or children aged 5-14 years not exposed in the household, and did not influence the distribution of the forms of leprosy in the cases detected. The lepromin reaction in relation to the age at intake was consistently stronger in the vaccinated children than in those of the control group; the younger the age group the more pronounced was the difference, which was only slight in the age group 10-14 years at intake. If the results of the late lepromin reaction are related to the age at onset (when the children are older than at intake), the differences between the BCG and the control groups tend to decrease. It does not seem that the BCG-vaccinated children suffer from a less serious form of leprosy than the nonvaccinated children (most of them nonreactors to tuberculin).

Adolescent↗