Acedapsone in the Prevention of Leprosy: Field Trial in Three High Prevalence Villages in Micronesia

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  • Department of Health, Queensland, Australia, University of Hawaii School of Medicine, Ponape Health Department, Ponape, U.S.P.H.S. Hospital, Center for Disease Control, U.S. Public Health Service, Honolulu, Hawaii 96816

The 1,659 non-leprous people in a Micronesian population experiencing an annual leprosy incidence rate of about 7/1,000 were offered 15 acedapsone (DADDS) injections during 1967–1970 for leprosy prevention purposes. Subsequent annual surveillance showed an initial cessation of new cases during the 3-year DADDS campaign, followed by a resumption of cases thereafter at a yearly level of about 2/1,000, with a longer pause and slower rise among those who received the full regimen. A secondary wave of cases that has occurred since 1973 among children born after 1968 shows that post-campaign transmission occurred, probably principally from relapsing multibacillary cases with onset before the campaign. Recommendations are made for a balanced, long-term control program with DADDS preventive treatment limited to contacts of multibacillary cases.