Pattern Of Treatment Outcome And Safety Of Prednisolone In The Treatment Of Leprosy Reactions Among Leprosy Patients In Alert Hospital, Addis Ababa, Ethiopia.

Abstract

ABSTRACT Background: Leprosy reaction is inflammation caused by the body's immune system attacking the leprosy bacteria. If left untreated or improperly managed, may lead to irreversible nerve damage causing mortality, disability, and physical deformities. Oral prednisolone is a recommended and widely used drug to manage these reactions. Despite this, the treatment outcome and safety of prednisolone in treating leprosy reactions as well as factors associated with clinical practices were not studied well. Thus, this study is conducted to assess the treatment outcome and safety of prednisolone in the treatment of leprosy reactions, and to asses associated factors or predictors in ALERT hospital. Methods: A Hospital based retrospective chart review was conducted. The sample size was calculated by using Open Epi StatCalc and the total sample size required becomes 249. Based on inclusion and exclusion criteria 262 charts were selected and all was included in the study. Data were collected using data abstract form from patient medical records and entered into Epi- data version 4.0. All data were exported to SPSS version 25 for further analysis. Descriptive statistics was computed to get summary results and binary and multinomial logistic regression analyses were used to predict factors that affect the treatment outcome and safety of prednisolone. Results: In this study 262 patients’ record files were reviewed. The median age of study subjects was 30 years, with an IQR of 25–42.5 years. Two-third of study participants (66.8%) were males. This study shows that improvement with prednisolone treatment in leprosy reaction (T1R&T2R) was 62.2%. The odds of improved outcome with treatment of prednisolone increases by 6.9 fold for patients who have grade 0 WHO grading as compared to those having WHO grade 2 grading at the start of treatment which is statistically significant. According to the finding of this study among 262 patients 79.4% of the patients experienced at least one adverse event. Conclusion: This study showed two fifth of patients with no improvement with prednisolone for both in type one and two reactions. WHO disability grading at start of treatment has a statistically significant impact on treatment outcome of prednisolone for treatment of leprosy reaction. This study also showed the percentage of adverse event associated with prednisolone treatment is high and the percentage increases significantly with duration and dose of prednisolone treatment without benefit for outcome of treatment. Key Words: Leprosy, Leprosy reaction, Prednisolone, Treatment outcome, Effectiveness Safety, Adverse drug events/reaction, and Side effects