XXXX : an urgent need to step up use of MDT in Africa.

@entity1 @entity3761 @entity5117 @entity13637 @entity1202 @entity4430 @entity1215 @entity1201
10-12 million @entity1 in the world have @entity1201 . India claims about 4 million of these cases. Overall at least 20% of the cases are @entity1 . In the 1940s, @entity3761 was the only drug used to treat @entity1201 . By the early 1970s, @entity3761 did not perform as expected and @entity4430 were beginning to exhibit resistance to @entity3761 . In 1982, WHO published results of its study which recommended fixed and relatively short duration regimens of multiple drug therapy (MDT) for all @entity1 with @entity1201 . It also listed recommendations on diagnosis, classification, and distribution of @entity1 to either pauci or multibacillary groups. MDT depends on what type of @entity1201 @entity1 have. For example, @entity1 with @entity1202 receive @entity1215 , @entity13637 , and @entity3761 whereas those with @entity5117 receive only @entity1215 . In many African countries, however, MDT is not used. Yet cases of @entity1201 exist in 94% of Africa's countries. Moreover 37% have highly prevalent @entity1201 and the lowest percentage of @entity1 on MDT (18% vs. world average of 56%). In fact, Nigeria is included in the group of 5 countries with 84% of all cases. Until the various countries in Africa can satisfy the ideal requirements for establishing a MDT program, they should begin MDT at least on a small scale. They do need, however, an adequate supply of the drugs. The other requirements include a good plan of action, laboratory facilities, transport, and referral centers. If the period of time needed to meet these requirements is long, then physicians should conduct pre MDT screenings to diagnose cases and determine who needs chemotherapy. The best way to diagnose cases is from clinical experience and paying particular attention to dermatological and neurological findings. Early identification is needed since @entity1201 cases are stigmatized. This article includes MDT dosages in adults and @entity1 .
