U.S.-Japan Cooperative Medical Science Program. Workshop on leprosy chemotherapy.

A Workshop on Leprosy Chemotherapy was convened under the auspices of the U.S. Leprosy Panel of the U.S.-Japan Cooperative Medical Science Program of the National Institute of Allergy and Infectious Disease on 26 October 1975 in Bethesda, Maryland. The workshop provided a unique opportunity to bring together participants from other countries as well to discuss three of the most pressing issues of leprosy chemotherapy: I) the persistence of drug-susceptible M. /eprae in lepromatous leprosy despite apparently adequate long-term chemotherapy; 2) drugresistant relapse in lepromatous leprosy; 3) chemotherapy trials in nonlepromatous leprosy . Discussion included elucidation of the magnitude and significance of the problems, newer work in leprosy pharmacology t ha t might prove useful in considering future approaches to chemotherapy, and lastly, recommendations to deal with these problems and to plan new chemotherapy trials. Dr. C. C. Shepard, Atlanta, who chaired the first session on bacterial persistence in leprosy, stated that the first evidence that this might be a problem in the treatment of leprosy came from a study in the Karimui of Papua New Guinea in which 5 of about 30 lepromatous patients were found to have solid bacilli in their smears despite regular treatment with acedapsone (DADDS) for three to five years. The treatment had produced the expected blood sulfone levels. Dr. M. F. R. Waters, Sungei Buloh, reported on a biopsy study with mouse inoculation of specimens from 12 Malaysian lepromatous patients who had completed a minimum of ten years of supervised dapsone (DDS) therapy in full dosage. All 12 patients show'ed full clinical response to the treatment al-