British Leprosy Relief Association
Intolerance to Leprosy Multi-Drug Therapy: More Common in Women?
CardosoFernando José Ramosb
de MacêdoAna Luiza Braga Britoc
de SousaIgor Leonardo Cardosoc
LeiteRenata Cristina Barrosc
aDivision of Infectious Diseases and Center for Global Health, Weill Cornell Medical College, New York, NY, USA
bGiselda Trigueiro Hospital, Natal, RN, Brazil
cDepartment of Biochemistry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
dNational Institute of Science and Technology (INCT/DT), Natal, RN, Brazil
eInstitute of Tropical Medicine of Rio Grande do Norte, Federal University of Rio Grande do Norte, RN, Brazil
fPost-graduate Program in Tropical Medicine, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, RJ, Brazil
Correspondence to: Mauricio Lisboa Nobre, Hospital Giselda Trigueiro, Rua Conego Monte, 110, Quintas, Natal, RN 59037-170, Brazil (Tel: +55-84-3615-5454; e-mail: firstname.lastname@example.org)
The objective was to characterise and identify potential risk factors for intolerance to multi-drug leprosy therapy (MDT) which prompted a medication change in a leprosy referral centre in northeastern Brazil.
A retrospective chart review of leprosy patients treated at a state referral centre for leprosy in Natal, Rio Grande do Norte, Brazil was completed. Chart review focus was on adverse effects necessitating modification of MDT regimen.
Six hundred and twelve records were reviewed with detection of 91 (14.8%) adverse effects with associated change in MDT regimen. The most common recorded causes of medication intolerance were anemia (8.7%), headache (4.2%), cyanosis (1.8%), and gastrointestinal symptoms (1.6%). Both female gender (OR = 2.63) and age less than 42 years old (OR = 2.7) remained risk factors for MDT intolerance in a multivariate model including gender, age, and WHO regimen type. With intolerance due to anemia as the outcome, female gender (OR = 2.36) and age less than 42 years (OR = 1.86) were associated.
In this study, female gender and younger age were associated with greater risk of medication intolerance and medication intolerance related to anemia. These findings have important operational implications for drug intolerance monitoring during therapy for leprosy.