Table 1.
Tests performed at the post-MDT index re-evaluation: operational definitions and analytic denominators.
Fig 1.
Overlap of clinical domains among patients with paired Simplified Neurological Assessment (SNA) at the post-MDT index visit (n = 99).
The diagram shows the distribution of patients fulfilling three domains: persistent skin lesions (33/99, 33.3%), neurological deterioration defined as any increase in WHO disability grade from diagnosis to the index visit (43/99, 43.4%), and leprosy reaction with neuritis occurring at or within six months of discharge (73/99, 73.7%). A total of 11/99 (11.1%) patients met all three domains simultaneously; 24/99 (24.2%) presented deterioration with neuritis without skin lesions; 12/99 (12.1%) had skin lesions with neuritis without deterioration; 3/99 (3.0%) had skin lesions with deterioration without neuritis; and 11/99 (11.1%) had none of the three domains.
Table 2.
Socio-demographic and clinical characteristics.
Table 3.
Reactional profiles at the post-MDT index visit (mutually exclusive).
Table 4.
Clinical and laboratory characteristics at diagnosis and after completion of 24-dose MDT (post-MDT index re-evaluation).
Fig 2.
Case 1 (A and B): After the treatment (24 doses of MDT), neural branches with an intense peri and endoneural lymphohistiocytic inflammatory process were observed (A) (→).
The histopathological bacilloscopic examination showed numerous well-stained fragmented bacilli and rare solid bacilli inside the Schwann cells (B) (→). Case 2 (C, D, and E): after 24 doses of MDT, a skin biopsy shows numerous well-stained fragmented bacilli and some solid bacilli in the vessel walls and endothelium D and E) (→). H&E in A (×20) and C (×20). Fite-Faraco in B (×20), D (×20), E (×40).
Fig 3.
Proportions of patients at diagnosis and after completing 24 doses of MDT are shown.
Bacilloscopic index (BI) categories follow Ridley’s scale; denominators for BI and morphological index correspond only to patients with a valid slit-skin smear at each time point. Skin lesions, neurological symptoms, and leprosy reactions refer to the entire cohort (n = 131). Disability grades follow WHO classification (0/1/2); denominators differ between baseline (n = 100) and post-MDT (n = 117) due to availability of paired SNA. No imputation was performed.
Table 5.
Concordance between histopathology and nude mice inoculation results.