Relapse and aggravation were confirmed by a study of the history of the disease after
onset and clinical observations of 1,668 cases (935 male and 733 female). The patients
were from seventeen settlement villages located in Seoul, Gyeonggi province, and
Gangwon province, and were observed from May, 1974 to April, 1977. The results were
as follows :
1. Of 1,668 patients, 48, or 2.9% were relapse cases and 29, or 1.7% were aggravation
cases. Eight patients, or 0.5% were bacteriologically positive whey they came to the
settlement villages but due to negative patients converting to positive while in the
villages 3.4% of the total 1,668 settlement villagers are now positive.
2. For males, there were 27, or 2.9% relapse cases and 20, or 2. 1% aggravation cases
for a total of 47(5.0%) relapse and aggravation patients. In females, the total relapse and
aggravation cases were 30, or 4.1%; 21(2.9%) relapse cases and 9 (1.2%) aggravation
cases. There was no significant between males and females.
3. The average age of patients was 43.79±9.84 clears: 42.73±7.45 years for relapse
patients (lower than the average age) and 46.14±9.66 years far aggravation patients
(higher than the average age). However or, there was no significant difference between
relapsed patients and aggravated patients'age.
4. The average duration of disease after onset was 24.15±9.31 years; 23.98±6.83 years
for relapse patients(lower than the average) and 26.48±11.32 years for aggravated
patients(higher than the average). There was no significant difference in the average
duration of disease after onset between relapsed patients and aggravated patients.
5. Relapse and aggravation appeared most often in L-type Patients. There were 48
(4.2%) relapse cases and 33(2.9%) aggravation cases in L-type, but only 6(1.2%)
aggravation cases in T-type. No relapse or aggravation was found in I-group. Relapse
and aggravation of L-type patients under irregular treatment was seven times that of
patients under regular treatment. Aggravation in T-type patients under irregular
treatment was 5 times that of patients under regular treatment.
6. The average duration of treatment was 20.25±8.47 years. The duration of treatment
for relapse and aggravation was a little higher-21.17±6.80 years for relapsed patients,
21.66±9.82 years for aggravated patients-but there was no statistical significance.
7. Of thssf on previous treatment taking only dapsone, 21 or 3.6% were relapse or
aggravation cases. Those on previous treatment with sulfone and chaulmoogra oil
showed 37 cases(4.5%) of relapse or aggravation, and those taking sulfones (other then
dapsone) had 10 cases or 5.0% of relapse and aggravation. In the cases where previous
treatment did not include a sulfone, there was a much higher proportion of relapse and
aggravation. Those taking two types of antileprosy drugs (excluding dapsone) showed 3
cases or 17.6%, and those taking 3types of antileprosy drugs (excluding dapsone)
showed 6 cases or 22.2% of relapse and aggravation. The frequency of relapse was
significantly higher in cases of irregular treatment than in cases of regular treatment
among those taking only dapsone, other sulfones and sulfone plus chaulmoogra oil.
There was no significant difference bewtteen regular and iregular treatment among
those taking two or three kinds of antileprosy drugs excluding sulfones.
8. Relapse and aggravation cccured most frequently 5 to 9 years after the patients
converted from bacteriologically positive to negative or inactive; 12 of 48 relapsed
patients and 10 of 29 aggravated patients. There were 11 cases of relapse and 3 cases
of aggravation occuring less than 5 years after bacteriological conversion. Over 20 years
after bacteriological conversion, there was 1 case of relapse and 2 cases of aggravation.
9. Of the skin smears from 34 relapsed patients after two and half years from the
diagnosis of relapse, there were 20 negative cases, 12 cases of decrease and 2 cases of
increase in bacterial index. There were 28 cases of 0%, 5 cases of decrease and 1 case
of increase in morphological index.
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