This study aims to reduce the incidence of dapsone allergy on leprosy patients, by testing the patients’ blood for a genetic markerbefore they receive dapsone as part of their treatment.
Implementation of Dapsone Hypersensitivity Syndrome (DHS) Biomolecular Predictive Test to reduce the incidence of DHS among Leprosy Patients in Papua and Nepal
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Project summary
Leprosy can cause permanent disability, especially if diagnosis and treatment is delayed. Leprosy patients are treated with multi-drug therapy (MDT) for 6-12 months consisting of: dapsone, rifampicin and clofazimine. Dapsone is taken daily. Unfortunately, for some people, dapsone may cause an allergy called dapsone hypersensitivity syndrome (DHS). Dapsone hypersensitivity may cause irreversible organ failure and may be life threatening. Many patients have to be hospitalized for weeks or months or receive intensive care due to DHS. DHS is very severe and traumatic and worsens the stigma of leprosy in the community.
Papua and Mollucas are islands with the largest leprosy population in Indonesia. In those regions, dapsone allergy has an incidence of 3%, with deaths reported in an estimated 10% of dapsone allergy cases. In Nepal, approximately 2% of Anandaban Hospital’s leprosy patients develop dapsone allergy after initiating MDT.
This study aims to reduce the incidence of dapsone allergy on leprosy patients in Papua, Mollucas and Nepal by testing the patients’ blood before they receive dapsone as part of their MDT. As previously shown by the research group, a special blood DNA test can be used to identify if the patient is at high risk for developing dapsone allergy. This test can predict up to 85% of cases that may develop dapsone allergy.
If the patient has the DNA marker, they are at risk for dapsone allergy, and they should not take dapsone for leprosy or any other sickness for the rest of their life. If the marker is absent in the DNA test, the patient is at low risk for dapsone allergy. However, they should still be careful to note any symptoms over the first 4-6 weeks of treatment and notify their doctor of any changes. They could still be in the 15% of cases who develop dapsone allergy without the DNA marker (< 0.5% of leprosy cases).
This study will also provide DNA test instructions in an online, open access publication so that leprosy care providers around the world can use it in clinical settings to better protect patients from dapsone allergy.
Co-funder: Turing Foundation
