Leprosy (Hansen's Disease)

100 mg once daily, always with rifampicin (and with clofazimine in multibacillary disease) - WHO: 6 months paucibacillary, 12 months multibacillary. US National Hansen's Disease Program: 12 and 24 months

1-2 mg/kg/dose [child max 100 mg]

(THE TWO PROGRAMMES DIFFER, AND THE GRID SPANS BOTH. US National Hansen's Disease Program 2018: 1 mg/kg once daily, maximum 100 mg, for 12 months in paucibacillary disease. WHO 2016: children under 10 years and under 20 kg, 2 mg/kg once daily for 6 months; children 10 years and over and adolescents up to 14 years weighing 20-40 kg, a flat 25 mg once daily for 6 months. Both are given with rifampicin.)

Alternatives. Dapsone and rifampicin together are the backbone of every leprosy regimen; clofazimine is added for multibacillary disease and is not stocked in Egypt through normal channels.

Egyptian National Drug Formulary - Antimicrobial 2023 (dapsone monograph, p292)

The formulary's first listed indication for dapsone is treatment of leprosy due to susceptible strains of Mycobacterium leprae, and its dosing paragraph gives both regimens side by side - the WHO's and the US National Hansen's Disease Program's - which differ only in how long treatment runs. Never given alone: the formulary and the disease article both state that multidrug therapy is what prevents resistance, and resistance to dapsone monotherapy is documented history, not theory.

600 mg daily, with dapsone x 12 months for tuberculoid disease; 24 months for lepromatous disease, with clofazimine

No paediatric leprosy dose for rifampicin appears in the Egyptian formulary, because its rifampicin monograph does not cover leprosy at all. A child's regimen must come from the national leprosy programme.

Leprosy - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK559307/

The cited disease article gives the regimens directly: tuberculoid disease, dapsone 100 mg daily with rifampicin 600 mg daily for 12 months; lepromatous disease, dapsone, rifampicin and clofazimine 50 mg daily for 24 months. The dose is cited to that article and not to the formulary for a reason worth stating plainly: the Egyptian formulary's rifampicin monograph lists only tuberculosis and meningococcal carriage as indications, so it does not answer for leprosy. What the formulary does confirm is the pairing - its dapsone monograph names rifampin as the drug dapsone is combined with in every leprosy regimen it gives.

Chronic mycobacterial infection of skin and peripheral nerves. Egypt has reached WHO elimination thresholds but sporadic cases still occur, mostly in Upper Egypt/Delta foci, so a GP should recognise a suspicious hypopigmented anaesthetic patch or thickened nerve and refer to the national leprosy control programme, which supplies multidrug therapy free of charge rather than the GP prescribing it. - Refer, with advice

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

No dose - referral pathway, no medicine given in primary care

Chronic mycobacterial infection of skin and peripheral nerves. Egypt has reached WHO elimination thresholds but sporadic cases still occur, mostly in Upper Egypt/Delta foci, so a GP should recognise a suspicious hypopigmented anaesthetic patch or thickened nerve and refer to the national leprosy control programme, which supplies multidrug therapy free of charge rather than the GP prescribing it.