ORIGINAL ARTICLE Variations in the Clinical Management of Multibacillary Leprosy Patients in Selected Hospitals in Metro Manila Veincent Christan F. Pepito, 1 Arianna Maever L. Amit, 1 Rae Erica D. Samontna, 1 Sarah Jane A. Abdon, 1 David Norman L. Fuentes 1 and Ofelia P. Saniel 2 1 College of Public Health, University of the Philippines Manila 2 Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines Manila ABSTRACT Introducton. This paper documents the variatons in the diagnosis and management of multbacillary leprosy patents in three of the biggest case-holding hospitals in Metro Manila. Furthermore, we aimed to discuss the implicatons of these variatons on the country’s leprosy control and eliminaton program. Methods. Focus group discussions (FGD) were conducted with 23 health professionals composed of doctors and nurses with at least a year of experience in managing leprosy patents. The topics included procedures on patent diagnosis and management such as treatment duraton, patent follow-up and defnitons of treatment completon and default. The FGD partcipants provided suggestons to improve treatment compliance of patents. Their responses were compared with World Health Organizaton (WHO) standards and/or the 2002 DOH Manual of Operatng Procedures (MOP) for leprosy. Transcripts of the recordings of the FGDs were prepared and thematc analysis was then performed. Results. There were variatons in the hospitals’ procedures to diagnose leprosy, in treatment duraton, and in patent follow-up. Defnitons for treatment completon and default difered not just between hospitals but also with the WHO guidelines and the 2002 MOP. Hospitals extended treatment up to 24 or even 36 months, despite the 12 months stpulated in the MOP. Two hospitals required slit skin smear and skin biopsy in diagnosis, despite the MOP and WHO provisions that these were not mandatory. One hospital defned default as three consecutve months without treatment, which was diferent from the MOP and WHO standards and from the other hospitals. Conclusion. Given the variatons in patent management, we recommended that efectveness of the standard treatment relatve to other regimens being practced by specialists be evaluated. Key Words: Multbacillary Leprosy, Multple Drug Therapy, Patent Management INTROduCTION Leprosy or Hansen’s disease is a chronic infectious illness that afects the nerves and manifests as hypoaesthetic macules, papules, and lesions. Te World Health Organization (WHO) classifes it into paucibacillary (PB), when there are fve or less hypopigmented skin lesions, and multibacillary (MB) when there are more than fve of these skin lesions with invasion of the nasal mucosa. 1 Patients with MB leprosy are treated with rifampicin, clofazimine, and dapsone for 12 months. Termed collectively as Multiple Drug Terapy (MDT), these medications are given monthly to patients in blister packs. 1,2 Parts of this research were disseminated via poster presentaton in the 16th Department of Health - Natonal Health Research Forum for Acton at Softel Hotel, September 16, 2016, Pasay City, Philippines. Corresponding Author: Veincent Christan F. Pepito College of Public Health University of the Philippines Manila 625 Pedro Gil Street, Ermita Manila 1000 Philippines Mobile Phone: +63 9065317664 Email: vcfpepito12345@gmail.com ACTA MEdICA PHILIPPINA VOL. 52 NO. 3 2018 268