Epidemiological indicators and clinical profile of leprosy cases in Dhaka
Keywords:
Leprosy, epidemiological indicators, clinical profileAbstract
Objective To evaluate epidemiological indicators and clinical profile of leprosy patients in Dhaka city. Methods In this cross-sectional observational study 722 new leprosy patients registered in six different clinics of The Leprosy Mission International – Bangladesh, Dhaka program over two and half years (January 2011 to June 2013) were included. Demographic details and clinical characteristics during diagnosis were recorded. Results Out of 722 patients, 390 (54%) were males and 332 (46%) were females. Proportion of cases under 15 year age was 8.7%. Borderline tuberculoid was the most common form of the disease (81.0%) followed by tuberculoid (9.3%), lepromatous (4.3%), borderline lepromatous (3.5%), borderline (1.8%) and pure neural (0.1%). Proportion of multibacillary leprosy was 22.4%. Most of the patients had duration of symptoms from 6 months to 1 year (53.0%). 12% of patients had history of contact with leprosy patients. Type 1 reaction was more prevalent than type 2 (7.6% and 2.9%, respectively). Proportion of cases with grade 2 disability was 5.9%. Most common presentation was with hypopigmented macule with obvious margin, marked anesthesia and mild infiltration. Ulnar nerve was the most common nerve to be involved (15.8%). Conclusion Leprosy cases are being frequently diagnosed in Dhaka city. Epidemiological indicators reflect that there may be ongoing disease transmission and relative delay in diagnosis despite a strong surveillance program.References
Lockwood DNJ. Leprosy. In: Burns T, Breathnach S, Cox N, Griffths C, editors. Rook’s Textbook of Dermatology, 8th ed. Oxford: Blackwell Publishing; 2010. p. 32.1-32.20.
Edward C, Klatt EC, Robbins SL, Cotran RS, editors. Robbins Pathologic Basis of Disease, 6th ed. Philadelphia: Saunder Elsevier; 2010. p. 385-7.
Jopling WH, McDougall AC, editors. Handbook of Leprosy. Oxford: Heinemann professional publishing; 1988. p. 114-5.
Khan I, Khan AR, Khan MS. Clinicopathological study of 50 cases of leprosy in Northern Pakistan. J Pak Assoc Dermatol. 2012;22:200-6.
Levinson W, Jqwetz E, editors. Medical Microbiology and Immunology, 6th ed. New York: McGraw-Hill; 2000. p. 140-1.
World Health Organization. Weekly Epidemiological Report. 2014;89:389-400.
National guidelines and technical manual on leprosy. Ministry of Health and Family Welfare, Govt. of Bangladesh and World Health Organization 2005. 3rd ed. p. 4, 55.
Soomro FR, Pathan GM. Leprosy awareness among doctors during survey of District Larkana. Infect Dis J. 2005;14:98-9.
James WD, Berger TG, Elston DM. editors. Andrew’s Diseases of the skin Clinical Dermatology, 11th ed. Philadelphia: Saunders Elsevier; 2011. p. 334-44.
Haque MA, Sharmin S, Ekram ARMS, Mahmood I. Epidemilogical trends of Leprosy in Rajshahi district. J Teach Assoc RMC Rajshahi. 2009;22:88-92.
Soomro FR, Pathan GM, Bajaj DR, Bhatti NS. Leprosy in Larkano region; an analysis of 102 cases from 2001-2011 at leprosy centre Larkano, Sindh, Pakistan. J Pak Assoc Dermatol. 2012;22:126-9.
Jindal N, Shanker V, Taqta GR et al. Clinico-epidemiological trends of leprosy in Himachal Pradesh; a five-year study. Indian J Lepr. 2009;81:173-9.
Toweir AA, Chaudhary RC. Review of leprosy cases in Benghagi, Libyan Arab Jamahiriya, 1994-98. East Mediterr Health J. 2000;6:1098-1102.
Boggild AK, Correia JD, Keystone JS, Kain KC. Leprosy in Toronto: an analysis of 184 imported cases. Can Med Assoc J. 2004;170:55-9.
Barbosa-junior AA, Jambeiro J, Jonelia SO, Cirqueira, Silva TC. Retrospective histopathological classification of 1,108 skin biopsies from patients clinically suspected of having leprosy from Bahia, Northeast Brazil. Revista da Sociedade Brasiteira de Medicina Tropical. 1998;31:533-7.
World Health Organization. Enhanced global strategy for further reducing the disease burden due to leprosy (2011-2015) Operational guidelines (Updated) 2009. SEA-GLP-2009.4.
Golfurshan F, Sadaghi M, Goldust M. Leprosy in Iran: an analysis of 195 cases from 1994-2009. J Pak Med Assoc. 2011;16:558-61.
Hussein A, Mohammed H, Eltahir A et al. Frequency of neurological deficits in Sudanese lepromatic patients. Sudan J Med Sci. 2010;5:17-24.
Tiwary PK, Kar HK, Sharma PK et al. Epidemiological trends of leprosy in an urban leprosy center of Delhi: a retrospective study of 16 years. Indian J Lepr. 2011;83:207-8.
Teixeira MA, Silveira VM, Franca ER. Characteristics of leprosy reaction in paucibacillary and multibacillary individual attended at two reference centers in Recife, Pernambuco. Rev Soc Bras Med Trop. 2010;43:287-92.
Bongorno MR, Pistone G, Note S. Tuberculoid leprosy and type 1 lepra reaction. Travel Med Infect Dis. 2008;6:311-4.
Skacel M, Antunes SI, Rodrigues MM et al. The diagnosis of leprosy among patients with symptoms of peripheral neuropathy without cutaneous lesions: a follow up study. Arq Neurosiquiatr. 2009;58:800-7.
