Clinico-epidemiological profile of adult leprosy patients from a referral hospital in Eastern India: A retrospective study
Keywords:Adult leprosy, Paucibacillary, Multibacillary, Disability, Lepra reaction
AbstractBackground The prevalence of leprosy has drastically reduced globally after the introduction of multidrug therapy. However, it continues to be a major public health challenge in India. The present study was conducted to evaluate the clinical and epidemiological profile of adult leprosy patients attending a tertiary care hospital in eastern India over a period of six months. Methods A retrospective record-based study was carried out to collect clinical and demographic data of patients over 18 years of age attending the leprosy clinic of a tertiary care institution in Kolkata, West Bengal, India, from 1st January 2019 to 30th June 2019. The data collected were tabulated and analyzed using appropriate statistical methods. Results 132 adult leprosy patients attended the clinic during the study period. Most of them were between 31-45 years of age, with a predominance of male patients (68.2%) and patients from an urban background (62.9%). A high prevalence (87.1%) of multibacillary leprosy was noted and the commonest type was borderline tuberculoid (66.7%). Prevalence of borderline lepromatous and lepromatous leprosy showed a rising trend above 45 years of age. 22% patients presented with disabilities, with significant predilection for older age groups, multibacillary disease and towards the lepromatous spectrum (P = 0.0042, 0.0424 and < 0.0001 respectively). Lepra reactions were noted in 13.6% patients at presentation. Conclusion Our findings highlight the need for implementation of sustained effective measures for early diagnosis and treatment of leprosy in order to prevent disabilities, while improving awareness to ensure appropriate health seeking behavior.
Global leprosy update, 2018: moving towards a leprosy-free world. Wkly Epidemiol Rec 2019;94:389-412.
NLEP Annual Report 2015‑2016. Central Leprosy Division, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, Nirman Bhavan, New Delhi.
Training manual for medical officers: NLEP. Chapter 7. Classification and management of leprosy. Directorate of Health Services, Ministry of Health and Family Welfare, Nirman Bhavan, New Delhi.
World Health Organization. World Health Organization Expert Committee on Leprosy. 6th Report. Technical Report Series 768. Geneva: World Health Organization; 1988.
Barua JK, Anurag D, Barik G, Ghoshal L, Shukla DK, Banerjee G. A Clinico-Epidemiological Study of Leprosy in an Urban Leprosy Centre of West Bengal. IOSR J Dent Med Sci 2016;15(8):12-5.
Adil M, Amin SS, Mohtashim M, Mushtaq S, Alam M, Priya A. Clinico-epidemiological study of leprosy from a North Indian tertiary care hospital. Int J Res Dermatol 2018;4:518-21.
Thakkar S, Patel SV. Clinical profile of leprosy patients: A prospective study. Indian J Dermatol 2014;59:158-62.
Norman G, Bhushanam JDRS, Samuel P. Trends in leprosy over fifty years in Gudiyatham Taluk, Vellore, Tamilnadu. Indian J Lepr 2006;78:105-11.
Richardus JS, Meima A, Croft RP, Habbema JD. Case detection, gender and disability in leprosy in Bangladesh: a trend analysis. Lepr Rev 1999;70:160-73.
Ishore K, Das DK, Banerjee S. Disability in New Leprosy Cases - Magnitude, Pattern and Associated Factors: A Cross Sectional Study in a Subdivision of Darjeeling District, West Bengal. Indian J Lepr 2019;91:207-215.
Arora M, Katoch K, Natrajan M, Kamal R, Yadav VS. Changing profile of disease of leprosy patients diagnosed in a tertiary care centre during years 1995-2000. Indian J Lepr 2008;80:257-65.
Mahajan VK, Sharma NL, Rana P, Sood N. Trends in detection of new leprosy cases at two centers in Himachal Pradesh, India: a ten year study. Indian J Lepr 2003;75;17-24.
Mohite RV, Mohite VR, Durgawale PM. Differential trend of leprosy in rural and urban area of Western Maharashtra. Indian J Lepr 2013;85:11-8.
Reyila VP, Betsy A, Riyaz N, Sasidharanpillai S, Sherjeena PV, Majitha MP, et al. Clinico-epidemiological study of disability due to leprosy at the time of diagnosis among patients attending a tertiary care institution. Indian J Dermatol 2019;64:106-11.
Bhat RM, Chaitra P. Profile of new leprosy cases attending a South Indian referral hospital in 2011-2012. ISRN Trop Med 2013;2013:4.
Ramu G. Clinical leprosy through the last seventy-five years. Indian J Lepr 2000;72:199-214.
Patel NR, Modi KR. A cross-sectional study of deformities in patients of leprosy at a tertiary care center of Western India. Indian J Lepr 2016;88:209-15.
Sarkar J, Dasgupta A, Dutt D. Disability among new leprosy patients, an issue of concern: An institution based study in an endemic district for leprosy in the state of West Bengal, India. Indian J Dermatol Venereol Leprol 2012;78:328-34.
Richardus JH, Finlay KM, Croft RP, Smith WC. Nerve function impairment in leprosy at diagnosis and at completion of MDT: A retrospective cohort study of 786 patients in Bangladesh. Lepr Rev 1996;67:297‑305.
Moura SH, Grossi MA, Lehman LF, Salgado SP, Almeida CA, Lyon DT, et al. Epidemiology and assessment of the physical disabilities and psychosocial disorders in new leprosy patients admitted to a referral hospital in Belo Horizonte, Minas Gerais, Brazil. Lepr Rev 2017;88:244-57.
Noor SM, Paracha MM, Ali Z, Rauf A. Frequency of disabilities in newly diagnosed patients of leprosy presenting to Lady Reading Hospital, Peshawar. Ann Pak Inst Med Sci 2010;6:210-3.
Kumar B, Dogra S, Kaur I. Epidemiological characteristics of leprosy reaction:15 years experience from North India. Int J Lepr Other Mycobact Dis 2004;72:125-33.