Clinico-epidemiological study of leprosy in a tertiary care hospital of Eastern India
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20231161Keywords:
Leprosy, Hansen’s disease, Tuberculoid, Lepromatous, Borderline, HistoidAbstract
Background: Accurate diagnosis of leprosy is of paramount importance, because delays and misdiagnosis are more common in non-endemic zones. It has a long incubation period, varied clinical presentations, and reaction states which can present in any point of lifetime, becoming more challenging for proper management of this enigmatous disease.
Methods: This was conducted as an institution based cross- sectional study over a period of 12 months. 100 patients were selected. Inclusion and exclusion criteria were maintained. Data collected was checked, tabulated, statistically analysed and compared with existing literature.
Results: In our study, majority, 49% belonged in age group of 41-60 yrs, only 6% were less than 20 years old. Male: female ratio was 3.34. 62% were from rural areas. Family history of Hansen was present in 5%. 6% had Histoid while 5% had pure neuritic representing least common subtypes. Most common occupations were Housewives (19%), shopkeepers (16%) and office workers (16%). 59% presented with hypoesthesia, 28% with fever. 59% belonged to borderline, 27% belonged to polar spectrum. Trophic ulcers were found in 20%, clawing of digits in 27%.
Conclusions: Leprosy is still a pressing problem in our country. A considerable number of children and adolescents get affected indicating high rate of transmission in community. A comprehensive approach includes proper diagnosis, treatment, and identification of reaction patterns, prevention of disability and deformities, and implementation of rehabilitation measures.
References
Eidt LM. Breve historia da hanseniase: sua expansao do mundo para as Americas, o Brasil e o Rio Grande do Sul e sua trajetoria na saude publica brasileria. Saude Soc. 2004;13:76-88.
Cavaliere IAL, Costa SG. Isolamento social, sociabilidades e redes sociais de cuidados. Physis. 2011;21:491-516.
Cunha VS. solated ‘like us’ or isolated among us? The controversy within the National Academy of Medicine over compulsory isolation of leprosy sufferers. Hist Cienc Saude Manguinhos. 2010;17:939-54.
Opromolla PA, Martelli ACC. Terminology related to Hansen’s disease. An Bras Dermatol. 2005;80:293-4.
Martelli ACC. Global leprosy situation, 2012. Wkly Epidemiol Rec. 2018;87:317-28.
Elimination of leprosy as a public health problem. Available at: https://www.who.int/news/item/26-04-2021-leprosy-(hansen-s-disease)-interrupting-transmission-and-achieving. Accessed on 20 November 2022.
Distribuicao da hanseniase no Brasil. Available at: ttps://scielosp.org/article/rpsp/2018. Accessed on 20 November 2022.
Aprova as directrizes para vigilancia, Atencao e Controle da hanseniase. Available at: https://bvsms. saude.gov.br/bvs/saudelegis/gm/2010/prt3125_07_10_2010.html. Accessed on 20 November 2022.
Talhari s, Grossi MA, Oliveira ML, Gontijo B, Talhari C, Penna GO. Hansen’s disease: a vanishing disease? Mem Inst Oswaldo Cruz. 2012;107:13-6.
Penna MLF, Oliveira MLW, Carmo EH, Penna GO, Temporao JG. The influence of increased access to basic healthcare on the trends in Hansen’s disease detection rate in Brazil from 1980 to 2006. Rev Soc Bras Trop. 2008;41:6-10.
Barbieri CL, Marques HH. Leprosy in children and adolescents: bibliographical review and current situation in Brazil. Pediatria. 2009;31:281-90.
Ignoti E, Rodrigues AM, Andrade VLG, Valente JG. Aplicacao de metodos de estimative da prevalencia de hanseniase no Estado de Mato Grosso. Rev Bras Epidemiol. 2004;7:155-66.
Goulart IB, Dias CM, Oliveira ACS, Silva AA, Alves RR, Quaresmin CR, et al. grau de incapacidade: indicador de prevalencia oculta e qualidade do programa de controle da hanseniase em um centro de saude-escola no municipio de Uberlandia- MG. Hansen int. 2002;27:5-13.
da Cunha MD, Cavaliere FA, Hercules FM, Duraes SM, de Oliveira ML, de Matos HJ. Os indicadores da hanseniase e as estrategias de eliminacao da doenca, em municipio endemic do Estado do Rio de Janeiro, Brasil. Cad Saude Public. 2007;23:1187-97.
Rees RJW, Young DB,. The microbiology of leprosy. In: Hastings RC, eds. Leprosy. 2nd ed. New York: Churchill Livingstone; 1994:49-83.
Nolte FS, Metchok B. Mycobacterium. In: Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of clinical microbiology. 6th ed. Washington: American Society for Microbiology; 1995:400-37.
Shepard CC. Temperature optimum of Mycobacterium leprae in mice. J Bacteriol. 1965;90:1271-5.
Hastings RC, Brand PW, Mansfield RE, Ebner JD. Bacterial density in the skin in lepromatous leprosy as related to temperature. Lepr Rev. 1968;39(2):71-4.
Desikan KV. Viability of Mycobacterium leprae outside the human body. Lepr Rev. 1977;48:231-5.
Mohammad A, Syed SA, Mohammad M, Sabha M, Mehtab A, Annu P. Clinico-epidemiological study of leprosy from a North Indian tertiary care hospital. J Bacteriol. 1955;89:1132-7.
Nigam P. Clinico-epidemiological study of Leprosy in a rural population of Bundelkhand. Lepr India. 1977.
Salodkar AD. A clinico-epidemiological study of leprosy in arid North-west Rajasthan, Jodhpur. Indian J Lepr. 1995.
Patil AA, Sherkhane MS. Clinico-epidemiological study of Hansen disease patients attending a tertiary care centre in South India. Int J Community Med Public Health. 2016;23:2394-8.
Sirisha NL, Sangem S, Kumar AS, Pavani N, Kumar SC. Clinico-epidemiological study of Hansen’s Disease (Leprosy) in patients attending Government General Hospital, Kadapa. Indian J Lepr. 2019.
Sonkar VK. A clinico-epidemiological study of leprosy in a tertiary care centre. IJCAR. 2018;7:14350.
Gupta R, Sinha R, Pradhan S. Clinico-epidemiological profile of leprosy in Post-elimination era: A Hospital based study. Indian J Lepr. 2019;91:197-205.
Mahajan R, Ninama K, Jain V, Bilimoria FE, Lakhani S. A 5 year study of leprosy patients in a tertiary care centre. Indian J Lepr. 2018;23:32-8.
Jindal N, Shanker V, Tegta GR, Gupta M. Clinico-epidemiological trends of leprosy in Himchal Pradesh: A 5 year study. Indian J Lepr. 2009;81(4):173-9.
Bishnoi S, Verma A, Nijhawan M, Bagri M, Nijhawan S, Sharma A. Leprosy. Gulf J Dermatol Venereol. 2019;26:1