Leprosy Profiles In Post Elimination Stage: Experience At A Tertiary Care Hospital
DOI:
https://doi.org/10.70284/njirm.v9i2.2329Keywords:
AFB, Leprosy, Smear-positive casesAbstract
Background: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae mainly affecting skin, peripheral nerves. Leprosy has been statistically eliminated from India since 2006, still wide variations in prevalence rates continue to exist across the states and union territories in the country. Objectives: The present study was conducted to determine the pattern, prevalence and trends of smear positive leprosy cases in a tertiary care hospital in Akola, Maharashtra. Methods: This is a retrospective record based study conducted over a period of 25 months commencing from January 2016 to February 2018. All the patients suspected of leprosy were referred to the Department of Microbiology, GMC Akola, where cases were confirmed by slit skin smear examination. From OPD records details on age, type and duration of disease, deformity status were noted. Results: Of total 502 clinically suspected cases174 were diagnosed as smear positive for acid fast bacilli in which males outnumbered the females. Smear positivity was highest in age group 21-40 years. Multibacillary and paucibacillary cases were 102(58.62%) and 72(41.37%) respectively. 67(38.50%) cases developed grade II deformities. Reactional episodes with or without neuritis occurred in 84 patients (48.27%) of which 56 (32.18%) developed Type 1 reaction and 28 (16.09%) developed Type II reaction with lesions of erythema nodosumleprosum (ENL). Interpretation &Conclusion: The study shows that despite statistical elimination, leprosy still continues to be a challenge to health worldwide. Approaches like destigmatizing the disease, family councelling, integrating leprosy care into general health care systems, developing newer diagnostic & epidemiologic tools, chemoprophylactic regimens and vaccines are needed to develop an eradication strategy which can reduce the burden of leprosy in India.
References
2. Sagar V. Prevalence of leprosy “A five year study†in a tertiary care hospital in Ludhiana. International J of Physical and Applied Sciences 2015;2(7):1-4.
3. Stuti K, Pushpa Devi. Raising burden of smear-positive leprosy cases in tertiary care hospital of North India. International J of Scientific Research 2015;4(9):388-9.
4. NLEP--Progress report for the year 2015-2016. 2016.
5. Richardus JH, Meima A, Croft RP et al (1999). Case detection, gender and disability in leprosy in Bangladesh: a trend analysis. Lepr Rev. 70: 160-173.
6. Chhabra N, Grover C, Singal A, et al. Leprosy scenario at a tertiary level hospital in Delhi: a 5-year retrospective study. Indian J Dermatol 2015;60(1): 55-9.
7. Seher SM, Sreedevi S, Sumanth G, et al. Current scenario of smear-positive leprosy cases in a rural tertiary care hospital in Nandyal, Andhra Pradesh. J. Evolution Med. Dent. Sci. 2017;6(34):2849-2851.
8. Singh AL, Vagha SJ, Agarwal A, et al. Current scenario of leprosy at tertiary care level hospital of rural central India. Indian J DermatolVenereolLeprol 2009;75(5):520-2
9. Jindal N, Shanker V, Tegta GR, et al. Clinico-epidemiological trends of leprosy in Himachal Pradesh: a five year study. Indian J Lepr 2009;81(4): 173-9.
10. Mathan R, Devan KM. Incidence and clinical profile of leprosy in a tertiary care hospital: a retrospective study. International J of Scientific Study 2016;4(3):178-9.
11. Arora M, Katoch K, Natrajan M, et al. Changing Profile of Disease in Leprosy Patients Diagnosed in a Tertiary Care Centre during Years 1995- 2000.Indian J Lepr 2008, 80 : 257-265.
12. Pandey A, Patel R and Rathod H Comparative profile of new leprosy cases coming to a referral institute in pre- and postintegration periods. Indian J Lepr 2006;78: 339-346.
13. Rao S, Moodalgiri VM. Leprosy in a tertiary care hospital, Bagalkot, India: Clinical study and a reappraisal in the post-elimination era. MedicaInnovatica 2015. Volume 4- issue 2.DDecember 2015, Volume 4 - Issue 2ecember
14. Mahajan VK, Sharma NL, Rana P. Trends in detection of new leprosy cases at two centres in Himachal Pradesh, India: a ten year study. Indian J Lepr. 2003;.75:17-24.
15. Rao PSS and Jayakumar S Trends in new case detection rates at the leprosy mission trust India centers. IndianJ Lepr 2006 ;78: 187-194.
16. Norman G, Bhushanam JDRS and Samuel P (2006). Trends in Leprosy over fifty years in Gudiyatham Taluk, Vellore, Tamilnadu. Indian J Lepr. 78: 167-185.
17. Kumar B, Dogra S and Kaur I (2004). Epidemiological characteristics of leprosy reactions: 15 years experience from north India. Int J Lepr Other Mycobact Dis. 72: 125-133.
18. Dogra S,Narang T and Kumar B (2013). Leprosy - evolution of the path to eradication. Indian J Med Res. 137:15-35.
19. Mahajan VK. Slit-skin smear in leprosy: lest we forget it ! Indian J Lepr 2013;85(4):177-83.