Title: Clinical profile of Leprosy Patients who attended Department of Dermatology, Government Vellore Medical College Hospital during 2012-13 to 2015-16

Authors: Dr Dharmambal. C, Dr Vasanthamoorthy.R, Dr Balachander.J,  Dr Somasundaram.A

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i5.22

Abstract

Introduction: Leprosy is a communicable disease caused by M. leprae mainly affecting the skin and nerves.  In India the prevalence rate has declined from 4.2 in 2001 to 0.68 in 2015. Despite reaching elimination level and progressively declining trends in the state of TamilNadu, new cases are being reported1 and are likely to continuously occur. We conducted a retrospective study on the leprosy patients to understand the clinical profile of the leprosy cases in Government Vellore Medical College.

Materials and Methods: The study is a descriptive retrospective study. We did a retrospective analysis of the 179 cases who attended Government Vellore Medical College; Vellore during April 2012 to March 2016Statistical analysis was done with Epi info software.

Results: The number of cases in 2012-13 was 52 which declined to 31 in 2015-16. The proportion of male cases among adults is 63%. Majority of the cases (37%) were more than 45 years of age. Borderline Tuberculoid (60%) was the major type based on clinical finding.13 cases were pure neuritic type. The proportion of multibacillary cases was 70 %.

Discussion: Despite Leprosy Elimination strategies many cases are reported and they are lately detected. The decline shown in our study is consistent with the trend in the state. The majority patients belonged to the late age group (> 45years of age). Late diagnosis is a cause for concern both for the individual, in terms of complications and disability, and for the contacts in terms of transmission of the disease. Late diagnosis may lead to complications and also adversely affect the quality of life.  Child cases were 10% and the occurrence of child cases indirectly indicates the presence of infection in the community.  Majority of the cases are Multibacillary which could act as source of infection

Conclusion: Active case search strategy is to be intensified and sustained. Intensive IEC campaigns to be undertaken on early health seeking, and avoidance of stigma and discrimination. Health providers are to be continuously trained. 

References

1.      Central Leprosy Division Directorate General of Health Services Nirman Bhawan, New Delhi – 110011. NLEP – Progress Report for the year 2014-15: pg 4

2.      Centre for Disease Control available  from Hansens Diseease Leprosy Transmission https:// www.cdc.gov/ leprosy/ transmission/

3.      Lustosa, Anselmo Alves, Nogueira, Lídya Tolstenko, Pedrosa, José Ivo dos Santos, Teles, João Batista Mendes, & Campelo, Viriato. (2011). The impact of leprosy on health-related quality of life. Revista da Sociedade Brasileira de Medicina Tropical, 44(5), 621-626. https://dx.doi.org/ 10.1590/ S0037- 86822011000500019

4.      Ezenduka, Charles et al. “Cost-Effectiveness Analysis of Three Leprosy Case Detection Methods in Northern Nigeria.” Ed. Christian Johnson. PLoS Neglected Tropical Diseases 6.9 (2012): e1818. PMC. Web. 25 Apr. 2017.

5.      Pinheiro RO, de Souza Salles J, Sarno EN, Sampaio EP. Mycobacterium leprae–host-cell interactions and genetic determinants in leprosy: an overview. Future microbiology. 2011;6(2):217-230. doi:10.2217/fmb.10.173.

6.      Oral mucosa as a source of Mycobacterium leprae infection and transmission, and implications of bacterial DNA detection and the immunological status Martinez, T.S. et al. Clinical Microbiology and Infection , Volume 17 , Issue 11 , 1653 – 1658.

Corresponding Author

Dr C.Dharmambal

Department of Dermatology, Govt. Vellore Medical College Hospital, Vellore

Tamil Nadu, India – 632011

Telephone: +91 9443812849, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.