Leprosy elimination: A myth busted

Abstract

Background: Leprosy is mainly a chronic infectious disease caused by Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and eyes. Though the target of leprosy elimination was achieved at national level in 2006 even then a large proportion of leprosy cases reported globally still constitute from India.

Aim and objective: To study the clinico-epidemiological profile of new cases of leprosy in a rural tertiary hospital.

Materials and methods: Thirty-five newly diagnosed cases of leprosy presented in out-patient/admitted in the department of Dermatology, Venereology and Leprosy (between September 2012 and August 2013) were included in the study. Detailed history regarding leprosy, deformity, sensory loss, skin smear for AFB and histopathological examination were done in every patient.

Results: The incidence was more in age group of 20 to 39 years (48.57%) and 40 to 59 years (37.14%). 68.57% were males. 48.57% cases were found to have facial deformity and ear lobe thickening was found to be pre-dominant form of facial deformity. Ulnar (88.87%) and common peroneal nerve (34.28%) were the most commonly involved nerves. The split skin smear examination was found to be positive in 27 out of 35 cases. On histopathological examination 10 patients (28.57%) were of lepromatous pole (LL), 4 (11.43%) were of indeterminate, 6 (17.14%) were of tuberculoid type (TT), 4 BT (11.4%) and 1 BL type (2.8%).

Conclusions: This study helps in concluding that leprosy is still not eliminated. Active surveillance is still needed to detect the sub-clinical cases and undiagnosed cases.

Keywords: Deformity; elimination; subclinical cases.

Figure 1

Results of split skin smear (SSS) for acid fast bacilli in leprosy

Figure 2

Pie chart showing histopathology pattern in leprosy. (TT = tuberculoid leprosy, BT = borderline tuberculoid, BL = borderline lepromatous, LL = lepromatous leprosy, I = indeterminate)