A clinicoepidemiological study of leprosy among children and adolescents in a tertiary care centre in the post elimination era

Abstract

Leprosy amongst younger age indicates active foci of transmission in the community. Our aim is to analyse the epidemiological profile, clinical spectrum, reactions and deformities of leprosy among children and adolescents. This is a prospective observational study conducted on all newly diagnosed leprosy patients under the age of 19 years for one year. Of 113 newly diagnosed leprosy cases, 38 patients were under 19 years of age. Male-female ratio was 5.3:1. Mean age was 16.6 years. Borderline tuberculoid (BT) was the most common type followed by borderline lepromatous (BL) and Indeterminate (I) leprosy most common manifestation was hypopigmented anaesthetic skin lesion over exposed parts. 79% had multiple nerve trunk involvement of which ulnar nerve was the most common. Reaction and deformity were found to be in 21% and 18.3%. Both were seen only in multibacillary cases and predominantly in 15-19years of age. Risk factors for reactions were male sex, increasing age, labourers, borderline spectrum, skin lesion involving the nerve trunk, multiple nerve involvement and smear positivity. Risk factors for deformities were migrants in lower socio-economic status, increased duration of active disease and delayed diagnosis. Leprosy, a disease of long incubation period, among adolescents may indicate missed cases of childhood leprosy. Training through integrated service in early diagnosis and its complication, introduction of an exclusive type of treatment (MB MDT) for all categories for a shortened duration and newer drugs for reactions, sustained commitment to follow-up care and health education among community is a need at this post elimination era.