Clinicoepidemiologic profile of leprosy in geriatric population in post-elimination era: A retrospective, hospital-based, cross-sectional study from Eastern India.

Abstract

Geriatric populations are susceptible to leprosy infection with masked clinical signs due to lower immunity in them. Our aim was to analyze the clinicoepidemiologic profile of patients with geriatric leprosy and find out the reasons for delayed diagnosis and treatment. A retrospective, record-based study was conducted in a tertiary care center from May 2019 to May 2022. The clinicodemographic data of biopsy-confirmed leprosy cases aged ≥60 years were obtained from the leprosy clinic record. Various reasons for the delay in treatment were also recorded. Simple statistics was used for analysis. Out of 605 leprosy cases, 50 (7.4%) cases belonged to the geriatric population. Males outnumbered females (M/F = 37/13). The mean age of the patients was 66.28 + 6.5 years. Maximum patients belonged to 60-69 years of age. The mean duration of illness was 35.22 months (range 1-240 months). Most of the patients were illiterate (33.6%), and 56% were farmers by occupation. The ulnar nerve was the most common nerve to be thickened in 90% (45/50) cases, followed by the common peroneal nerve in 54% (27/50) cases, radical cutaneous nerve in 52% (26/50) cases, and posterior tibial nerve in 24% (12/50) cases. Borderline tuberculoid was the most common type in 44% cases, followed by lepromatous leprosy in 22%, borderline lepromatous leprosy in 18% (9/50), and pure neuritic leprosy in 14%. Type 1 and type 2 lepra reactions were found in 18% and 14% cases, respectively. Also, 38% had grade 2 disability. Common reasons for the delay in treatment were financial constraints, lack of family support, and personal superstitious beliefs. The study was limited by its retrospective nature. Geriatric leprosy needs special attention as the elderly are more prone for deformities; also, because of low immunity, there is a high chance of developing multibacillary leprosy, and therefore, they are potential sources of infection to the community.