Epidemiological immunological studies on leprosy in Okinawa. V. Statistical observation of outpatients

Abstract

One hundred and seventy-four outpatients attending the skin clinic in Naha or Miyako were surveyed by the same methods as those used for the inpatients in the first report of this series. As the age-distribution of outpatients was significantly deviated from normal distribution, Kolmogorov-Smirnov's test was used for statistical examination of their age, age at onset, years after onset and period of contact with consanguineous patient accrding to the subgroups classified by personal and family histories and clinical findings. The results were shown in Tables 1-5. Average age of the patients at home after the onset was significantly lower than that of the discharged cases, but the latter was also lower than that of inpatients. Average age of outpatients showed signi-ficant difference according to presence or absence of consanguineous patient, classification (form) of leprosy and living place, but not according to the other findings. Average age at onset was also significantly different between two subgroups with or without consanguineous patient, the result being similar to those of inpatients. Average years after onset of outpatients were significantly different according to the form of leprosy and its stage. However, average period of contact with consanguineous patient was not significantly different among the subgroups classified by consanguinity and leprosy form of index case, the fact being discrepant from that of the inpatients.A correlation between two items or a comparison of two or more percentages among the subgroups was examined by chi-square test, as shown in Tables 6-17. Male patients were more frequently found in Yaeyama and other islands than those in Main Okinawa and Miyako islands. No difference by sex was found in the other subgroups. The outpatients with lepromatous leprosy were more frequently found in the discharged cases than those at home, in Yaeyama and other islands than in Main Okinawa and Miyako islands, and in physical workers than in brain workers. The skin eruption was more fre-quently found in progressive and retrogressive stages than in quiescent and arrested. However, the frequencies of fall of eyebrow and nose involvement were significantly less than those of inpatients and not significantly different among the subgroups classified by sex, form and stage of leprosy of outpatients.On the other hand, the frequency of the enlargement of peripheral nerve was not significantly different between in- and out-patients but significantly higher in male than in female. The other neural symptoms such as claw hand, drop hand or foot, facial palsy and lagophthalmos were far less frequently found in the outpatients than in the inpatients, but the frequency of these symptoms showed no significant difference among the subgroups of outpatients as described above. The percentage of outpatients under conti-nuous treatment was significantly higher than that of inpatients. Nearly 62% of outpa-tients was bacteriologically negative (BI= 0). This percentage was not significantly different from that of inpatients, but significantly different among the subgroups classified by leprosy form, stage and complication.Based on these findings, it is concluded that relatively mild cases with leprosy and those at early stage were more frequently found in the outpatients than in the inpatients and that because of this mildness they might be suited to the treatment at a skin clinic. The results also suggest that the appearance of mild leprosy may be more strongly influenced by post-natal and empirical conditions than by genetic and physiologi-cal factors.