Pattern of Leprosy in Post-Elimination Stage: A 20-Year Retrospective Study in The Largest Specialized Leprosy Hospital of Bangladesh

Abstract

Background: Leprosy has affected humanity for over 4000 years. The global registered number of new leprosy cases in 2019 were 202256. Bangladesh has been achieved Elimination of leprosy in 1998, but a slow resurgence of the disease still continues in several parts of the country. Aims and objectives: Understanding the current magnitude of the disease is vital for the community, service providers and policy makers. The present study was undertaken to describe the pattern of the disease after leprosy has been declared eliminated. This will help for proper planning of patient- oriented leprosy services and judicial allocation of scarce resources. Materials and Methods: This descriptive study has been carried out using the registered record of patients attending the outpatient department (OPD) of leprosy hospital, Sylhet, Bangladesh during the period 2001- 2020. Results: The new case detection pattern was declining. Of the 1835 new cases, males (76.95%) outnumbered females (23.05%). The PB and MB cases were 27.74% and 72.26% respectively. Leprosy reactions developed in 31.39% cases and 18.09% cases presented with grade 2 disabilities. Smear positive cases were 19.89%. Mode of case detection was mainly passive (98.75%). The new case detection of childhood leprosy (≤14 years) was declining. Majority of patients (40.27%) were from >40 age group. Borderline type (44.20%) was more common. Leprosy reactions and G2D were common in MB type of leprosy, 78.69% and 66.57% respectively. Conclusion: New case detection is declining but burden of leprosy in the community has not changed significantly. MB patients with grade 2 disabilities are still in upward trend. Although leprosy has been eliminated globally, the disease continues accompanying the significant cause of disabilities in Bangladesh. Community based surveillance could help to improve early detection, treatment, prevention of disabilities and stigma.