Abstract
Objectives Leprosy in children is a strong indicator of disease transmission in the community and the rapidity of case detection. Grade 2 disability (G2D) in children denotes a delay in diagnosis, which could be due to delay either at the health care level or in recognition and referral by the family. The current study determines the proportion of G2D among newly diagnosed leprosy-affected children and adolescents and identifies the associated factors. Methods A 5-year retrospective analysis of records of children and adolescents aged ≤18 years newly diagnosed with leprosy between April 2014 and September 2019, was carried out with special reference to G2D presentation at the time of diagnosis. Results Children and adolescents comprised 8.26% (327/3955) of all subjects. Among them, 58 (17.7%) had G2D at the time of diagnosis. G2D occurred more frequently among the 15–18 years age group and was significantly associated with registration delay, presence of household contact cases, having multibacillary leprosy, nerve thickening and neuritis. Conclusions We report a high rate of G2D among newly diagnosed leprosy cases in children and adolescents, much higher than the reported national average for adults. With such a high occurrence of G2D, the target of having zero disability in childhood cases is unlikely to be met in India in 2020. Early case detection activities with a child-focused approach may reduce the delay in diagnosis, preventing leprosy-associated disability in children.
Highlights
The National Leprosy Elimination Program (NLEP) of India reported 126,164 new leprosy cases during 2017–2018, contributing to over one-half of the global leprosy cases.[1]
Focused approach may reduce the delay in diagnosis, preventing leprosy-associated disability in children
Records of children (0–14 years) and adolescents, who were diagnosed with leprosy and treated at specialized leprosy referral centres (RC) of Lepra society, from Andhra Pradesh, Telangana, Madhya Pradesh and Bihar states of India, between April 2014 and September 2019, were analyzed
Summary
The National Leprosy Elimination Program (NLEP) of India reported 126,164 new leprosy cases during 2017–2018, contributing to over one-half of the global leprosy cases.[1]. During this period, 10,287 (8.15%) new child cases were reported, indicating continued disease transmission.[2]. The epidemiology of leprosy in children is complicated by the long and variable incubation period for leprosy.[3,4]. With a long incubation period, leprosy usually manifests during adolescence or early adulthood.[6,7]. Leprosy in children typically presents with equal male/female sex ratios, a higher proportion of paucibacillary cases and reactions. Leprosy related disabilities are supposed to be less common in children because it takes a long time for disabilities to develop.[7–9]
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