The burden of leprosy in children and adolescents in rural southern Ethiopia

Abstract

Background: Childhood leprosy has an important bearing on the epidemiology of disease and reflects the level of control in a community. There is limited information about this disease in rural Ethiopia.Subjects and Methods: Data were collected retrospectively from leprosy patient records and treatment cards in a rural mission hospital in southern Ethiopia from 1999 to 2011.Results: Over the 13-year period, 298 patients with leprosy were registered for treatment. Of these, 22 (7·4%) were children (under 15 years) and 66 (21·1%) were adolescents (from 15 to 18 years). The male:female ratio was 2·6:1 in children and 1·7:1 in adolescents. Slit skin examination was positive in eight of 15 (36·4%) child patients and in 26 of 53 (41·3%) adolescents. Multibacillary leprosy was the most common type in both age groups, encountered in 95·5% of children and in 84·1% of adolescents. Six (27·3%) children and 18 (28·6%) adolescents had deformities of the hand, feet or eyes (WHO grade II), detected either at the time of diagnosis or during follow-up. Sixty-one per cent of children were transferred to their health institutions for treatment and follow-up; seven children (38·9%) completed the treatment and one (5·9%) defaulted while on therapy. Of 63 adolescent patients, 31 (49·2%) completed the recommended therapy, 28 (44·4%) were transferred out, and four (6·3%) defaulted on therapy.Conclusion: Childhood leprosy continues to be a common problem in rural southern Ethiopia. Multibacillary disease and disabilities remain common in children. Early detection and treatment of cases including the study of contacts should reduce the burden of leprosy in the community.