Leprosy In Children Research Articles

A clinico histopathological study of childhood leprosy in a tertiary care institute

Background: Leprosy in children forms an important link in the natural evolution and the epidemic profile of the disease. This study was undertaken to know the clinical and histopathological features of childhood leprosy in skin biopsies.Methods: This was both a retrospective and prospective study of childhood leprosy, undertaken in the Department of Pathology, Karnataka Institute of Medical Sciences, Hubballi, over a period of 42 months from January 2013 to June 2016.Results: There were 37(13.21%) cases of paediatric leprosy in this study. Most common clinical type and histological type of leprosy was BT (19 cases, 51.37%) and IL (16 cases z, 43. 24%) respectively. Conclusion: Early detection and effective treatment of leprosy patients in the paediatric age group can prevent the development of more severe devastating or crippling adult form of the disease.

Factors associated with leprosy in children contacts of notified adults in an endemic region of Midwest Brazil

ObjectivesTo analyze the factors associated with leprosy in children who were intradomiciliary contacts of notified adults with the disease in an endemic municipality in Mato Grosso, Brazil. MethodCase–control study with 204 children under 15 years of age, living in an endemic municipality. Cases (n=40) were considered as the children with leprosy registered at the National Information System of Notifiable Diseases in 2014 and 2015, who were intradomiciliary contacts of at least one adult diagnosed with the disease in the family, and as a control group (n=164) of children living within a radius of up to 100m of the notified cases. Data were obtained through medical file analysis, interviews, and blood samples for anti-PGL-I serological test by the ELISA method. The binary logistic regression technique was used, with p≤0.05. ResultsAfter adjustments, the following were associated with leprosy: age (95% CI: 1.24–9.39, p=0.018), area of residence (95% CI: 1.11–6.09, p=0.027), waste disposal (95% CI: 1.91–27.98, p=0.004), family history of the disease (95% CI: 3.41–22.50, p=0.000), and time of residence (95% CI: 1.45–7.78, p=0.005). ConclusionFactors associated with the disease indicate greater vulnerability of children aged 8–14 years, associated with living conditions and time of residence, as well as the family history of the disease.

Childhood leprosy: A review

Leprosy in children is of special importance as it is the indicator of transmission in community. It affects both the child and family members psychologically and functionally. In this review, we will discuss regarding epidemiology of childhood leprosy in detail, types of leprosy in children, diagnostic difficulties in children, prevention of disabilities in children, and effect of childhood leprosy on the community.

Childhood leprosy: A retrospective descriptive study from Delhi

Background: Childhood leprosy is an important marker of the status of the ongoing leprosy control program, as it is an indicator of active disease transmission in the community. Despite achievement of elimination status of leprosy in 2005, the reported prevalence of childhood cases continues to be high. Materials and Methods: A retrospective analysis of 10-year records of leprosy patients aged <15 years in a tertiary care hospital of central Delhi was carried out from 2005 to 2015. Data were analyzed using the SPSS 22.0 system. Results: A total of 113 (7.6%) cases of childhood were reported during the 10-year period from 2005 to 2015. Multibacillary cases constituted a total of 57 (50.4%) cases, whereas paucibacillary constituted 56 (49.5%) cases. The M:F ratio noted was 2.5:1. Signs of reaction were noted among 15% of cases, while deformity was noted in 24.7% of cases. Conclusion: The rate of childhood leprosy continues to be high. Lack of proper access to health facilities, ignorance among the general population, high susceptibility due to immature immune system, etc., make this population highly vulnerable.

DIAGNÓSTICO PRECOCE DE HANSENÍASE EM CRIANÇAS DA VILA SANTO ANTÔNIO DO PRATA, REGIÃO HIPERENDÊMICA NO ESTADO DO PARÁ

This article reports the extension project of early detection of leprosy in schoolchildren from the Eastern Amazon. These are the activities developed by the project promotion focusing on education and diagnosis of leprosy in children in schools in the village of Santo Antonio do Prata, linked to a Higher Education Institution in the North of Brazil and conducted between March and July 2017 in a hyperendemic area. Children (n = 154) were screened using a protocol from the Brazilian Health Ministry with the help of a multi-professional health team, and 3 new cases were diagnosed by clinical and histopathological criteria in children aged 3 to 7 years old. The importance of this type of activity is that school age does not usually represent an age group of leprosy occurrence, so its detection indicates the need for early diagnosis to control leprosy at the family level.

Child Welfare, Leprosy, and Mental Illness: Australian Medical Volunteerism in Modern Korea (1902–1941)

Child Welfare, Leprosy, and Mental Illness: Australian Medical Volunteerism in Modern Korea (1902–1941)

Leprosy in children

Children are believed to be the most vulnerable group to infection with Mycobacterium leprae due to their immature or nascent immunity and exposure to intrafamilial contacts. The child proportion among newly detected cases of leprosy is a strong indicator of continued transmission of the disease and one of the main targets of the current World Health Organization strategy is “to reduce transmission of the disease and reduction of grade-2 disability among new child cases.” Despite an effective treatment and global achievement of leprosy elimination, the childhood leprosy proportion has not improved significantly. Leprosy in children does not just affect a child's health like other diseases; they can be stigmatized, bullied, and shunned for their lives. Hence, effective planning to bring down the incidence of leprosy and its complications in children should become a top priority. Regular school surveys and annual contact surveys for early detection of cases is therefore an important tool in achieving the goal of elimination of leprosy. In addition to continuing to administer multidrug therapy to patients, new preventive approaches need to be considered to break the chain of transmission and reach zero disease status.

Trends of leprosy in children under fifteen years in Rondonópolis-MT (2007 to 2016)

Trends of leprosy in children under fifteen years in Rondonópolis-MT (2007 to 2016)

Assessment of the diagnostic value of immunocytochemitsry and in situ hybridization in cytological specimen of childhood leprosy

Background: Hardly any studies have been done to study diagnostic value of immunocytochemistry and in situ hybridization in cytological specimens for the diagnosis of leprosy in children. The objective of this study is to assess the diagnostic value of immunocytochemistry and in situ hybridization in cytological specimens of leprosy patients. To compare these techniques with Z.N. staining.Methods: This prospective study was carried out in 24 patients (≤18 years of age) of leprosy. Clinical examination of each patient was done and categorized according to IAL. After taking consent, three skin smears was taken, one for Z.N. staining and remaining two for immunocytochemistry and in situ hybridization respectively.Results: Routine skin smear examination by ZN staining method confirmed the diagnosis in 2/24 (8.3%) cases and they belonged to BL category. Immunocytochemistry showed positivity in 4/7 (57.1%) in early leprosy (BT) and 82.3% (BB/BL) in late leprosy. Immunocytochemistry improved the diagnosis by 66.7%, and the results were statistically significant (p&lt;0.01). In situ hybridization showed the positive results in 66.6% cases of early leprosy and 86.6% cases of late leprosy (BB/BL). In situ hybridization improved the diagnosis 72.6% in comparison to ZN staining and the results were statistically significant (p&lt;0.01).Conclusions: Immunocytochemistry and in situ hybridization enhance the diagnosis of leprosy when compared to routine skin smears stained by ZN staining. They are important diagnostic tools for definitive diagnosis in early as well as established cases of leprosy.

Genotyping of Mycobacterium leprae in a Son-and-Father Pair of Patients Indicated the Possible Mode of Leprosy Transmission: a Case Report

Abstract One of the success indicators of the World Health Organization (WHO) leprosy eradication program is the decreasing number of new cases of pediatric leprosy with a grade 2 disability. A case of borderline lepromatous (BL) leprosy with partial claw hand in a 13-year-old boy was reported. On physical examination, we found claw fingers on the fourth and fifth fingers of the left hand accompanied by hypoesthetic erythematous plaques on both cheeks. The patient also presented with the enlargement of bilateral great auricular, ulnar, and peroneal nerves. The bacteriological examination showed the bacterial index 3+ and morphological index 35%. The results of histopathological and serological anti-phenolic glycolipid-I examinations supported the diagnosis of BL type of leprosy. Genotyping of Mycobacterium leprae by variable number tandem repeat of the patient showed 24 copies thymine-thymine-cytosine that were similar to his father, who had been diagnosed with leprosy 12 years before, without adequate therapy. The result indicated the possibility of leprosy transmission from the father to a son. This case report revealed the presence of leprosy in children with a multibacillary infection who have been living with leprosy family members. Genotyping seems to be feasible for epidemiological analysis of leprosy transmission.

Childhood leprosy - still a problem in the era of elimination!

Childhood leprosy - still a problem in the era of elimination!

Effect of Brazil’s Conditional Cash Transfer Programme on the new case detection rate of leprosy in children under 15 years old

Background: Poverty and other socio-environmental determinants may contribute to the occurrence of leprosy. However, there is no previous evidence on the effectiveness of cash transfer programmes in reducing leprosy case detection among children under 15 years old. Objective: This study aimed to assess the effect of the Brazilian conditional cash transfer programme (Bolsa Família Programme, BFP) on the reduction of new case detection rates (NCDR) of leprosy in Brazilians under 15 years old. Methods: We performed a mixed ecological study with the Brazilian municipalities as units of analysis, during 2004–2015. The main independent variables were: BFP coverage of target population (poor and extremely poor families) and BFP coverage of the total population of the municipalities. Data were obtained from public databases. We included 1,120 (of 5,570) municipalities in the analysis, using fixedeffects negative binomial models for panel data, adjusted for the municipal coverages of the Brazilian primary health care programme (Family Health Strategy, FHS) and for a set of sociodemographic covariates. Results: We found an increasing trend in the median BFP coverages and a decreasing trend in the NCDR of leprosy in individuals under 15 years old. This indicator was significantly reduced in municipalities with higher BFP coverages of target population (RR = 0.75; CI 95% 0.63–0.88) and higher BFP coverages of the total population of the municipalities (RR = 0.85; CI 95% 0.79–0.93). Conclusions: During the study period, BFP was associated with a reduction of the NCDR of leprosy among Brazilians aged less than 15 years old, living in municipalities with a high risk of leprosy transmission.

Childhood leprosy in the postelimination era: A vision achieved or a concern growing at large

Background: The proportion of childhood leprosy has been gaining importance of late as a performance indicator of the National Leprosy Eradication Program. A sizable proportion of the newly detected cases comprises children. The prevalence rate has been used as a measure of existence of infection though leprosy has attained elimination levels in the country. Materials and Methods: A retrospective descriptive study was conducted. Case records of children newly diagnosed with leprosy aged <15 years between April 2005 and October 2015 were studied and included in the study. Findings such as patches, nerve thickness, spectrum of leprosy, grade of deformity, smear status, presence of reaction, histopathological diagnosis, and treatment history were noted. Results: The percentage of childhood leprosy among the newly diagnosed cases in our study was found to be 11.2%. A solitary skin lesion was the most frequent manifestation in 64.4% children. The second most common finding seen in these patients included the presence of thickened nerves in 46.6% children. Smear showed acid-fast bacilli in 8.8% cases. Conclusion: There is an urgent need for improving clinical acumen in diagnosing childhood leprosy. The importance of appropriate and complete treatment along with meticulous surveillance in endemic areas and looking for household contacts needs to be stressed on.

Childhood Leprosy: A Retrospective Descriptive Study from Delhi.

Background:Childhood leprosy is an important marker of the status of the ongoing leprosy control programme, as it is an indicator of active disease transmission in the community. Despite achievement of elimination status of leprosy in 2005, the reported prevalence of childhood cases continue to be high.Method:A retrospective analysis of 11 year records of leprosy patients aged less than 15 years in a tertiary care hospital of central Delhi was carried out from 2005-2015. Data were analysed using SPSS 22.0 system.Result:A total of 113 (7.6%) cases of childhood leprosy were reported during the 11 year period from 2005-2015. Multibacillary cases constituted a total of 57 (50.4%), while paucibacillary constituted 56 (49.6%) cases. The M:F ratio noted was 2.5:1. Signs of reaction were found in 15% cases, while deformity was noted in 24.7% cases.Conclusion:The rate of childhood leprosy continues to be high. Lack of proper access to health facilities, ignorance among the general population, high susceptibility due to immature immune system etc make this population highly vulnerable.Limitations:Limited data of 11 years from an urban center were analyzed.

Current Situation of Leprosy in India and its Future Implications.

The global leprosy situation has changed significantly over the last four decades after the introduction of multidrug therapy (MDT) in 1982 with a reduction in prevalence from over 5 million cases in the mid-1980s to less than 200,000 at the end of 2016. The programme in India also saw a reduction from a prevalence rate of 57.8/10,000 in 1983 to less than 1/10,000 by the end of 2005 when India declared to have reached the World Health Organization (WHO) target of elimination as a public health problem. Post 2005, major changes in the programme were made by the National leprosy eradication programme (NLEP) and the global leprosy programme, which may have affected the new case detection (NCD), disability, and child leprosy trends, which continue to show no appreciable regression. This article reviews the current global and Indian leprosy scenario to bring out its achievements and successes, including the impact of Leprosy Case Detection Campaigns (LCDC) on leprosy numbers. The basis and expected benefits of recent introduction of chemo and immune-prophylaxis in the programme are also discussed. It also discusses the shortcomings, the areas of concern, and the need for an inclusive strategy in the Indian leprosy programme that includes an intersectoral collaboration within the country for reaching the desired goal of leprosy eradication.

Profile of leprosy in children under 15 years of age monitored in a Brazilian referral center (2004-2012).

Leprosy in children under 15 years of age is a serious public health problem. In this retrospective case series conducted in a Brazilian reference center (2004-2012), we found 18 cases with a mean age of 10.0±3.6 years of age and 16.6% between 0-5 years of age. Almost 56% of the cases were female, with a median time between the first symptoms and diagnosis of 11 months (4-24); 77.8% reported household contact with leprosy patients. Upon hospital admission, 66.7% presented mostly skin symptoms, while 27.8% presented a degree 2 disability. Most were classified as multibacillary (66.7%). Half of the sample developed a reaction (predominantly type 1) during the follow-up period, while 22.2% developed a late disability.

Caracterização da hanseníase em menores de 15 anos em município prioritário do nordeste brasileiro

Caracterização da hanseníase em menores de 15 anos em município prioritário do nordeste brasileiro

Barriers to prevent disability due to leprosy in children are breachable

Barriers to prevent disability due to leprosy in children are breachable

Clinico-epidemiological study of childhood leprosy from a tertiary care hospital

Clinico-epidemiological study of childhood leprosy from a tertiary care hospital

Leprosy in Children.

This manuscript aims to review the cutting-edge developments regarding to the diagnosis, management, and prevention of leprosy in children. Leprosy transmission still occurs continuously in some endemic areas in the world. Leprosy in children below 15years old is a robust indicator of active source of infection in the community where they live. A special focus on children to reduce disabilities and reduce transmission is one of the core areas of interventions of the global leprosy strategy 2016-2020. Ongoing research is trying to develop better diagnostic tests and to advance chemoprophylaxis and immunoprophylaxis approaches. Early diagnosis in children can be hard because of the wide range of clinical aspects of the skin lesions and mainly due to the difficulty of performing the clinical peripheral nerve evaluation. We must maintain leprosy expertise and improve the health professionals training for leprosy diagnosis, since we still have a long journey to reach leprosy elimination.