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Leprosy Scenario at a Tertiary Level Hospital in Delhi: A 5-year Retrospective Study.

Chhabra N, Grover C, Singal A, Bhattacharya SN, Kaur R - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: WHO grade II deformities were diagnosed in 37.9% with claw hand being the most common paralytic deformity (23.3% cases).Our study offers insight into the current status of the disease in an area of otherwise low prevalence.Delhi's unique demography with a high degree of migrant workers, presenting to our center (near border location) could be a possible contributing factor towards these aberrations.

View Article: PubMed Central - PubMed

Affiliation: Departments of Dermatology, Venereology and Leprology, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India.

ABSTRACT

Background: Leprosy has been officially eliminated from India since December, 2005; still, there are districts and blocks reporting high prevalence indicating ongoing transmission. The present study aimed at determining the current clinical profile of leprosy from a tertiary level hospital in Delhi.

Materials and methods: A retrospective, record-based study was carried out on patients diagnosed and registered in the leprosy clinic of a tertiary level teaching hospital in East district of Delhi (April 2007 to March 2012). Data regarding demographic details, clinical features, treatment started and complications was analyzed.

Results: A total of 849 patients were registered over a 5-year period, with M: F ratio of 2.3:1. 9.3% were children (≤14 years). 54.3% patients were immigrants from adjoining states. Multibacillary leprosy was the most common clinical type (86.9%). Borderline tuberculoid leprosy was the most frequent morphologic type, seen in 56.3% followed by borderline-borderline (1.5%), borderline lepromatous (24.9%), lepromatous leprosy (8.1%), pure neuritic (8.1%), histoid and indeterminate leprosy (0.5% each). 37.4% patients presented in reaction (Type I in 30.4% cases and Type II in 7% cases). WHO grade II deformities were diagnosed in 37.9% with claw hand being the most common paralytic deformity (23.3% cases).

Conclusion: Our study offers insight into the current status of the disease in an area of otherwise low prevalence. It is seen that despite statistical elimination, multibacillary disease, leprosy reactions and deformities are commonly seen as presenting manifestations, in contrast to national projected trends. Delhi's unique demography with a high degree of migrant workers, presenting to our center (near border location) could be a possible contributing factor towards these aberrations. It highlights the need for continuation of targeted leprosy control activities and active case detection.

No MeSH data available.


Related in: MedlinePlus

Clinical presentation of the newly registered leprosy patients
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Figure 2: Clinical presentation of the newly registered leprosy patients

Mentions: MB leprosy was the most common clinical type of leprosy encountered in 86.9% patients (n = 738). According to the RJ classification, 82.8% (n = 703) patients were in the borderline spectrum. Borderline Tuberculoid (BT) was the most frequent morphologic type, seen in 56.3% (n = 478) followed by Borderline (BB) in 1.5% (n = 13), Borderline Lepromatous (BL) in 24.9% (n = 212) and Lepromatous (LL) in 8.1% (n = 69) patients. Additionally, special types of leprosy were recorded in 9.06% patients (n = 77) with Histoid, PNL and indeterminate forms in 4 (0.5%), 69 (8.1%) and 4 (0.5%) patients, respectively [Figure 2]. Among BT cases, 52.5% had single skin lesion, 30.3% had two to five lesions and 17.1% patients had more than five skin lesions.


Leprosy Scenario at a Tertiary Level Hospital in Delhi: A 5-year Retrospective Study.

Chhabra N, Grover C, Singal A, Bhattacharya SN, Kaur R - Indian J Dermatol (2015 Jan-Feb)

Clinical presentation of the newly registered leprosy patients
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318064&req=5

Figure 2: Clinical presentation of the newly registered leprosy patients
Mentions: MB leprosy was the most common clinical type of leprosy encountered in 86.9% patients (n = 738). According to the RJ classification, 82.8% (n = 703) patients were in the borderline spectrum. Borderline Tuberculoid (BT) was the most frequent morphologic type, seen in 56.3% (n = 478) followed by Borderline (BB) in 1.5% (n = 13), Borderline Lepromatous (BL) in 24.9% (n = 212) and Lepromatous (LL) in 8.1% (n = 69) patients. Additionally, special types of leprosy were recorded in 9.06% patients (n = 77) with Histoid, PNL and indeterminate forms in 4 (0.5%), 69 (8.1%) and 4 (0.5%) patients, respectively [Figure 2]. Among BT cases, 52.5% had single skin lesion, 30.3% had two to five lesions and 17.1% patients had more than five skin lesions.

Bottom Line: WHO grade II deformities were diagnosed in 37.9% with claw hand being the most common paralytic deformity (23.3% cases).Our study offers insight into the current status of the disease in an area of otherwise low prevalence.Delhi's unique demography with a high degree of migrant workers, presenting to our center (near border location) could be a possible contributing factor towards these aberrations.

View Article: PubMed Central - PubMed

Affiliation: Departments of Dermatology, Venereology and Leprology, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India.

ABSTRACT

Background: Leprosy has been officially eliminated from India since December, 2005; still, there are districts and blocks reporting high prevalence indicating ongoing transmission. The present study aimed at determining the current clinical profile of leprosy from a tertiary level hospital in Delhi.

Materials and methods: A retrospective, record-based study was carried out on patients diagnosed and registered in the leprosy clinic of a tertiary level teaching hospital in East district of Delhi (April 2007 to March 2012). Data regarding demographic details, clinical features, treatment started and complications was analyzed.

Results: A total of 849 patients were registered over a 5-year period, with M: F ratio of 2.3:1. 9.3% were children (≤14 years). 54.3% patients were immigrants from adjoining states. Multibacillary leprosy was the most common clinical type (86.9%). Borderline tuberculoid leprosy was the most frequent morphologic type, seen in 56.3% followed by borderline-borderline (1.5%), borderline lepromatous (24.9%), lepromatous leprosy (8.1%), pure neuritic (8.1%), histoid and indeterminate leprosy (0.5% each). 37.4% patients presented in reaction (Type I in 30.4% cases and Type II in 7% cases). WHO grade II deformities were diagnosed in 37.9% with claw hand being the most common paralytic deformity (23.3% cases).

Conclusion: Our study offers insight into the current status of the disease in an area of otherwise low prevalence. It is seen that despite statistical elimination, multibacillary disease, leprosy reactions and deformities are commonly seen as presenting manifestations, in contrast to national projected trends. Delhi's unique demography with a high degree of migrant workers, presenting to our center (near border location) could be a possible contributing factor towards these aberrations. It highlights the need for continuation of targeted leprosy control activities and active case detection.

No MeSH data available.


Related in: MedlinePlus