A prospective study to validate various clinical criteria used in classification of leprosy: a study from a tertiary care center in India

Thapa, Manisha; Kumaran, Muthu Sendhil; Narang, Tarun; Saikia, Uma Nahar; Sawatkar, Gitesh U.; Dogra, Sunil

doi:10.1111/ijd.14041

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Fifth, the occurrence of false positive diagnosis and false negative diagnosis is due to the “subjectivity” in the diagnosis of leprosy cases due to its dependence on clinical criteria. There are several commentaries/studies on how using clinical criteria can lead to misdiagnosis [19–21]. There are serological tests to assess infection of leprosy that could be used for difficult cases (antibodies against Phenolic glycolipid (PGL-1) Mycobacterium leprae antigen) [22] or use split skin smears [23].…”

Section: Discussionmentioning

confidence: 99%

Does appreciative inquiry decrease false positive diagnosis during leprosy case detection campaigns in Bihar, India? An operational research study

Wagh¹,

Mugudalabetta²,

Gutierrez³

et al. 2018

PLoS Negl Trop Dis

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BackgroundIndia contributes ~60% to the global leprosy burden. The country implements 14-day community-based leprosy case detection campaigns (LCDC) periodically in all high endemic states. Paramedical staff screen the population and medical officers of primary health centres (PHCs) diagnose and treat leprosy cases. Several new cases were detected during the two LCDCs held in September-2016 and February-2018. Following these LCDCs, a validation exercise was conducted in 8 Primary health centres (PHCs) of 4 districts in Bihar State by an independent expert group, to assess the correctness of case diagnosis. Just before the February 2018 LCDC campaign, we conducted an “appreciative inquiry” (AI) involving the health care staff of these 8 PHCs using the 4-D framework (Discovery-Dream-Design-Destiny).ObjectivesTo assess whether the incorrect case diagnosis (false positive diagnosis) reduced as a result of AI in the 8 PHCs between the two LCDC conducted in September-2016 and February-2018.Methodology/principal findingsA three-phase quantitative-qualitative-quantitative mixed methods research (embedded design) with the two validation exercises conducted following September-2016 and February-2018 LCDCs as quantitative phases and AI as qualitative phase. In September-2016 LCDC, 303 new leprosy cases were detected, of which 196 cases were validated and 58 (29.6%) were false positive diagnosis. In February-2018 LCDC, 118 new leprosy cases were detected of which 96 cases were validated and 22 cases (23.4%) were false positive diagnosis. After adjusting for the age, gender, type of cases and individual PHCs fixed effects, the proportion of false positive diagnosis reduced by -9% [95% confidence intervals (95%CI): -20.2% to 1.7%, p = 0.068]ConclusionFalse positive diagnosis is a major issue during LCDCs. Though the decline in false positive diagnosis is not statistically significant, the findings are encouraging and indicates that appreciative inquiry can be used to address this deficiency in programme implementation.

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Section: Discussionmentioning

confidence: 99%

Does appreciative inquiry decrease false positive diagnosis during leprosy case detection campaigns in Bihar, India? An operational research study

Wagh¹,

Mugudalabetta²,

Gutierrez³

et al. 2018

PLoS Negl Trop Dis

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“…The combination of all three criteria had an overall sensitivity of 100% but specificity was reduced to 12.9%, rendering it not clinically useful. 34 Primary neural leprosy is defined as nerve involvement of leprosy without skin lesions, accounting for 5 to 10% of all patients. 35 This entity is difficult to diagnose given the absence of the cardinal skin findings, and nerve biopsy may not always identify M. leprae, in one case found in only 47% of patients.…”

Section: Classificationmentioning

confidence: 99%

Neurological Complications of Leprosy

Lau

2019

Semin Neurol

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Leprosy is a challenging international health concern. Despite tremendous efforts in reducing worldwide disease prevalence in the past decades, some countries remain endemic and are plagued by high levels of disability. The neurological complications of leprosy are varied and complex, with current research focused on evaluating tools for earlier diagnosis of neuropathy, especially in resource-limited countries. While treatment with multidrug therapy is highly effective, active research aims to simplify regimens to improve adherence, minimize adverse effects, and prevent antimicrobial resistance. Although promising progress has been made in the past decades, further efforts are needed to push the international community toward achieving worldwide elimination.

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“…Leprosy cases can be classified according to the number of skin patches or lesions and grade of disability (GD). 4 ),( 5 A person with grade 2 disability (G2D) has significant impairment, visible in the eyes, hands and feet. 3 …”

Section: Introductionmentioning

confidence: 99%

“…3 Leprosy cases can be classified according to the number of skin patches or lesions and grade of disability (GD). 4,5 A person with grade 2 disability (G2D) has significant impairment, visible in the eyes, hands and feet. 3 At the global level, in 2019, the rate of G2D leprosy diagnosis was 1.4 case/1 million inhabitants, reaching a total of 10,816 worldwide.…”

Section: Introductionmentioning

confidence: 99%

Clinical-epidemiological characteristics and temporal trend of new cases of grade 2 disability leprosy in the state of Maranhão, Brazil, 2011- 2020

Moreira,

Bezerra,

Santos

et al. 2023

Epidemiol. Serv. Saúde

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Objective: to describe the clinical and epidemiological characteristics of new cases of grade 2 disability leprosy and to analyze its trend in the state of Maranhão, from 2011 to 2020. Methods: this was a descriptive cross-sectional and ecological time-series study, using data from the Notifiable Health Conditions Information System. A descriptive analysis of the event was carried out according to the sociodemographic and clinical-laboratory characteristics of the cases. The temporal trend of event incidence was analyzed using Prais-Winsten regression. Results: of the 2,147 cases, 71.5% were male, 48.9% had up to 8 years of schooling, 66.5% were of mixed race/color, 95.5% had the multibacillary form, 58.8% were borderline, 32.3% had negative bacilloscopy at diagnosis. There was a stationary trend in the state and a falling trend in the São Luís Health Region (annual percentage change = -64.4%; 95% confidence interval: -73.7;-51.9). Conclusion: incidence trend was stable in the state of Maranhão and falling in São Luís.

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A prospective study to validate various clinical criteria used in classification of leprosy: a study from a tertiary care center in India

Abstract: The current WHO system of leprosy classification based on NSL seems to be best among available clinical criteria. Uniform and sensible application of this criteria itself assures appropriate categorizing and leprosy treatment with reasonable sensitivity and specificity.

Cited by 4 publications

References 7 publications

Does appreciative inquiry decrease false positive diagnosis during leprosy case detection campaigns in Bihar, India? An operational research study

Does appreciative inquiry decrease false positive diagnosis during leprosy case detection campaigns in Bihar, India? An operational research study

Neurological Complications of Leprosy

Clinical-epidemiological characteristics and temporal trend of new cases of grade 2 disability leprosy in the state of Maranhão, Brazil, 2011- 2020

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