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

Babu, Ashwini; Bhat, M Ramesh; Jayaraman, Jyothi

doi:10.4103/ijpd.ijpd_132_16

Cited by 13 publications

(12 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 15 ] Another study from Mangalore, Karnataka demonstrated the proportion of TT Hansen was around 46% and BT Hansen was around 44%. [ 16 ] Our study showed a higher occurrence of PB leprosy than MB leprosy. Interestingly, the prevalence of leparomatous and multibacillary leprosy was significantly higher than the previous studies (5.26% to 17.24% in different age group) indicating that though the overall incidence is declining, cases with MB are on a rising trend.…”

Section: Discussionmentioning

confidence: 56%

BCG vaccination: Effects on the patterns of pediatric leprosy

Sarkar

Patra

et al. 2020

J Family Med Prim Care

View full text Add to dashboard Cite

Introduction: Leprosy in pediatric population continues to remain as one of the major public health problems in India. BCG vaccination has been implicated in producing some protection against leprosy. Objectives: The present study intended to find out the patterns of leprosy in the pediatric age group (<12 years) and to determine the proportion of paucibacillary (PB) and multibacillary (MB) leprosy cases among the BCG-vaccinated and nonvaccinated groups. Methodology: It is a cross-sectional study among patients with leprosy up to the age of 12 years attending a tertiary care hospital in Eastern India by comprehensive history taking and through clinical examination. The history of BCG vaccination was enquired and the BCG scar was looked for to determine the BCG-vaccinated and nonvaccinated group. After collecting the data in a predesigned case sheet, the data were analyzed. Result: Of the 137 patients included in this study, 71.53% belonged to the 11–12 years age, 27.74% the 5–10 years age, and 1 patient the <5 year age group. The sex ratio was 1:1.63. PB leprosy was more common than MB leprosy. Smear positivity, deformity, and reaction were not very frequent. Among the vaccinated patients, the ratio of PB and MB leprosy was 5.3:1, while in the nonvaccinated group the ratio was 1.2:1. Data analysis showed that the proportion of MB leprosy was statistically significant in the nonvaccinated group than in the vaccinated group ( p = 0.0352). Conclusion: Our study pointed that BCG vaccination might have a role in enhancing the cell-mediated immunity (CMI).

show abstract

Section: Discussionmentioning

confidence: 56%

BCG vaccination: Effects on the patterns of pediatric leprosy

Sarkar

Patra

et al. 2020

J Family Med Prim Care

View full text Add to dashboard Cite

show abstract

“…The presence of childhood leprosy among new cases suggested the existence of the active source of infection [ 34 ] and high ongoing transmission of the disease in the community [ 22 ]. The higher proportion of childhood leprosy also a late performance indicator of the national leprosy control program [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Evidence for hidden leprosy in a high leprosy-endemic setting, Eastern Ethiopia: The application of active case-finding and contact screening

et al. 2021

View full text Add to dashboard Cite

Leprosy or Hansen’s disease is a disabling infectious disease caused by Mycobacterium leprae. Reliance on the self-presentation of patients to the health services results in many numbers of leprosy cases remaining hidden in the community, which in turn results in a longer delay of presentation and therefore leading to more patients with disabilities. Although studies in Ethiopia show pockets of endemic leprosy, the extent of hidden leprosy in such pockets remains unexplored. This study determined the magnitude of hidden leprosy among the general population in Fedis District, eastern Ethiopia. A community-based cross-sectional study was conducted in six randomly selected leprosy-endemic villages in 2019. Health extension workers identified study participants from the selected villages through active case findings and household contact screening. All consenting individuals were enrolled and underwent a standardized physical examination for diagnosis of leprosy. Overall, 262 individuals (214 with skin lesions suspected for leprosy and 48 household contacts of newly diagnosed leprosy cases) were identified for confirmatory investigation. The slit skin smear technique was employed to perform a bacteriological examination. Data on socio-demographic characteristics and clinical profiles were obtained through a structured questionnaire. Descriptive statistics and binary logistic regression were used to assess the association between the outcome variable and predictor variables, and the P-value was set at 0.05. From the 268 individuals identified in the survey, 6 declined consent and 262 (97.8%) were investigated for leprosy. Fifteen cases were confirmed as leprosy, giving a detection rate of 5.7% (95%, CI: 3%, 9%). The prevalence of hidden leprosy cases was 9.3 per 10,000 of the population (15/16107). The majority (93.3%) of the cases were of the multi-bacillary type, and three cases were under 15 years of age. Three cases presented with grade II disability at initial diagnosis. The extent of hidden leprosy was not statistically different based on their sex and contact history difference (p > 0.05). High numbers of leprosy cases were hidden in the community. Active cases findings, and contact screening strategies, play an important role in discovering hidden leprosy. Therefore, targeting all populations living in leprosy pocket areas is required for achieving the leprosy elimination target.

show abstract

“…In the current study, majority cases (63.6%) belonged to the age group of 11-15 years, corroborating with the observations made in earlier studies (59.3-71.1%). 10,11,16 The percentage of children belonging to the age group of 6-11 years is quite considerable also (>30%). Moet et al in their study observed that the risk of developing the disease between contacts increases from 5 to 15 years of age, peaking between 15 and 19 years of age.…”

Section: Discussionmentioning

confidence: 99%

Clinical and epidemiological trends in childhood leprosy: A 20-year retrospective analysis from a tertiary care hospital in Jammu, North India

Sakral¹,

Dogra²,

Dogra³

et al. 2022

IJDVL

View full text Add to dashboard Cite

Background: Slightly more than half the total number of childhood leprosy cases worldwide are from India. Aim: To analyze the clinical and epidemiological trends of childhood leprosy over 20 years in a tertiary care hospital. Methods: We retrieved the medical records of all children less than 15 years of age registered in the leprosy clinic between April 1998 and March 2018. We tabulated and analyzed data pertaining to demographic details along with clinical findings such as cutaneous lesions, nerves involved, sensory loss, deformities, reactions, smear status, histopathology and treatment. Results: Out of total 1548 leprosy cases registered during the study period, 55 (3.55%) cases of childhood leprosy were diagnosed. Thirty five (63.6%) children were in the age group of 11–15 years and 83.7% were migrants from other states. Thirteen (23.6%) children reported contact with a diagnosed case of leprosy, mainly in close contacts. Fifty three (96.4%) children presented with cutaneous lesions while 2 (3.6%) had pure neural involvement. Borderline tuberculoid leprosy was the most common clinical presentation in 27 (49.1%) followed by borderline lepromatous leprosy in 11 (18%). Thickened peripheral nerve trunks were detected in 42 (76.4%), most commonly the ulnar nerve. Reactional episodes occurred in 12 (21.8%) cases (Type 1 reaction, 10 (18.2%); Type 2 reaction, 2 (3.6%)). Grade 2 disability was detected in 4 (7.3%). Multidrug therapy was started in all patients, multibacillary (MB) regimen in 42 (76.3%) patients and paucibacillary (PB) regimen in 13 (23.7%). Twenty five (45.4%) children defaulted from the treatment. On comparing the data of 2008-18 with that of the previous decade (1998–2007), there was a higher proportion of migrant cases as compared to local cases (3:1–11:1) and MB cases as compared to PB cases (2:1–6:1). The proportion of treatment defaulters declined from 60% to 36%. Limitations: Relapse rate could not be calculated due to inadequate follow-up period. As it is a hospital-based retrospective study with no active surveys, these findings may not reflect trends in the community. Conclusion: Childhood leprosy continues to be a significant problem. There is a clear need to strengthen early detection, treatment and regular follow-up of these cases in both high and low endemic settings.

show abstract

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

Cited by 13 publications

References 1 publication

BCG vaccination: Effects on the patterns of pediatric leprosy

BCG vaccination: Effects on the patterns of pediatric leprosy

Evidence for hidden leprosy in a high leprosy-endemic setting, Eastern Ethiopia: The application of active case-finding and contact screening

Clinical and epidemiological trends in childhood leprosy: A 20-year retrospective analysis from a tertiary care hospital in Jammu, North India

Contact Info

Product

Resources

About