Management of leprosy in the context of COVID-19 pandemic: Recommendations by SIG leprosy (IADVL academy)

Rathod, Santoshdev P; Suneetha, Sujai; Narang, Tarun; Bhardwaj, Abhishek; Gupta, Sunil; Kamoji, Sushruth; Ashwini, P; Pradhan, Swetalina; Rather, Shagufta; Patnaik, Satyadarshi; Shankar, Vikas; Jandhyala, Sridhar; Rao, P Narasimha; Dogra, Sunil

doi:10.4103/idoj.idoj_234_20

Cited by 19 publications

(6 citation statements)

References 11 publications

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“…[12] Possible reasons for defaulting treatment may include limited access to healthcare services, socioeconomic challenges, non-compliance due to treatment reactions and side-effects, stigma and the impact of COVID-19 restrictions. [11,[38][39][40] Recent studies involving patients with pulmonary tuberculosis in our setting showed higher rates of completion of treatment in patients who participated in directly observed therapy short course (DOTS). [41,42] Similar results were noted in patients with leprosy globally.…”

Section: Complicationsmentioning

confidence: 99%

Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study

Sons,

Mkhize,

Dlova

et al. 2024

S Afr Med J

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Background. Although leprosy, a neglected tropical disease, has been eliminated (<1 case per 10 000 population) in South Africa (SA) since 1926, according to the World Health Organization, new cases continue to be reported. The management of leprosy poses several challenges, including patient adherence, education and insufficient training of healthcare practitioners. Objectives. To describe the biographical profile, clinical manifestations and treatment outcomes in patients with leprosy in KwaZulu-Natal Province. Methods. This retrospective study aimed to analyse the clinical data of leprosy patients in SA from 2002 to 2022. Data collected included patient demographics, comorbidities, cutaneous and neurological manifestations of leprosy, complications, treatment and adverse reactions. Descriptive statistics were used to summarise the data. Results. The study analysed the clinical data of 194 leprosy patients from 2002 to 2022. The majority of patients were male and middle aged, with a disproportionate representation of black South Africans. Regarding socioeconomic status, 80% were unemployed and 40% were social grant recipients. Most cases were clustered in urban centres and diagnosed at secondary care facilities, with 15% being HIV positive. The majority of patients (90%) were classified as having multibacillary leprosy. Common symptoms included upper respiratory tract involvement, hair loss and painful nerves, with the face and limbs being most frequently affected. Cutaneous morphology predominantly included plaques and hypopigmented patches, while neurological signs included ulnar nerve tenderness, muscle weakness and sensory deficits. Debilitating neurological complications were found in one-fifth of patients. Despite initiation of multidrug therapy in most patients, a significant proportion (27.3%) did not complete the full course of treatment, and treatment reactions were noted in 33.5% of patients. Conclusion. These findings emphasise the urgent need for enhanced patient and healthcare worker education, particularly in primary healthcare settings, to improve adherence to treatment, advocate for prophylactic measures and prevent new cases. Achieving leprosy-free status in SA requires the collaboration of many role-players to address these challenges and improve healthcare practices.

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Section: Complicationsmentioning

confidence: 99%

Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study

Sons,

Mkhize,

Dlova

et al. 2024

S Afr Med J

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“…Nonetheless, patients should be informed of the side effects and possible complications associated with leprosy reactions and neuritis. Prednisolone causes immunosuppression in a dosage >10 mg/d or a total cumulative dosage >700 mg [41]. The use of systemic steroids places patients at higher risk of severe COVID-19 infection and complications.…”

Section: Impact Of the Covid-19 Pandemicmentioning

confidence: 99%

Diagnosis and Treatment of Leprosy in Taiwan during the COVID-19 Pandemic: A Retrospective Study in a Tertiaty Center

Hsieh,

Hsiao

2023

Diagnostics

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Currently, over 200,000 new cases of leprosy are reported annually worldwide. Although leprosy was thought to have been eradicated in Taiwan, a few new cases still occur annually. Protean clinical manifestations of leprosy and immunological reactions result in delayed diagnoses. In addition, drug-resistant leprosy is emerging and poses treatment challenges. In this retrospective study, we collected and analyzed the clinicopathological features, leprosy type, treatment response, and relapse rate of patients with leprosy in our hospital between January 2009 and November 2022. We found that 54% of patients were Indonesian, and borderline lepromatous leprosy was predominant (39%); moreover, histoid leprosy and the Lucio phenomenon were also reported. Polymerase chain reaction analysis identified four positive cases, including a dapsone-resistant (4%) case. Our findings indicated good control of leprosy and a lower rate of dapsone resistance than that reported by the World Health Organization (4% vs. 13%) from 2009 to 2015. We found that the patient profile in terms of the treatment duration, recurrence rate, systemic symptoms, and neurological symptoms did not differ between before and during the pandemic. We report the recent advances in leprosy diagnosis, drug-resistant gene mutations, post-exposure prophylaxis, vaccination, and the effect of coronavirus disease 2019 on leprosy to facilitate updated leprosy diagnosis and management.

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“…The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) Special Interest Group (SIG) on leprosy, under the aegis of the IADVL Academy, published recommendations for the management of leprosy in the context of the coronavirus disease (COVID-19) pandemic based on available evidence and expert opinion in 2020. [ 1 ] These were deliberated and brought out early in the pandemic to benefit dermatologists and leprologists, regarding the management of leprosy cases with the advent of this novel virus. A couple of factors, that is, the plethora of data published regarding COVID-19 in the past year and the unprecedented surge which India witnessed, the SIG-leprosy sought to revisit these recommendations.…”

Section: Introductionmentioning

confidence: 99%

“…Salient changes in the recommendations between version 1[ 1 ] and the current version with level of evidence are summarized in Table 1 .…”

Section: Introductionmentioning

confidence: 99%

Updates on management of leprosy in the context of COVID-19 pandemic: Recommendations by IADVL SIG Leprosy

Bhardwaj

Gupta

Narang

et al. 2021

Indian Dermatol Online J

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The Special Interest Group (SIG) on leprosy thought it to be prudent to revisit its previous practice recommendations through this update. During this period, the pandemic course shifted to a 'second wave' riding on the 'delta variant'. While the number of cases increased manifold, so did the research on all aspects of the disease. Introduction of vaccination and data from various drug trials have an impact on current best practices on management of diseases including leprosy. The beneficial results of using steroids in management of COVID-19, gives elbow room regarding its usage in conditions like lepra reactions. On the other hand, the increase in cases of Mucormycosis again underlines applying due caution while recommending immunosuppressants to a patient already suffering from COVID-19. This recommendation update from SIG leprosy reflects current understanding about managing leprosy while the dynamic pandemic continues with its ebbs and flows.

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Management of leprosy in the context of COVID-19 pandemic: Recommendations by SIG leprosy (IADVL academy)

Cited by 19 publications

References 11 publications

Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study

Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study

Diagnosis and Treatment of Leprosy in Taiwan during the COVID-19 Pandemic: A Retrospective Study in a Tertiaty Center

Updates on management of leprosy in the context of COVID-19 pandemic: Recommendations by IADVL SIG Leprosy

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