Background:
The occurrence of leprosy among children under 15 years is a sensitive epidemiological indicator of ongoing transmission within a community. In endemic regions, paediatric cases commonly reflect recent household or close-contact exposure to an untreated multibacillary index case, signalling gaps in early detection and contact tracing. Recognizing childhood leprosy as a sentinel marker helps translate clinical findings into actionable public health indicators.
Aim:
To analyse childhood leprosy cases in a South Indian tertiary-care centre and interpret the paediatric proportion as a sentinel marker of transmission, while comparing findings with Indian literature and highlighting public-health implications.
Materials and Methods:
A retrospective descriptive study was conducted among children (<15 years) diagnosed with leprosy over four years in a tertiary dermatology outpatient department. Demographic, clinical, neurological, histopathological and treatment-outcome data were analysed. Findings were contextualized with published Indian paediatric studies.
Results:
Of the 93 leprosy cases registered, 14 (15.1%) occurred in children. Borderline-tuberculoid (BT) was the predominant clinical type, with frequent ulnar nerve involvement. Only one child presented with a type 1 reaction. All children completed MDT with no deformities at treatment completion. This profile is consistent with several Indian cohorts where BT disease predominates with early nerve involvement and good outcomes following timely treatment.
Conclusion:
A 15.1% paediatric proportion reflects recent transmission and reinforces childhood leprosy as a sentinel marker. Strengthening early diagnosis, structured contact screening, school-based awareness and timely management of reactions is essential to interrupt transmission and prevent disability among children.