03499nas a2200217   4500000000100000008004100001260001200042653002600054653002600080653001900106653001900125653001200144100001900156700002000175700002600195245016600221856026000387300001200647490000600659520261600665       2026                            d  c04/202610aMycobacterium leprae 10aBacteriological index10aPaucibacillary10aMultibacillary10aleprosy1 aAvinash Kumar 1 aSangeeta Datta 1 aBiswaroop Chatterjee 00aEpidemiological and microbiological profile of leprosy in the postelimination era: A five-year retrospective study from a tertiary care hospital in eastern India  uhttps://www.researchgate.net/profile/Avinash-Kumar-12/publication/403872689_Epidemiological_and_microbiological_profile_of_leprosy_in_the_post-_elimination_era_A_five-year_retrospective_study_from_a_tertiary_care_hospital_in_eastern_India/links/69e092bcd2  a29 - 360 v53 a<p><strong>Background:</strong></p>

<p>Although India achieved the official target of leprosy elimination as a public health problem, the country continues to contribute a substantial proportion of global new cases. This persistent disease burden suggests ongoing transmission in several endemic regions, warranting continued surveillance and clinical vigilance.</p>

<p><strong>Objectives:</strong></p>

<p>This study aimed to describe the demographic profile, temporal trends, and microbiological characteristics of clinically suspected leprosy cases presenting to a tertiary care teaching hospital in Eastern India over a five-year period. Methods: A retrospective observational study was conducted in the Department of Microbiology from January 2020 to December 2024. Slit-skin smears were obtained from all clinically suspected cases and examined using the modified Ziehl–Neelsen staining technique. For smear-positive cases, the bacteriological index (BI) and morphological index (MI) were calculated to assess bacillary load and the proportion of viable organisms. Descriptive statistics were used for analysis.</p>

<p><strong>Results:</strong></p>

<p>A total of 134 clinically suspected leprosy cases were evaluated. Of these, 39% (n=52) were confirmed as multibacillary (MB) cases based on clinical and microbiological criteria, while 61% (n=82) were classified as paucibacillary (PB). A gradual increase in both case detection and smear positivity was observed over the study period (descriptively assessed). The most affected age group was 21–30 years (25.3%), and males accounted for 67% of cases, indicating a clear gender predominance. Childhood leprosy constituted 4% (n=5) of total cases, including two MB cases, suggesting ongoing transmission in the community. Among smear-positive cases, the BI ranged from 1+ to 6+, with the highest proportion observed at 1+ (36.5%, n=19), followed by 6+ (17.3%, n=9). The MI exceeded 75% in approximately half of the positive cases (n=26), indicating a relatively high proportion of viable bacilli in a subset of patients.</p>

<p><strong>Conclusion:</strong></p>

<p>The study demonstrates a continued presence of leprosy cases with a notable proportion of high bacillary load infections in the study region. The detection of childhood cases and MB disease underscores the possibility of ongoing community transmission. These findings highlight the need for strengthened surveillance, early case detection, and sustained public health interventions, alongside improved diagnostic capacity at peripheral and tertiary care levels.</p>