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Burden of Leprosy Patients at Post-Elimination Stage: Evidence from Bangladesh

Abstract
Introduction: There has been a marked decline in the prevalence rate of leprosy in Bangladesh, but understanding the current magnitude is important for both the service providers and the community. Therefore, the present study is undertaken to describe the pattern and prevalence of leprosy at post-elimination stage.

Materials and Methods: This is a descriptive retrospective cross-sectional study carried out using the register records of patients attending the leprosy clinic in Chittagong Medical College Hospital (CMCH) during the period 2004 and 2019.

Results: Among a total of 865 patients, males 631 (72.95%) outnumbered females 234 (27.05%). There were 259 (29.59%) paucibacillary (PB) and 606 (70.05%) multibacillary (MB) cases. Smear positive cases were only 218 (25.20%). Of the 865 patients, 515 (59.54%) were BT, which was higher compared to other forms of leprosy. Four age groups were computed. The calculated age-specific cumulative detection rates showed that the highest case detection was in 26- 40 years group 324 (37.46%) patients. A total of 388 (44.87%) patients developed leprosy reactions and 149 (17.22%) patients presented with grade 2 deformities. The LRs comprised of 212 (24.50%) Type 1 Reaction, 74 (8.55%) Type 2 Reaction and 102 (11.79%) neuritis patients. From all, 865 new leprosy patients only 115 (13.29%) had presented with limb deformity, 61 (7.05%) had a trophic ulcer and 29 (3.35%) patients presented with ocular complication. Among the 115 (13.29%) patients with limb deformity 75 (8.67%) had a claw hand followed by foot drop 20 (2.31%), wrist drop 17 (1.96%) and nerve abscess 3 (0.35%).

Conclusions: The study shows that new case detection rate is declining but burden of leprosy in the community has not changed significantly. MB (70.05%) patients with grade 2 deformities (17.22%) are still high. Although leprosy has been eliminated globally on paper, the disease continues to be significant cause of peripheral neuropathy, deformity, disability and disfigurement in some developing countries like Bangladesh.

More information

Type
Journal Article
Author
Mowla MR
Shahrin S
Sonali TA
Dutta P
Rahman M
Ghosh AK
Khan JM
Mridha WA
Choudhury MI
Barua DP