Case detection and management of mobile leprosy in Baoan District, Shenzhen : A retrospective analysis

The mobile leprosy control programme in Baoan district was launched in the late 1990s with the goal of elimination of leprosy in mobile population. Here, we aims to describe the characteristics of mobile people suffering from leprosy and the achievements, over the past 30 years in Baoan District, Shenzhen, China, and identified the challenges for better mobile leprosy control. Data from the Leprosy Management Information System in China (LEPMIS) and the annual Leprosy Records were obtained, including patient’s basic demographic information and clinical characteristics. A total of ninety five patients were newly detected from 1991 to 2020, with the new case detection rate per 100,000 ranging from 0.14 to 0.07, while the prevalence rate per 100,000 ranging from 0.48 to 0.37. There were no childhood cases and relapse cases. 83.2% of mobile patients coming from southwestern and mid-southern provinces were detected. The median length of time between symptom onset and diagnosis was 31 months (range, 3-296 months). 61.1% of patients had nerve damage at the time of diagnosis. Ulnar nerve was the most commonly involved nerve in nearly 50.0% of total patients in the study. Nearly one third of patients had a reaction and neuritis at some point. 16.8% had a disability of Grade 2 and 25.3% of Grade 1. Among these deformities, leprosy deformities involving hand were 22(23.2%), feet were 30(31.6%), eye were 4(4.2%), respectively. A total of 76 patients have completed MDT treatment and none of them relapsed. 4 patients were loss to follow-up and 15 patients moved back to their household registered location. The case finding and management of mobile leprosy has made remarkable progress in this area. The challenges for mobile leprosy elimination in the next stage are multi-sectoral coordination, involvement of the whole society, sustainable support and investment form the government, stable professional workforce, regular follow-up and tracking survey, establishing an effective surveillance network and referral system.