Childhood leprosy: a retrospective descriptive study from Pakistan

Aim Leprosy remains a public health issue in many developing countries. The prevalence of leprosy in children is a useful indicator of the current status of disease transmission in a country. To date, studies pertaining to the proportion and characteristics of childhood cases in Pakistan are not available.  

Objective We aimed to describe the clinico-epidemiologcial pattern of childhood leprosy in Pakistan.

 Methods This retrospective descriptive analysis was done, from the medical records of all new childhood leprosy cases, diagnosed at Marie Adelaide Leprosy Centre, Karachi during a two-and-a-half-year period, from January 1, 2016 to June 30, 2018.

 Results A total of 11 cases were analyzed. The mean age at diagnosis was 9.3 years, with age range of 4-14. Male-female ratio was 0.8:1. Borderline tuberculoid (BT) was the most common classification (37%) and ulnar nerve was the most commonly found enlarged nerve (46%). 2 cases (18%) presented with a type 1 (reversal) reaction. None of the cases had a visible deformity (grade 2 disability), at the time of diagnosis. Mean delay in diagnosis was 9 months. 91% had a history of a household contact with leprosy. In 70% of these, the index case had lepromatous leprosy (LL).

 Conclusion Childhood leprosy is prevalent in Pakistan. Efforts should continue to carry out contact screening of all cases and to keep health care providers and communities informed, about its signs and symptoms. Early detection and treatment are the key to prevention.