A clinico-epidemiological scenario of leprosy at a tertiary care centre in sub-Himalayan region: A seven year retrospective study
Despite leprosy being an eliminated disease from most of the countries in the world including India, it continues to remain as a major burden on public health expenditure. The purpose of this study was to determine the current clinico-epidemiological profile of leprosy at tertiary care health institution in Himachal Pradesh. This retrospective study was conducted in the Department of Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. All patients registered from April 2010 to April 2017 were included in this study. Hospital records of 221 patients were analysed according to age, gender, region of permanent residence, history of contact with leprosy patients, number of patients within state or immigrants from nearby state/country, type of disease-multibacillary (MB) or paucibacillary (PB), type of lepra-reactions and grade of disability patient developed. Out of a total 221 patients majority were in the younger age group of 15-30 years (38.9%), with male predominance (male:female ratio 2.7:1). Majority had MB leprosy (85.5%), and had significant proportion of grade II disability (G2D) compared to national and global data. In clinical disease spectrum, Lepromatous Leprosy (LL) and Borderline lepromatous (BL) leprosy were the most common presentations. Migrants from other states or immigrants from neighbouring country constituted a significant proportion (44/221, 20% approximately). Pure-neuritic disease was diagnosed in 7 (3.2%) patients, childhood cases were only 5 (2.3%) patients, indeterminate leprosy in 3 (1.4%) patients and histoid leprosy in 1 patient (0.004%). To know the exact status of leprosy in the country, knowledge and understanding of the epidemiological profile is an essential pre requisite as it will assess and address public health needs and will help in efficient programme planning and management of leprosy cases in the country. High proportion of MB cases and very high disability percentage shows the need to increase the awareness in the community as well as health care workers so that cases report early, are diagnosed early and managed appropriately so that disabilities become zero in near future. Partnerships among different medical institutions in the state are expected to strengthen the quality referral services and research aimed at eradication.