Clinico-Epidemiological Spectrum of Childhood Leprosy in Post-Elimination Era: A Multi-Centre, Cross-Sectional Study from West Bengal

Childhood leprosy is a major concern in the post-elimination era as it reflects active disease transmission. This study aims to analyse the clinico-demographic profile of childhood leprosycases attending two tertiary care centres of West Bengal over a period of 18 months from April 2018 to June 2019. 32 children (<16 years) with histologically confirmed Hansen's disease were subjected to detailed history including contact screening and clinical examination. These comprised of 10.6% (32/303) of all new leprosy cases which were treated at these centres. Findings indicated that thirty-two children with leprosy (mean age 12.53± 3.01 years; M:F 25:7) constituted 10.6% of all new leprosy cases. Borderline tuberculoid (53.1%) was most the frequently seen type, while household contacts were identified in 25% cases, all multibacillary. Patch over hands was the commonest presentation. The ulnar nerve was involved most frequently (47.2%), followed by the common peroneal nerve (18.9%). Lepra reaction (type1>type 2) and disabilities (grade 2> grade 1) were noted in 18.8% children each. Lepra reaction showed a significant association with multibacillary leprosy, while disabilities significantly correlated with the number of skin lesions. Slit skin smear was positive in 21.8% of patients. Clinicord pathological correlation was observed in 2/3 cases, mostly BT type. The high incidence of childhood leprosy in our set-up suggests active diseases transmission even in the post-elimination era. Thus, active intervention is required to control its transmission and prevent complications in childhood leprosy cases in this part of the country.