Delayed diagnosis of leprosy cases that persist in China

Objective: To analyse the epidemiological trend of leprosy and determine the delay in diagnosis of new cases in Beijing, China from 1990 to 2013.
Methods: A retrospective analysis of the clinic records of 65 leprosy patients registered at Beijing Tropical Medicine Research Institute (BTMRI) from 1990 to 2013 was conducted to determine the geographic distribution of the cases, disease presentation and the time elapsing between first symptoms and confirmed diagnosis.
Results: All the cases had migrated from 18 provinces or autonomous regions and were now living in Beijing. Multibacillary leprosy (MB), seen in 50 patients (77%), was far more frequent than paucibacillary leprosy (PB), which occurred in 15 (23%). By the Ridley–Jopling criteria these included 30 patients with lepromatous leprosy (LL, 46%), 17 with borderline lepromatous leprosy (BL, 26%), three with borderline leprosy (BB, 5%), nine with borderline tuberculoid leprosy (BT, 14%), and six with tuberculoid leprosy (TT, 9%). The mean delay from the onset of symptoms to the final diagnosis was 181·5 months for TT, 50·2 months for BT, 44·0 months for BB, 53·0 months for BL and 57·9 months for LL.
Conclusion: Although China eliminated leprosy as a public health concern in 2007, we noted annual increases in the number of cases detected in Beijing between 1990 and 2013. All of the patients had migrated to Beijing and reported that the time required to confirm leprosy was very long and initial misdiagnosis was frequent.