Disabilities Among Newly Reported Leprosy Cases in Visakhapatnam District, India: A Cross-Sectional Study of Prevalence and Associated Factors

Introduction: This study evaluated disabilities among newly diagnosed leprosy cases in Visakhapatnam District, India, following the 2019 Leprosy Case Detection Campaign (LCDC). We aimed to quantify disability prevalence, classified by the World Health Organization (WHO) grades (0, 1, and 2), and identify associated sociodemographic and clinical factors.

Materials and methods: A cross-sectional analytical study included 68 out of 299 newly reported cases of leprosy selected via simple random sampling. Data were collected through clinical examinations, nerve assessments, and patient interviews after informed consent. Disability was graded per WHO criteria.

Results: Participants (mean age: 36.7 ± 18.0 years) included 62% males and 81% aged 15-60 years; 39% were middle-class. Multibacillary leprosy predominated (63%), with 10% of child cases (<15 years), indicating active transmission. Disabilities were observed in 14% of the leprosy cases: 6% grade 1 and 9% grade 2 (exceeding India's 7.7% grade 2 average). Hands were most commonly affected (9%), with ulnar nerve involvement in 62% of the patients. Median healthcare-seeking delay was eight months, correlating with the proportion of grade 2 disabilities (G2D) observed. Stigma was a noted barrier, with patients reporting concealment of symptoms.

Conclusions: Despite LCDC, high G2D rates persist, driven by delayed diagnosis and stigma. Recommendations include enhanced information education and communication, active case detection, and post-multidrug therapy follow-up. These findings support India's National Leprosy Eradication Program and global efforts to reduce leprosy-related disabilities.