Disability in New Leprosy Cases - Magnitude, Pattern and Associated Factors: A Cross Sectional Study in a Subdivision of Darjeeling District, West Bengal

Leprosy is an infectious disease, which may lead to disability before, during or after treatment. Leprosy is associated with social stigma and discrimination because of disability and disfigurement and recognized as a disease of major public health significance. As factors associated with occurrence and management of disabilities may vary from area to area, it is important to generate this information in affected populations. This study has been carried out to determine the extent and pattern of disabilities among newly diagnosed leprosy cases, factors associated with disability, provision and utilization of disability preventive services. This cross-sectional study was conducted in Siliguri subdivision of Darjeeling district, West Bengal. All newly diagnosed and registered leprosy cases in a reference year (April 2013 - March 2014) were included. Detailed medical examination and interviews was carried out to assess the disability and to study the relevant aspects. The entire collected data was analysed using SPSS software and chi-square, binary logistic regression were applied to test association between disability and other epidemiological correlates. It was observed that all the disabilities were in multibacillary (MB) cases only. Child leprosy rates of 5.5% appears to be promising statistics. Among 110 new leprosy cases studied, overall proportion of disability was 15.5%; grade 1 and grade 2 disabilities were 9.1% and 6.4% respectively. Hand was the commonest site of involvement, whereas grade 2 disability was highest in feet (2.7%). Disability status was found to be significantly associated with number of nerve involvement and history of treatment interruption. Utilization of disability preventive services was found very poor. Significantly the proportion of disability was highest among leprosy cases aged 60 years or more (37.5%). As no disability was noted in patients below 15 years, march towards achieving one of the targets of Global Leprosy Strategy 2016-20 appears to be closing to goal. Though the situation may be better comparably to some other parts of country, yet the overall proportion of disabilities as well as grade 1 and grade 2 disabilities among newly diagnosed leprosy cases is unacceptably high in the studied area. Community based studies and appropriate interventions can help in achieving the targets pertaining to leprosy situation in general and access to quality services in particular.