Exploring pediatric leprosy in an endemic area: Case series of eight patients in Indonesia

Background:

Leprosy remains a significant public health concern in endemic regions such as Indonesia. Children are particularly vulnerable due to their naive immunity and close familial contacts. This study aims to report cases of pediatric leprosy in Lembata, Indonesia, focusing on clinical characteristics and associated risk factors.

Case Illustration:

A case series of eight pediatric patients (<15 >years) diagnosed with leprosy was conducted during a community-based screening program in Lembata, Indonesia, in 2022. Of 140 individuals examined, 8 were children. Most patients were male (6/8) with a mean age of 11.75 years. Multibacillary (MB) leprosy predominated (7/8), and a history of household contact was identified in 6/8 cases. Skin lesions were present in all patients, with nerve involvement in 6/8. Leprosy reactions occurred in 2/8 cases, predominantly erythema nodosum leprosum. Ocular involvement was generally mild, with normal visual acuity in most cases. Ear, nose, and throat findings included atrophic rhinitis, cerumen impaction, and nasopharyngeal inflammation. One patient presented with World Health Organization grade 2 disability of the extremities.

Discussion:

The predominance of MB cases and the high proportion of household contact suggest delayed diagnosis and ongoing transmission within families. The relatively mild ocular findings may reflect shorter disease duration prior to treatment. These findings highlight gaps in early detection and contact tracing in endemic settings.

Conclusion:

Pediatric leprosy in Lembata, Indonesia, presents with diverse clinical presentations, often leading to delayed diagnosis and treatment. Familial transmission highlights ongoing challenges in leprosy control and the importance of early detection and treatment.