Leprosy among children in Senegal

Introduction: Leprosy in children is indicative of hyperendemic status of the disease in the community and reflects an active intra-familiar transmission of Mycobacterium leprae infection. Children with lower socio-economical background seem to be more vulnerable to this infection. Our objective was to study the epidemiological, anatomo-clinical aspects of childhood leprosy in Senegal.

Methods: A retrospective study was done at the National Reference Center of Leprosy in Dakar. Children aged sixteen or less followed for leprosy within the period between 2010 and 2015 were included.

Results: We collected 344 new cases of leprosy, of whom 32 cases (9, 3%) were children. The mean age was 13 years (5-16 years). The sex-ratio was 0,77. The mean duration of symptoms before diagnosis was 17 months. Paucibacillary form was the most common clinical type in 21 cases including indeterminate leprosy (1 case), TT (4 cases), BT (17 cases) and multi bacillary forms was seen in 11 cases (34.4%) including BL (4 cases) and LL (7 cases). WHO Grade 1 disability was observed in 2 children and Grade 2 disability in 5 children. In eight children, type 1 and type 2 leprosy reactions were observed. Children had received WHO multidrug treatment and an oral corticotherapy was given for severe reactions.

Conclusion: Our study reports a female preponderance of childhood leprosy with a mean age similar to literature data. Unlike in India, paucibacillary forms were more frequent. The severity was linked to leprosy reactions associated with neuritis leading to disabilities.