Multifactorial Etiology Contributes to Disabilities in Individuals with Leprosy at Presentation - A Clinical Study in Dermatology Outdoor of a Tertiary Care Centre

Among the communicable diseases, leprosy remains the leading cause of peripheral neuropathy and disabilities in the world. Despite extensive efforts to reduce the disease burden, the disease continues to be be responsible for stigmatization and rejection in society. It was aimed to study the prevalence, epidemiological profile and associated factors in the occurrence of such disabilities among leprosy patients at presentation attending Dermatology outdoor in a tertiary care centre. This study was conducted at Dermatology outdoor of a tertiary care centre in eastern India. All patients of leprosy (as per inclusion criteria) from February 2016 to June 2017 were recruited in the study. Results show that among total of 451 patients, disability was present in 75.83% (342 patients) of which 261 presented with Grade 1 and 81 with grade 2 disability. Interestingly, grade 2 disability appeared significantly earlier (p=0.0212) in patients with a delay in diagnosis of >12 months than patients in whom the diagnosis was made earlier. We have found that 'patient delay' (defined as the time between symptom onset and patients consulting a doctor and receiving appropriate treatment) contributes to disabilities in leprosy. As the study was conducted in a tertiary care centre, it does not perfectly indicate the status in the community. Community based studies should be carried out to understand the situation.