Newly diagnosed leprosy patients at a rural treatment centre in Uganda have high rates of grade 2 disability

To determine grade 2 disability rates among leprosy patients registered at a rural leprosy treatment centre in Uganda, 2005-2010. Data were retrieved from the Leprosy Register of St. Francis Hospital, Buluba for the six year period from 1st January 2005 – 31st December 2010 and analyzed for demographic and clinical characteristics of the patients who were registered for multi-drug therapy (MDT). 222 patients were registered for MDT between 2005 and 2010. The age range was 7-83 years with a mean of 46.9 and median of 50 years. 97.3% of cases were above 15 years of age. The proportion of males was 56.5% giving a male to female ratio of 1.2:0.8. Then majority of the patients were newly diagnosed (91.2%), 5.8% had previously defaulted on their leprosy treatment and the rest were relapses (1.8%). The proportion of Multibacillary(MB) cases was 84.7%. Grade 1 or 2 disability occurred in over half of the patients (55.4%). 41% of all cases registered for MDT had grade 2 disability. Majority of the cases (83.8%) registered at the centre for MDT came from regions not directly served by the hospital. Overall, 34.7% of the registered cases were transferred out. Of those who continued their MDT from the hospital (n=145), 72.4% completed MDT, 22.1% defaulted and 5.5% died while on MDT. Treatment completion rates were higher in patients with Paucibacillary (PB) leprosy than MB disease (91.7% vs. 68.6%), while defaulting was higher in those with MB leprosy (24.8%) compared to PB (8.3%). All the eight who died had MB leprosy. There was a high rate of Grade 2 disability which is an indicator of delayed diagnosis. The National leprosy program should actively promote and sustain activities that will maintain awareness of leprosy in the communities and among health workers to facilitate early diagnosis. It is important to have systems that can ensure all diagnosed cases complete their MDT, have nerve damage diagnosed and treated and that rehabilitative services remain available to address the needs of individuals with nerve function impairment.