Prevalence and risk factors for grade 2 disability among newly diagnosed leprosy in children and adolescents: a record-based analysis from India

Objectives

Leprosy in children is a strong indicator of disease transmission in the community and the rapidity of case detection. Grade 2 disability (G2D) in children denotes a delay in diagnosis, which could be due to delay either at the health care level or in recognition and referral by the family. The current study determines the proportion of G2D among newly diagnosed leprosy-affected children and adolescents and identifies the associated factors.

Methods

A 5-year retrospective analysis of records of children and adolescents aged ≤18 years newly diagnosed with leprosy between April 2014 and September 2019, was carried out with special reference to G2D presentation at the time of diagnosis.

Results

Children and adolescents comprised 8.26% (327/3955) of all subjects. Among them, 58 (17.7%) had G2D at the time of diagnosis. G2D occurred more frequently among the 15–18 years age group and was significantly associated with registration delay, presence of household contact cases, having multibacillary leprosy, nerve thickening and neuritis.

Conclusions

We report a high rate of G2D among newly diagnosed leprosy cases in children and adolescents, much higher than the reported national average for adults. With such a high occurrence of G2D, the target of having zero disability in childhood cases is unlikely to be met in India in 2020. Early case detection activities with a child-focused approach may reduce the delay in diagnosis, preventing leprosy-associated disability in children.