A retrospective clinico-epidemiological study of leprosy cases treated at a tertiary care hospital in Western Maharashtra

Background: Leprosy is a chronic communicable disease caused by Mycobacterium Leprae. Despite the multidrug regimen against this formidable pathogen for nearly four decades, leprosy remains a public health scourge. The World Health Organization has intensified its efforts to eliminate leprosy by launching “Global Leprosy Strategy 2016–2020. Notwithstanding, India had accounted for 60% of new cases globally in 2016. Aims: The aim of this study is to describe the clinical and epidemiological spectrum of leprosy patients encountered at a tertiary care center in Western Maharashtra. Settings and Design: Record-based, retrospective, descriptive study. Methods: Case records of leprosy patients treated at a tertiary care hospital over 10 years were studied. Two hundred and thirteen cases that fulfilled the World Health Organization's 1998 case definition of leprosy and whose case records were replete with a basic demographic, case history, examination, and treatment details were included in the study. Statistical Analysis: Data were compiled in MS Excel and analyzed with the SPSS statistical software version 20. Results: Majority (87.3%) cases were multibacillary leprosy. A significant number of patients had borderline tuberculoid leprosy (71.5%). Meantime taken for the diagnosis, i.e., time taken from the onset of symptoms to diagnosis was 271.74 days. Contact tracing could be elicited in only 1.4% of cases. A light-colored numb patch was the most common clinical presentation in 79% of patients. 96.7% of patients had peripheral nerve thickening, of which, the ulnar nerve was the most frequently involved (93.5%). Ninety-nine (46.5%) cases had documented leprosy reactions. Grade 2 disability accounted for 23% cases with claw hand as the most common deformity in17.4%. Conclusions: The present study provides an insight into disease burden as well as the effectiveness of health services at a tertiary care hospital in Western Maharashtra. The study also highlights the importance of early diagnosis and management of leprosy and reactions, thereby minimizing deformities and disabilities.