Scenario of Leprosy and Pattern of Disability in Post-elimination Era: A Seven Year Study from a Tertiary Care Hospital of Kashmir Valley
Leprosy is an infectious disease associated with fear, aversion and social stigma, mostly due to crippling deformities. As prevalence of leprosy decreases, so does the experience with disease, especially for younger physicians. Leprosy can have a significant impact on the quality of life (QOL) of the affected person owing to the chronic nature, disabilities and deformities associated with the disease. A high degree of social stigma in a conservative place like Kashmir further complicates the problem. This has necessitated the need to revisit realms of disabilities in leprosy in our region. Aim of study was to understand the profile of leprosy patients, categorize the pattern of disabilities and assess its impact on the QOL of persons affected with leprosy in our region. This cross-sectional study was conducted in a tertiary care hospital, over a period of 7 years. All patients diagnosed with leprosy were included in the project following an Institutional ethical committee clearance. Detailed history followed by a meticulous examination was done in all patients with distinctive attention to recording of disabilities. Grading of disabilities was done using the world health organization (WHO) grading of 1988. The assessment of QOL was done using WHOQOL-BREF scale. Out of the 90 cases, 42 patients (46.67%) were found to suffer from a total of 72 disabilities with majority suffering from more than one, averaging 1.7 disabilities per person. 48 patients (53.33%) did not have any disability. Fourteen cases (15.56%) had grade 1 disability while grade 2 and grade 3 disability were seen in 23 (25.56%) and 5 (5.55%) cases respectively. The assessment of QOL using WHOQOL-BREF scale demonstrated the quality of life to be worst for the physical domain (median 42) followed by environmental (median 48), global (median 49), psychological (median 56) and social relations domain (median 57). Disabilities and deformities are commonly encountered in our leprosy patients and can have a significant physiological, psychological, economic and social impact on the patient. The disease has a significant impact on the QOL of patients contrary to previous beliefs. Our data also indicates the need for community level studies and interventions to overcome the problem of late diagnosis and proper management as well as proper after care for deformities/ disabilities.