Trends and patterns of leprosy over a decade in a tertiary care hospital in Northern India: A retrospective analysis.

Background: Leprosy was declared to be eliminated from India in 2006, but recent reports point to an increase in newly detected cases despite the overall fall in prevalence.

Aim: This study aimed to analyze the patterns and trends of epidemiological and operational indicators of leprosy at a tertiary care center in northern India over a decade.

Methods: This is a 10-year retrospective study from 2005 to 2014 conducted at the urban leprosy centre (ULC) of the Department of Dermatology, Venereology, and Leprology, Government Medical College, Jammu (J and K), India. Data were obtained from the preformatted standard leprosy cards of the urban leprosy centre. Details of demographic data, clinical features, smear results and treatment received were collected from individual cards and analyzed to observe various epidemiological trends.

Results: A total of 743 cases were analyzed for the period 2005-2014, of which 8.6% were childhood cases, 52.5% patients were immigrants, and 56.4% were farmers and laborers. Lepromatous cases showed a significantly increasing trend when compared with tuberculoid cases (P < 0.05). Smear positivity was seen in 29.6% of cases and showed an increasing trend (P < 0.05). An important observation was the increase in multibacillary cases. World Health Organization (WHO) grade 2 disability also showed an increasing trend over the past decade pointing to delayed diagnosis.

Limitation: The study is limited by its retrospective design.

Conclusion: The increasing trend of lepromatous and multibacillary cases and cases with grade 2 disability is a poor sign as it indicates delays in diagnosis. Further, smear-positive cases contribute to continued transmission of disease in the community. Leprosy has been declared to be eliminated, but recent reports including the present study suggest a rise in newly detected cases and hence in disease burden.