The use of chart review to elucidate the epidemiology of leprosy in the Mbingo leprosarium of Cameroon

The WHO introduced MDT for the treatment of leprosy in 1982 because dapsone monotherapy was life long and resistant. "The objective of this study was to determine the impact of MDT on leprosy control and its epidemiology in Mbingo leprosarium'. Patients who attended the Mbingo leprosarium from 1961 to 1998 were identified through a thorough manual review of hospital records in 2002. A structured data collection form containing information on sex, age, type of disease, province of origin, date of admission and whether it was a new case , transferred, relapsed, readmission, discharged, absconded or defaulted. Patients with incomplete data were dropped from the investigation. The review was carried out before and after the introduction of MDT in 1982. 1045 case files comprised of 271 for the period 1961 to 1967 and 774 for 1982 to 1998 were reviewed. The epidemiological trend of leprosy showed peak values in 1964,1984,1986 and 1991 and a decrease in 1967, 1982 and 1998. In the pre-MDT period, admissions increased from 4 (0.4%) in 1961 to 70 (10.9%) in 1964 and decreased to zero in 1982. Since MDT implementation, admissions increased to 39 (6.1 %) in 1986 and a continuous gradual drop till 1998. Immediately after MDT) T-implementation many patients were cleared from the registers with peak values in 1984, 1986, 1991 and 1993. 283 (27.1%) new admissions, 60 (5.7%) transfers, 10 (1.0%) readmissions, 20 (1.9%) relapses, 15 (1.4%) defaulters, 14 (1.3%) deaths and 373 (35.7%) f discharges were reported from 1992 to 1998.