An evaluation of risk factors of leprosy and how it affects treatment outcome in a low endemic state of India
Keywords:Demographic, Early detection, Leprosy, Risk factors, Treatment outcome
Background: Leprosy is a chronic infectious disease caused by Mycobacterium leprae. India achieved elimination at the national level in 2005. But it still had world’s leprosy burden in 2015 and currently has a prevalence rate of 0.81 per 10,000. The aim of our study was thus to identify the risk factors associated with the development of leprosy and assess their effect on the treatment outcome of the disease, especially in a low endemic state like Punjab.
Methods: A retrospective study conducted across Punjab by assessing the medical records of 55 leprosy admissions that were diagnosed, treated, and monitored at a tertiary hospital and those living in leprosy homes, from a time period of 2015 to 2018. Data was analysed using SPSS 25 software and presented in the form of figures and percentages.
Results: Maximum number of leprosy patients under study belonged to upper lower socioeconomic class (46.2%) according to The Modified Kuppuswamy Scale. 48.7% of the patients were migrants to the state of Punjab. Overall, 24 patients (61.5%) were successfully treated. 20.5% were relapse cases while 7.7% default and 2.6% failure cases were seen.
Conclusions: This study shows the current status of disease in an otherwise low endemic state. Leprosy is associated with a lower socioeconomic status due to lesser access to health services and lower levels of education. The high rate of disease, lower case reporting and treatment outcomes, as compared to the national averages is a cause for alarm thus more health seeking practices need to be encouraged.
United Nations Enable. Fact sheet: the Millennium Development Goals (MDGs) and disability, 2009. Available at http://www.un.org/disabilities/default. asp. Accessed Jan 25, 2010.
Noordeen SK. The epidemiology of leprosy. In: Leprosy, Hastings RC (ed). Churchill Livingstone, Produced by Longman Group Ltd. Hong Kong;1958:15-30.
Scollard DM, Martelli CM, Stefani MM, de Fatima Maroja M, Villahermosa L, Pardillo F, et al. Risk factors for leprosy reactions in three endemic countries. Am J Trop Med Hyg. 2015;92(1):108-14.
Uniting to Combat Neglected Tropical Disease. Fact Sheet: Country Leadership and Collaboration on Neglected Tropical Diseases: Third progress report of the London: 2017.
Sampaio LH, Stefani MM, Oliveira RM, Sousa AL, Ireton GC, Reed SG, et al. Immunologically reactive M. leprae antigens with relevance to diagnosis and vaccine development. BMC Infect Dis. 2011:11-26.
Chhabra N, Grover C, Singal A, Bhattacharya SN, Kaur R. Leprosy scenario at a tertiary level hospital in Delhi: A 5-year retrospective study. Indian J Dermatol. 2015;60:55-9.
Jindal N, Shankar V, Tegta GR, Gupta M, Verma GK. Clinico-epidemiological trends of leprosy in Himachal Pradesh. Indian J Lep. 2009;(81)173-9.
Swarnakumari G, Narasimha Rao TV, Ngeswaramma S, Vani T, Ch R, Neenavathu RN, et al. A Study of clinical profile of leprosy in post leprosy elimination era. IOSR. 2014;14(11);04-12.
Cohen S, Williamson GM. Stress and infectious disease in humans. Psychological bulletin. 1991 Jan;109(1):5.
Vivoli R, Rovesti S, Borella P, Cermelli C. Relation between psychoneuroendocrine profile in stressful conditions and antibodies to herpesvirus 6 and 7. J biological regulators and homeostatic agents. 2008;22(4):239-45.
Ponnighaus JM, Fine PE, Sterne JA, Malema SS, Bliss L, Wilson RJ. Extended schooling and good housing conditions are associated with reduced risk of leprosy in rural Malawi. International journal of leprosy and other mycobacterial diseases: official organ of the International Leprosy Association. 1994 Sep;62(3):345-52.