Profile of New Leprosy Cases Attending a South Indian Referral Hospital in 2011-2012

Background. Leprosy, a disabling infectious disease, is a major public health problem in some regions, requiring knowledge of its epidemiological variations so that strategies for case detection and disease control can be subsidized. Objectives. This study aims to evaluate the clinical and epidemiological profiles of leprosy patients attending a referral hospital in South India between 2011 and 2012. Methods. Medical records of newly diagnosed leprosy cases between April 2011 and March 2012 were analysed at the Department of Dermatology, Venereology and Leprosy, Father Muller Medical College Hospital, Mangalore, India. Data were obtained using a specific questionnaire and entered into the database system. Results. Adult males outnumbered females in our study. Detection rate among women and children under 15 years seems to be on the rise. Multibacillary leprosy was more frequent among the new cases with borderline tuberculoid as the predominant type, although smear positivity was seen in less than half of these clinical multibacillary cases. A higher occurrence of lepra reactions, neuritis, and deformities at the time of diagnosis was observed. Conclusion. The results of this study point to a high circulation of lepra bacilli in the community in the “elimination era” and also highlight the need for early diagnosis and appropriate treatment at the field level to prevent spread of bacilli and development of disabilities. 1. Introduction Leprosy is one of those few chronic infectious diseases that are associated with serious physical and functional disabilities affecting the skin and peripheral nerves. Mycobacterium leprae, the causative organism of this malady, is transmitted by droplet spread which is facilitated by close contact. Although leprosy was the first infectious disease to have its etiological agent discovered, it still remains a disease of public health concern because of the case load and the social stigma attached to the disease [1]. With the advent of multidrug therapy (MDT), the prevalence and incidence of the disease has drastically reduced. Compared to more than 5 million cases diagnosed in the year 1990, only 244,796 new cases of leprosy were detected globally in the year 2009 [2]. Among the African and Southeast Asian countries that report the highest numbers, India leads the list by contributing the majority of the cases. This situation is deplorable, considering the fact that on January 30, 2006, India announced the elimination of leprosy at the national level [3]. About 127,295 new cases are still detected at the end of the year 2011