A study of household contacts of children with leprosy

The new case detection rate of leprosy and new cases among children remain high in Sri Lanka indicating ongoing transmission. Identification of the positive contacts and the source of infection would break this chain of transmission. Contact tracing is known to identify early disease and thus prevent disabilities. However, in the recent past little emphasis has been laid on contact tracing by the health care providers.

This study looked at the household contacts of children with leprosy to identify the-rate of positive contacts within the household.

The study was conducted at the Lady Ridgeway Hospital, Colombo, Sri Lanka, during a period of one year and nine months from January 2007. The index cases were defined as children of less than 12 years who were presently on anti leprosy treatment or who were newly diagnosed with leprosy. A total of 311 contacts of 100 index cases were examined for evidence of leprosy.

The total of positive contacts was 51 per 100 index cases. 33% of the index cases had a positive contact within the household. 11% had more than one member affected. 83.2% of positive contacts were of tuberculoid type. 20.8% of the contacts were less than 15 years of age. When considering the relationship to the index case, most (33.3%) were siblings while 25.0% were parents and 20.8% were grandparents. Twenty five persons (8.0%) out of 311 household contacts were de novo cases.

This study highlights the value of contact screening of leprosy patients.