Disabilities in leprosy patients ascertained in a total population survey in Karonga District, northern Malaŵi

This paper describes the pattern of disability among 1654 leprosy patients ascertained between 1973 and 1987 in Karonga District, Northern Malaŵi. Approximately 20% of patients identified prior to 1980 had some disability at registration, but this percentage fell to approximately 10% with the introduction of total population surveys in the Lepra Evaluation Project. The proportion of patients with disabilities at registration increased with age, was higher among males than females, was higher among borderline and lepromatous than tuberculoid patients, and was higher for passively than for actively detected patients. The risk of developing disabilities among patients without any disabilities at registration was approximately 5 per 1000 person years, and appeared to be slightly higher after the completion of treatment than during treatment.