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Leprosy among children under 15 years of age: literature review
Marcela Bahia Barretto de Oliveira1, Lucia Martins Diniz1
1Universidade Federal do Espírito Santo, Vitória, ES, Brazil.
Abstract:
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age.
Insights
New leprosy cases in children under 15 indicate ongoing transmission, with household contacts being the main source. Paucibacillary leprosy is common, but nerve involvement and reactions pose risks, requiring weight-based multidrug therapy.
Area of Science:
- Infectious Diseases
- Public Health
- Pediatrics
Background:
- Leprosy, caused by Mycobacterium leprae, remains a public health concern.
- Detection in children under 15 signals active disease transmission and control issues.
- Household contacts are the primary source of infection in pediatric cases.
Purpose of the Study:
- To review the epidemiological, clinical, and therapeutic aspects of leprosy in children under 15 years of age.
- To highlight the significance of pediatric leprosy in disease surveillance and control.
- To discuss challenges and recommendations for managing childhood leprosy.
Main Methods:
- Literature review of epidemiological, clinical, and therapeutic data on childhood leprosy.
- Analysis of case reports and studies focusing on patients under 15.
- Synthesis of information regarding transmission, clinical presentation, reactions, and treatment.
Main Results:
- Paucibacillary leprosy, particularly borderline-tuberculoid, is prevalent, often presenting as a single lesion.
- Peripheral nerve involvement is a significant concern, increasing deformity risk.
- Type 1 Lepra Reaction is the most frequent reactional state, though rare overall.
- BCG vaccination's protective effect is debated; multidrug therapy is recommended, with weight-based dosing crucial.
Conclusions:
- Pediatric leprosy indicates persistent transmission and highlights the need for enhanced control strategies.
- Early detection and appropriate, weight-adjusted multidrug therapy are essential for managing leprosy in children.
- Peripheral nerve involvement and reactional states require careful monitoring and management in pediatric patients.
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