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Profile of Childhood Leprosy Cases Attending a Tertiary Care Centre
Insights
Leprosy remains a public health issue in India, with a concerning rise in childhood cases. Early detection and contact tracing are crucial for controlling pediatric leprosy transmission.
Area of Science:
- Dermatology
- Public Health
- Pediatrics
Background:
- Multidrug Treatment (MDT) has been implemented for 33 years by the National Leprosy Eradication Programme (NLEP) in India.
- Despite extensive efforts, leprosy persists as a significant public health concern in certain Indian regions.
- An observed increase in pediatric leprosy cases at a tertiary care center prompted this investigation.
Purpose of the Study:
- To describe the clinical characteristics of leprosy in children under 15 years of age.
- To analyze trends in childhood leprosy detection between 2010 and 2014.
- To identify key demographic and clinical features of pediatric leprosy cases.
Main Methods:
- A descriptive study analyzing patient records from 2010 to 2014.
- Inclusion criteria: children aged 0-15 years diagnosed with leprosy.
- Data collected included age, sex, leprosy type, deformity grade, BCG vaccination status, and contact history.
Main Results:
- Children constituted 13.1% (86/664) of all leprosy cases registered.
- Newly detected pediatric leprosy cases increased significantly from 8% in 2010 to 34% in 2014.
- The majority of childhood cases were in the 10-15 age group (59%), with a male predominance. Paucibacillary (PB) leprosy (71%) was more common than multibacillary (MB) leprosy (29%). Borderline tuberculoid leprosy was the most frequent type (77%).
Conclusions:
- Childhood leprosy is an increasing concern, necessitating targeted public health interventions.
- Family contact tracing and active case-finding through surveys, especially in schools, are vital for early detection.
- Further field-based studies are recommended to validate these hospital-based findings and inform comprehensive control strategies.
Abstract:
In spite of 33 years of use of Multidrug Treatment (MDT) implemented by National Leprosy Eradication Programme (NLEP), leprosy continues to be a major public health problem in some regions of India. Recent increase in number of cases of leprosy at our tertiary care centre especially in children encouraged us to undertake a descriptive study for last 5 years. Records were analysed to describe the clinical pattern of leprosy in children below 15 years pertaining to the period 2010 to 2014. Amongst 664 leprosy cases registered during 2010 to 2014, 86 were found to be children between 0-15 years of age (13.1%). The number of newly detected children with leprosy increased from 7 cases (8%) in the year 2010 to 29 cases (34%) in the year 2014. Majority of patients of childhood category belonged to 10-15 years of age group 51/86 (59%), with a male preponderance. PB cases were significantly more (71%) than cases of MB (29%). Borderline tuberculoid leprosy was the commonest type seen (77%). Grade l and grade 2 deformity were observed in 8% and 6% of childhood cases respectively. 91% of these childhood cases had history of BCG vaccination: 21% of children had a contact in family or neighbourhood which shows the importance of asking the patients to bring family contacts specially children for examination or public health workers being asked to approach the families for check up of contacts. Active surveys/school surveys to find cases specially in female children should be considered. As this is a hospital based study it may be indicative of trends only which should be followed by properly designed field based studies.
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