Health Burden of Hansen's Disease in Central India: A 4-Year Retrospective Study
Vrutika H Shah1, Rajesh P Singh2, Shashank K Agrawal2
1Department of Dermatology, Venereology and Leprosy, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, India.
Insights
High rates of Hansen's disease (HD) transmission persist despite multidrug therapy. This study analyzed 400 new HD cases in central India, revealing a significant disease burden and the need for early diagnosis to prevent disabilities and stigma.
Area of Science:
- Dermatology
- Infectious Diseases
- Public Health
Background:
- Despite WHO's multidrug therapy for Hansen's disease (HD), high new case detection rates indicate ongoing transmission.
- The study addresses the persistent challenge of HD in central India, even in the post-elimination era.
Purpose of the Study:
- To investigate the clinical profile and epidemiological characteristics of Hansen's disease in central India.
- To understand the current burden and transmission patterns of HD in the region.
Main Methods:
- Retrospective analysis of medical records of 400 clinically diagnosed Hansen's patients from January 2015 to December 2018.
- Evaluation included demographic, clinical, histopathological, and bacteriological data, along with reaction and deformity assessment.
- Patients were classified using the Ridley Jopling classification and received appropriate treatment.
Main Results:
- The most common clinical spectrum was borderline lepromatous HD (39%), followed by lepromatous HD (30%).
- Pediatric cases accounted for 4% of the total, with Grade 2 deformity observed in 52 patients and Grade 1 in 16.
- Type 2 lepra reaction was the most frequent (28%), and 3.25% of patients experienced HD relapse.
Conclusions:
- Early diagnosis and timely treatment are crucial to prevent sequelae and physical disabilities associated with Hansen's disease.
- The high number of detected cases underscores a significant HD burden in the study area, necessitating continued public health efforts.
- Addressing the social impact, including stigma and prejudice, is vital for effective HD management.
Background:
Despite the implementation of multidrug therapy by WHO to treat Hansen's disease (HD), new case detection rates are still high indicating active transmission.
Aims And Objectives:
To study the clinical profile of HD in central India along with its epidemiological characteristics.
Materials And Methods:
Medical records of clinically diagnosed Hansen's patients were recruited retrospectively during January 2015 to December 2018. Case records were evaluated with respect to demographic, clinical, histopathological, and bacteriological investigations, development of reaction, and deformities. Patients were classified based on Ridley Jopling classification and treated accordingly. Statistical analysis was done using proportion, mean, and percentage.
Results:
A total of 400 new patients were enrolled and males outnumbered females. Maximum cases, 115 (28.75%), were in the age group of 31-40 years. Sixteen (4%) cases belonged to the pediatric age (less than 18 years) group. Most common clinical spectrum was borderline lepromatous (n = 156, 39%) followed by lepromatous HD (n = 120, 30%). Eleven patients had pure neuritic HD and nine had histoid HD. Grade 2 deformity was found in 52 and grade 1 deformity was found in 16 patients. Most common lepra reaction was type 2 lepra reaction (n = 112, 28%). Thirteen (3.25%) patients were of relapse of HD among which maximum eight were BL HD followed by LL HD three (0.75%) and TT HD two (0.5%).
Conclusion:
Early diagnosis is very important for timely and proper implementation of treatment which will prevent sequelae and physical disabilities that can have an impact on the individual's social and working life, which are responsible for stigma and prejudice regarding the disease. Detection of this huge number of cases signifies a high burden of HD in this area even in the post elimination era.
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