The effect of footwear on sensory testing in leprosy

The aim of this study was to identify the effect of footwear on sensory testing in leprosy. This was achieved by using 3 methods of sensory testing within 1 district of East Africa. We included 72 leprosy patients and 36 patients (nonleprosy patients) in the study and these were subdivided into 2 groups, depending on whether they normally wore shoes or went barefoot. The methods used were the WHO sensory test, graded monofilaments and the biothesiometer. The results showed significant differences in the threshold levels between both groups of patients with the biothesiometer and monofilaments, demonstrating the importance of having separate values when screening for leprosy and assessing which patients are at the most risk of developing ulcers. The importance of having quantitative methods of testing was also demonstrated, as only then can the results be sufficiently standardized to identify the at-risk groups and also be sufficiently sensitive to differentiate between shoe wearing and nonshoe wearing patients.