Title: Systemic Manifestations of Leprosy: A Comprehensive Epidemiological Study from Eastern India
Authors: Jayanta Kumar Panda, Manjushree Nayak, Arpita Nibedita Rout, Swapna Jena
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.221
Abstract
Background: Leprosy is a chronic infectious disease primarily affecting skin and peripheral nerves. Involvement of various other systems has been well documented in the literatures, but all the studies date back to the pre-elimination era. India achieved leprosy elimination as a public health problem in 2005. But, as a country, India still has the highest burden of cases worldwide. In India, Odisha is among the seven states where the disease is still highly prevalent. Thus, this study was undertaken to assess the prevalence of systemic manifestations of leprosy.
Materials and Methods: The aim of this study was to assess the prevalence of systemic involvement in leprosy and to compare the prevalence of systemic involvement among various types of leprosy. A total of 218 new cases of leprosy were included and were divided into 6 groups, namely indeterminate leprosy, borderline tuberculoid leprosy, mid borderline leprosy, borderline lepromatous leprosy, lepromatous leprosy and pure neuritic leprosy. The clinical features and investigation findings of various system involvements in all groups were recorded and compared.
Results: Out of a total of 218 new cases, most commonly involved system was nose and paranasal sinuses and the least commonly involved was male reproductive system. Features of various system involvement were more common in the multibacillary group except, involvement of musculoskeletal system, which was more commonly involved among patients of paucibacillary group. This points to the fact that higher bacillary load correlates with higher incidence of systemic involvement.
Conclusions: Systemic involvement, as evident from our study, is more common in the lepromatous end of the disease spectrum and during reactional states. Features of various system involvements were more common in the multibacillary group, except involvement of musculoskeletal system, which was more commonly involved among the paucibacillary patients. Systemic involvement in post-elimination era is not significantly different from that of previous studies, which is a matter of concern.
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