Title: Risk Factors for grade 2 Disability in Leprosy at the time of Diagnosis
Authors: Dr Reeba M Mani, Dr Swapna Dominic, Dr Bindu Vadakkayil, Dr Sarita S
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.37
Abstract
Background: In the post elimination era of leprosy the major challenge posed by the disease is disability prevention and rehabilitation. Hence studies on disability burden in leprosy should be top priority of research.
Objectives: To document grade 2 disability due to leprosy at the time of diagnosis in patients above 12 years attending a tertiary referral centre and to determine the association between age, sex, diagnostic delay, multibacillary disease and leprareaction with grade 2 disability.
Methods: Retrospective analysis of case records of leprosy patients who attended a tertiary care centre from 1.1 2017 to 31.12.2018 was carried out to study the grade 2 disability pattern at diagnosis and its risk factors.
Results: During the study period 27/52 leprosy patients (51.9%) who attended our tertiary referral centre had grade 2 disability at diagnosis. Male sex, diagnostic delay, disease manifesting with neurological symptoms as initial event and disease requiring mulibacillary treatment were found to be statistically significant risk factors for grade 2 disability.
Conclusions: Our finding of more than 50% cases manifesting grade 2 disability at diagnosis highlights the role rehabilitation specialists in managing the disease. We propose leprosy need a multidisciplinary approach to improve the quality of life of the affected. Retrospective nature of the study and small sanple size were our limitations
Keywords: Leprosy, Multidisciplinary approach, Grade 2 disability.
References
- Singhi MK, Ghiya BC, Gupta D, Kachhawa D. Disability rates in leprosy. Indian J DermatolVenereolLeprol 2004;70:314-6.
- SelvarajG . Incidence of disability among multi bacillary cases after initiation of drug therapy and factors associated with the risk of developing disabilities. Indian j Lepr.70:7-12.
- Dhanaselvi H, Manjula J, Sudha K, Anandan H. Prevalence of Deformities in Leprosy in Tertiary Care Center. Int J Scientific Study 2017; 5: 169 – 71.
- WHO expert committee on leprosy. Eighth report. Technical report series 968. World Health Organisation, Geneva, 2010.
- Lockwood DNJ, Nicholls P, Smith WCS et al. Comparing the clinical and histological diagnosis of leprosy and leprosy reactions in the INFIR cohort of Indian Patients with multibacillary leprosy. PLoSNegl Trop Dis, 2012; 6: e1702.
- Brandsma JW, van Brakel WH. WHO disability grading: Operational definitions. Lepr Rev 2003;74:366-73.
- Sasidharanpillai S, ReenaMariyath OK, Riyaz N, Binitha MP, George B, Janardhanan AK, et al. Changing trends in leprosy among patients attending a tertiary care institution. Indian J Deramatol Venereol Leprol 2014; 80: 338-40.
- Ahmad ML, Khan MS, Hussain I, Kazmi AH. Deformity and disability index in patients with leprosy Journal of Pakistan Association of Dermatologists 2004; 14: 64-9
- Sarkar J, Dasgupta A, Dutt D. Disability among new leprosy patients, an issue of concern: An institution based study in an endemic district for leprosy in the state of West Bengal, India. Indian J Dermatol Venereol Leprol 2012;78:328-34.
- Schreuder PA. The occurrence of reactions and impairments in leprosy: Experience in the leprosy control program of three provinces in northeastern Thailand, 1987‑1995 [correction of 1978‑1995]. III. Neural and other impairments. Int J Lepr Other Mycobact Dis 1998;66:170‑81.
- Monterio LD, Martins- Melo FR, Brito AL, Alencar CH, Heukelbach J. Physical disabilities at diagnosis of leprosy in a hyperendemic area of Brazil: trends and associated factors. Lepr Rev 2015; 86: 240–50.