ABSTRACT
Elimination of leprosy as public health problem (defined as a registered prevalence of less than 1 case per 10,000 population) was achieved globally in 2000 and in 2005 from India. However, new cases including those in children continue to be reported. As pediatric leprosy shows active transmission of infection in the community, these have special epidemiological significance. The objective of this study was to study the profile of leprosy and deformity in pediatric age group (<15 years). A descriptive cohort study was carried out. The present study comprises of pediatric leprosy patients among 200 patients of leprosy who presented to outpatient Department of a tertiary dermatology center in Western Gujarat during the period 2009-10 and followed up until 2016. All newly diagnosed, on-treatment and relapse cases of leprosy in pediatric age group during that period were included. Detailed history, relevant past and family history were noted. A detailed physical examination was carried out, Slit Skin Smear (SSS) and punch biopsy to confirm the diagnosis was also done. The patients were then classified as per WHO into Paucibacillary(PB) / Multibacillary(MB) cases for treatment purpose and treatment provided accordingly. The patients were regularly followed up during the study period. Findings shows that out of 200 patients, 7.5% (n=15) patients belonged to pediatric age group. Tuberculoid leprosy was the commonest type seen in 53.2% (n=8) of pediatric patients. Male: Female ratio (4:1) was much higher in cahildren than adults. 33% (n=5/15) patients had a positive household contact. There were no deformities seen in this age group. This study signifies the importance of transmission in close contacts. However, the matter of concern remains that 67% of children had no household contacts. Such cases require in-depth epidemiological investigations for other possible sources of transmission.
ABSTRACT
Migration has been a major influencing factor facilitating movement of disease between endemic and nonendemic areas. Both internal migration and global immigration contributes to spread to disease to nonendemic areas. This review discusses the findings of studies carried out all over the world regarding the role of migration in leprosy. It focuses on factors contributing to migration within the country, effect of migration on leprosy control programme, migration related factors adding to stigma and leading to administrative problems in leprosy control programmes. Migration of leprosy patients affects the opportunities to seek timely treatment at other places due lack of leprosy treatment facilities or awareness among the users. This review analyses the published studies available in PubMed and news articles related to migration in Leprosy. Out of total 2506 search results, only 18 were found to be relevant. In these studies migration has been identified as one of the important obstacles in achieving elimination of leprosy as the affected individuals may continue to spread the disease and themselves may suffer from disabilities with social consequences. The review also finds paucity of scientific studies carried out to study the role of migration in leprosy at present. There is clear need to focus on in depth studies on this aspect in the contemporary scenario for achieving the goal of world without leprosy.