ABSTRACT
Covid - 19 disease was declared as a pandemic by World Health Organization in March 2020. Subsequently, a nationwide lock down for variable intensity and periods was announced in India to contain the disease. Leprosy patients faced difficulties during this pandemic owing to their long-term health care requirements and lack of access to leprosy services during covid time. This resulted in deprivation of multi - drug therapy (MDT), steroids and other drugs to leprosy patients, which is detrimental to the patients as well as to the society. This study was conducted to analyze the impact of covid-19 pandemic induced lock downs and movement restrictions on leprosy patients attending a tertiary care centre. This provides data to assess their impact on leprosy healthcare services. The study observed a marked decrease in the number of leprosy patients attending the leprosy out patient care and also a reduction in the number of new cases registered during the year 2020. Quarterly analysis showed maximum reduction of cases occurring during the lockdown period and peak covid-19 infection periods. As there is a likelihood of this pandemic continuing and similar other disruptions may occur again, there is a need to assure that MDT and health care services reach leprosy patients by various other means. Some of the modifications can be a) supplying a 3 to 6 month course at a time as A-MDT, b) home delivery of drugs by health workers c) promotion of telemedicine services for leprosy patients d) optimal utilization of social media to educate and counsel leprosy patients on both covid-19 and leprosy. It is also important that leprosy clinics and drug delivery services should be continued both in Covid and Non-covid hospitals at par with Revised National TB Control Programe (RNTPC) renamed as National Tuberculosis Elimination Programme (NTEP) and Anti-Retroviral Treatment (ART) services.
ABSTRACT
Leprosy is a major public-health problem in developing countries like India. Studies pertaining to proportion and characteristics of pediatric cases are few in number. As these reflect indirectly the effectiveness of programme, this study has been carried out to know the clinical, bacteriological and histopathological characteristics of childhood leprosy cases who came to Dermatology Venerology Leprology (DVL) Outpatient Department of a Tertiary Care Centre in South India over a period of 2 years (from January 2015 to December 2016). This prospective observational study had 26 (23%) pediatric cases of leprosy out of 113 who attended DVL OPD. The age of childhood leprosy cases ranged from 10 to 18 years with mean of 14 years. 76% cases were males and 24% cases were females. 84% cases presented with hypopigmented, anaesthetic patches, 11% cases with grade 3 disabilities and 3% with tingling and numbness of both feet. 80% cases were MB and 20% were PB. 76% of children had multiple skin lesions and 24% had single skin lesion (SSL). Of the 20 multiple skin lesions cases examined histopathologically, 11 showed features of BT, BL and LL with overall concordance of 55% (11/20). Among cases clinically classified as MB, 33 % cases were smear positive. Overall 7/26 ( 26%) of child cases in our study were bacteriologically positive. Only 19% of patients had history of contact within the household. 8% cases developed LR. Six cases had deformities. The mean duration of symptoms was around six months. All the patients were treated with MDT. The present study though small and may/may not be representative of distribution/profile of leprosy in children at population level indicates the severity of childhood leprosy in society as evidenced by MB nature, high bacteriological positivity and unacceptable disability rate. After in depth studies at community level, strategy need to be improved to ensure early diagnosis and treatment.