ABSTRACT
This study aims to assess the continuity of medical care, the impact on disease condition and to highlight the major challenges faced by people affected by leprosy during the pandemic. Telephonic questionnaire-based survey was conducted among previously registered patients of leprosy at referral hospitals in India. Leprosy affected people aged >18 years, either on treatment or who had completed treatment with access to phone and willingness to participate were included. The questions were asked pertaining to demographic details, baseline disease characteristics and various problems faced during lockdown relating to livelihood, finances, treatment, and mental status. A total of 196 patients consented to participate in the study. Mean age of study participants was 37.31 (13.86) years, male participants (n=123, 62.7%) were more than females (n=73, 37.2%). Overall, 101 patients (51.5%) experienced exacerbation, 21 patients (10.7%) reported improvement and 74 patients (37.8%) reported no change in disease status during the pandemic. Most common difficulty faced was the procurement of medicines (115 patients, 58.6%) followed by difficulty in diagnostic testing (61 patients, 31.1%). Course of treatment was interrupted in 16 patients. Most of the patients (n=147, 75%), agreed that teleconsultation services would aid in management of their disease. The majority of patients (88.2%) were able to continue some form of treatment. Two patients (1%) tested positive for COVID-19. Nearly all patients (n=189, 96.4%) were informed regarding the risks and preventive measures related to COVID-19. Fifty percent of the patients reported deterioration in mental health due to the pandemic. The present study highlights the gaps in healthcare delivery and social inequalities along with their impact on the health, livelihood and mental status of people affected by leprosy during the current COVID-19 pandemic.
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.