ABSTRACT
A descriptive observational study was conducted in five high prevalent districts of West Bengal with an objective to estimate incidence of new cases of leprosy among children. A total 441,954 children were examined from October 2013 to September, 2014 by conducting a house-hold as well as school surveys in five endemic districts of West Bengal namely Kolkata, Burdwan, Paschim Midnapur, Bankura & Purulia. A total 248 suspected child leprosy cases were identified. The male/female sex ratio of suspects was 1:1. Clinically confirmed leprosy child cases ware 17/248.The overall incidence of leprosy suspects and clinically confirmed leprosy cases was 56.11 and 3.85 per 100,000 children screened, respectively. District-wise difference in incidence of leprosy suspects was found to vary from 23.53 per 100,000 in Purulia to 91.01 per 100,000 in Paschim Midnapur district. Of the 248 suspected cases in the child population, 17 cases were confirmed as leprosy by the CHC and PHC medical officers of NLEP and the State Health Services. All these cases were put on treatment. The incidence of new child cases during this 1 year period was observed to be 3.85/100,000 of examined child population. All these cases resided in Burdwan, Kolkata as well as Paschim Midnapur districts. No cases were confirmed in the suspected cases in Bankura and Purulia districts. One child in Kolkata district also had Grade 2 disability. The incidence of suspected leprosy cases among adult contacts of suspected leprosy children in the study is 33.01/100,000 population (23 suspected to have leprosy in a population of 69655). Among these, 8 cases were confirmed as leprosy cases, by the NLEP and State health services staff. It appears that transmission of leprosy is still high in some geographical areas/pockets and active search in addition to IEC on signs, symptoms and treatment of leprosy is required for the general population as well as other health care workers for effective & early treatment as well as to block transmission of leprosy in the community. While for leprosy programme confirmed cases are relevant, need to strengthen the capacity of health services to differentiate and treat other conditions which created suspicion of leprosy will be equally important.
ABSTRACT
Os autores relatam o caso de uma paciente de 14 anos, do sexo feminino, com eritema nodoso hansênico, em tratamento com predinisona em altas doses, de difícil controle há dois anos, que iniciou o quadro concomitante à introdução de poliquimioterapia para tratamento de hanseníase multibacilar. O manuseio do eritema nodoso hansênico em pacientes pediátricos é um grande desafio na área médica. O único tratamento formalmente indicado é a prednisona, já que a talidomida está contraindicada em pacientes menores de 12 anos e mulheres em idade reprodutiva. É sabida a grande quantidade de efeitos colaterais deletérios da corticoterapia crônica em crianças; além disso, ainda há pacientes refratários ao tratamento. Portanto, fica evidente a necessidade de discussão da terapêutica atual, sendo de suma importância o incentivo à pesquisa de novas drogas para o combate a essa moléstia...