Leprosy among adolescents in Kolkata, India.

Leprosy, manifesting during adolescence when significant physical and emotional changes are taking place, poses further stress and strain both on the individual and on the family. Based on hospital records, focus group discussions and in-depth interviews, data on 258 adolescent leprosy patients seen at a leprosy referral hospital in Kolkata, India, are presented. The male-female sex ratio was 1.93:1, 56.6% were multibacillary patients and 13.2% had grade 2 disability. At the time of final follow up, 10% of PB and 33% of MB patients had already discontinued treatment. The commonest complication was reaction (14.5%). Adolescents were still dependent on their parents for health matters. Data obtained from questionnaires confirmed the role of social stigma in hiding, delay in starting of MDT and defaulting. Frequent hospital admissions resulted in loss of jobs and disruption of studies and caused psychological disturbances. It is critical to identify and treat adolescent leprosy on a priority basis. Health education and counselling programmes must be more focused and acceptable. Further research is necessary.

Incidence of neuritis among paucibacillary leprosy patients during treatment and surveillance.

A cohort study was done on 180 patients receiving the standard WHO PB-MDT regimen at the TLM Hospital in Kolkata, during MDT and 2 years of surveillance to determine the incidence of neuritis. Neuritis occurred in only 2 out of the 180 patients, confirming that the current WHO treatment for PB-MDT is attendant with minimal risk of neuritis. No risk factors were found, except pregnancy in a female patient. While addition of clofazimine in the new U-MDT under trial might take care of the occasional neuritis, further clinical research might be useful to identify sub-groups of PB patients at risk of neuritis.