Incidence of leprosy in Firozabad district (Uttar Pradesh)

Objective: To assess incidence of leprosy in Firozabad District (U.P.). Materials and Methods: A random sample of 148,061 population was covered by this second survey, spread over 259 units (230 rural/29 urban). The survey was conducted between March 2011 and November 2012. Clinically confirmed cases detected in known disease-free population were labeled as incident cases and treated. Results: The overall incidence rate of leprosy was found to be 3.4 per 10,000 person years; In healthy contacts it was 3.1, in paucibacillary contacts 29.7 while it was 89.3 in multibacillary contacts. The differences in incidence rate of these three groups were significant (P < 0.001). Incidence rate was significantly higher by age; 1.1 in persons <15 years to 8.0 in those >44 years of age, and in high endemicity areas with three or more cases. In terms of incidence rate ratio (95% confidence interval), the incidence for ages 15–24 years was 3.2 times significantly higher than for those under 15 years, 5.3 times (4.3–6.5) in ages 30–44 years and 7.0 times (5.6–8.7) for age ≥45 years. Incidence rate ratio was also significantly higher in paucibacillary contacts, by 9.5 times (7.0–13.0) and 27.7 times (18.8–40.6) in multibacillary contacts, as compared to healthy controls. Incidence rate ratio (95% confidence interval) was significantly higher by 2.9 times (2.4–3.5) in areas with endemicity status of 3 to 5 cases and by 2.0 times (1.6–2.5) in areas with >5 cases as compared to areas with no endemicity. It was 2.4 times more (1.6–3.5) in Narkhi, 2.4 times higher (1.7–3.5) in Tundla and 3.0 times higher (2.1–4.5) in Aravon blocks than in Aeka block of the district. Incidence rate was also found to be significantly higher (3.7) among females, 1.3 times higher (1.1–1.5) than in males (2.9). Incidence rate ratio (95% confidence interval) was also 2.5 times higher (1.2–5.1) among persons having reported disease of greater than 4 years in comparison to 1.5 in persons having disease for 2 to 3 years. Limitations of Study: None to the best of our knowledge. Conclusion: The present study suggests that incidence rate of leprosy is significantly higher among persons of above 15 years, in females, among contacts of paucibacillary/multibacillary disease, in areas where >3 leprosy cases were found and in Tundla, Narkhi and Aravon blocks in Firozabad district.