Profile of Disease in Leprosy Patients Diagnosed in a Tertiary Care Centre in Kolkata during 2014-2017

ABSTRACT

Study of profile of leprosy in a Tertiary care Centre in an Urban Metropolitan settings has important epidemiologically relevant messages. This study has been carried out to find out the profile of leprosy patients attending a Tertiary Care Centre at Kolkata and to interpret data in respect to different epidemiological variables. The cases attending R.G. Kar Medical College for the year 2014-2017 and who were referred to Microbiology Department for slit skin smear examination were studied. Their profile analyzed according to age, sex, type of disease, past treatment, presentation of disease, deformity status, presence of reactions, bacteriological status of the patients and treatment history. Diagnosis was based on the clinical assessment and slit skin smear for Bacteriological Index (BI) as well as Morphological index (MI). Among 2380 cases 720 (30.25%) were females and 1660 (69.75%) were males. Maximum patients (74%) belong to upper lower (Class IV) socio-economic class. 20-40 years age group was reported as peak age of onset with average onset of age as 35 years, 7.56% were children below 15 years of age. Maximum patients (63.87%) were in reproductive age group. Multibacillary (BL/LL) cases are more prevalent (71.47%). 21% of cases were bacteriologically positive with 10.9% having >3+ BI. MI upto 25% was observed in 92% of 360 smears examined for this purpose. Proportion of type 1 reaction was more than type 2 in both males and females. 440 (18.5%) had reactions, 12.6% had type 1 and 5.9% type 2 reactions. Reactions in females were more associated with pregnancy/ lactation. 24% of cases had grade I disability whereas grade II disability was present in 14% of cases which indicates delayed diagnosis and inadequate management or both. Both grade 1 and grade 2 were more in males. Leprosy was found to be more prevalent in males, more prevalent in upper lower (Class IV) socioeconomic class and more commonly of borderline type. Strategy need to be fine tuned to improve early detection, more focus on females during the reproductive years and appropriate intervention to reduce overall morbidity and deformity/disability