A Study on Prevalence of Deformities in Leprosy in a Tertiary Care Hospital at Davangere

Abstract

Introduction: Leprosy is a chronic granulomatous infectious disease affecting the peripheral nervous system, the skin and certain other tissues. WHO announced the level of leprosy >1 per 10,000 population as a public health problem. WHO defined the elimination level of leprosy was <1 per 10,000 population. The paradigm shift in natural course of leprosy is shifting from regular antileprotic treatment to deal with the prevention of disabilities and deformities of leprosy. Objective: To evaluate the prevalence of deformities due to leprosy in a tertiary care hospital. Materials & methods: Prospective studies with 113 cases of leprosy were conducted from 2015 to 2018 in department of Dermatology and Orthopaedics, JJM Medical College, Davangere. All the cases were subjected for thorough clinical examination, baseline laboratory investigations, neuro-diagnostics and radiographic analysis of affected joints. The cases were classified as pauci and multibacillary leprosy with AFB staining of biopsies. All cases were treated with a multi drug treatment according to the bacillary classification. The progress of natural course of disease was monitored and charted for statistical analysis. Results: In our study population of 113 cases, the disabilities were found more from low socioeconomic status. In our study, 37.16% of trophic ulcers, 33.62% of autoamputation of fingers and toes, 32.74% of claw hand, 10.61% of foot drop, 7.96% of corneal opacity, 6.19% of leonine facies, 4.42% of ape thumb deformity, 2.65% of lagophthalmos and 1.76% of madarosis have been reported. Conclusion: Leprosy still continues to be a public health problem due to prevalence of disease in low socioeconomic status people. The management of leprotic deformities is a multi-disciplinary model and to train all health related workers to identify leprosy. Rehabilitation is the mainstay of treatment in deformity prevention and to improve the quality of life of leprotic patients.