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      Clinico-epidemiological Study of Disability Due to Leprosy at the Time of Diagnosis among Patients Attending a Tertiary Care Institution

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          Abstract

          Background:

          With the declared elimination of leprosy as a public health problem, the World Health Organization has shifted the focus on the disabilities and deformities associated with leprosy.

          Aims:

          The aim was to study the Grade 1 and Grade 2 disability among newly diagnosed leprosy patients.

          Materials and Methods:

          All newly diagnosed leprosy patients attending the Outpatient Department of Government Medical College, Kozhikode, from January 1, 2013 to December 31, 2013 were included in the study and the Grade 1 and Grade 2 disabilities observed were analyzed.

          Results:

          During the 1-year period, 76 patients were diagnosed to have leprosy. Grade 1 and Grade 2 disabilities were noted in 31.6% and 17.1%, respectively. Major factors identified as risk for leprosy disability at the time of diagnosis were age >45 years, >5 skin lesions, ≥2 thickened peripheral nerve trunks, pure neuritic and borderline tuberculoid spectra of leprosy.

          Limitation:

          As the study was conducted in a tertiary care center, it does not perfectly indicate the status in the community.

          Conclusion:

          Disability noted in nearly 50% of leprosy cases at the time of diagnosis highlights the need to improve the effectivity of existing health-care system in early case detection and timely referral. In addition, it underscores the need to educate the affected regarding protective eye, foot, and hand care, so that progression to Grade 2 disability can be prevented.

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          Most cited references19

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          Prevalence of Disability and Associated Factors among Registered Leprosy Patients in All Africa Tb and Leprosy Rehabilitation and Training Centre (ALERT), Addis Ababa, Ethiopia

          Background Delay in leprosy diagnosis and treatment causes disabilities due to nerve damage, immunological reactions and bacillary infiltration. Leprosy disability leads not only to physical dysfunction and activity limitation but also disrupts social interaction of affected individuals by creating stigma and discrimination. This study was aimed at assessing leprosy disability status in patients registered at All African TB and Leprosy Rehabilitation and Training Centre. Methods Medical records of leprosy patients registered from September 11, 2010 to September 10, 2013 G.C were reviewed. Prevalence of disability calculated, bivariate and multiple logistic regressions were used to determine crude and adjusted odds ratios with 95% confidence interval. Results The overall prevalence of disability was found to be 65.9% from all categories of patients (40.2% Grade I and 25.7% Grade II). The Prevalence among the new category was 62.8% (39.1% Grade 1 and 23.7% Grade 2). Those ageed above 30 years, with duration of symptoms 6–12 months and above 24 months, with sensory loss, nerve damage and reversal reaction were more likely to develop disability. Conclusion In this study the prevalence of disability, both Grade I and II, is very high. Disability was associated with age, duration of symptom, sensory loss, signs of nerve damage and reversal reaction. These risk factors indicate the existence of delay in diagnosis and treatment of leprosy cases. Therefore, the national leprosy control program should investigate leprosy case detection and diagnosis system in the country and work on improving early case detection and prevention of disability.
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            Enhanced global strategy for further reducing the disease burden due to leprosy: 2011-2015.

            V Pannikar (2009)
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              Disability among new leprosy patients, an issue of concern: an institution based study in an endemic district for leprosy in the state of West Bengal, India.

              Both magnitude and severity of disability in new leprosy patients measure indirectly the disease transmission in the community and rapidity of case detection. Various factors might be associated with the presence of impairment at registration.
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                Author and article information

                Journal
                Indian J Dermatol
                Indian J Dermatol
                IJD
                Indian Journal of Dermatology
                Wolters Kluwer - Medknow (India )
                0019-5154
                1998-3611
                Mar-Apr 2019
                : 64
                : 2
                : 106-111
                Affiliations
                [1] From the Department of Dermatology and Venereology, DM Wayanad Institute of Medical Sciences, Wayanad, Kerala, India
                [1 ] Department of Dermatology and Venereology, Government Medical College, Thrissur, Kerala, India
                [2 ] Department of Dermatology and Venereology, Government Medical College, Kozhikode, Kerala, India
                [3 ] Department of Dermatology, MBH Hospital, Malappuram, Kerala, India
                Author notes
                Address for correspondence: Dr. Vengarakath Puthiyapura Reyila, Cherumadathil House, Parakkadavu, Moonniyoor, Malappuram, Kerala, India. E-mail: reyilavp@ 123456yahoo.com
                Article
                IJD-64-106
                10.4103/ijd.IJD_185_17
                6440182
                30983605
                62872478-8175-40a2-931d-70118172d1e1
                Copyright: © 2019 Indian Journal of Dermatology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : March 2017
                : October 2018
                Categories
                Original Article

                Dermatology
                grade 1 disability,grade 2 disability,leprosy
                Dermatology
                grade 1 disability, grade 2 disability, leprosy

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