@article{32139,
  keywords = {Uganda, manifestations, leprosy},
  author = {Kyebambe P S and Mugabe F and Ochola B},
  title = {Manifestations of leprosy in an urban Ugandan hospital},
  abstract = {<div>
<p><strong>Background:</strong> Leprosy continues to be a cause of morbidity and suffering in Africa despite years of efforts to control it. This is further complicated by the difficulty in diagnosis due to the often subtle signs, ignorance by clinicians and lack of diagnostic tests such as phenolic glycolipid -1 and nerve biopsy in our setting. The incidence rate in Uganda is 330 cases per year. The WHO states a worldwide prevalence rate of 1 case per 10,000 and incidence rate of 1 case per 100,000.</p>

<p><strong>Methods &amp; Materials:</strong> A senior physician at our hospital set out to identify the causes of painful neuropathy refractory to standard neuropathic treatment among the cases referred to him.. The patients were screened and found negative for other illnesses known to cause neuropathy: diabetes, HIV, syphilis, brucellosis, hepatitis B/C, vitamin B 12 deficiency, Systemic Lupus Erythematosus</p>

<p>Diagnosis was made basing on two clinical criteria: enlarged ulnar nerves and hypoesthetic hypopigmented skin lesions</p>

<p><strong>Results:</strong> In the last reporting year (July 2016-June 2017) 5 patients were clinically diagnosed with leprosy at our medical outpatient department.</p>

<p>All the 5 had complaints of painful neuropathy and were females above 40 years of age. All had enlarged ulnar nerves on pulpation and hypopigmented hypoesthetic lesions on their skins. Three had features of osteoporosis clinically radiogically and one had monoparesis and thenar/hypothenar wasting due to cervical nerve root compression (confirmed by MRI). This case had been diagnosed as having ‘stroke’ Anothet had chronic hypertrophic scalp lesions resembling carbuncles that began healing on starting anti-leprotic treatment. Yet another had recurrent tenosynovitis and carpal tunnel syndrome.</p>

<p>Four of the five had tuberculoid and one had borderline tuberculoid types. Those with tuberculoid were given Multiple Drug Therapy-Paucibacillary (MDT-Pauci) and the borderline got Multiple Drug Therapy-Multibacillary (MDT-Multi). The first patient registered very significant improvement in signs and symptoms after completion of therapy. The others are still undergoing treatment.</p>

<p><strong>Conclusion:</strong> Leprosy is still a significant cause of morbidity in Uganda and it is being missed for other diseases. More studies need to be done about manifestations of leprosy in Uganda and in Africa We need to raise its awareness among health workers on the continent.</p>
</div>
},
  year = {2018},
  journal = {International journal of infectious diseases},
  volume = {73},
  pages = {344–345 },
  issn = {12019712},
  url = {https://www.ijidonline.com/article/S1201-9712(18)34280-2/pdf},
  doi = {10.1016/j.ijid.2018.04.4196},
  language = {eng},
}