02515nas a2200205 4500000000100000008004100001260001000042653003600052653001800088653001000106653001400116100001300130700001300143700001300156700001300169700001200182245011100194520197900305022002502284 2024 d bWiley10aNerve function impairment (NFI)10aWHOQOL–BREF10aSALSA10aTreatment1 aSharma A1 aNarang T1 aTakkar A1 aPadhi BK1 aDogra S00aNerve function impairment and quality of life in patients with leprosy: a prospective, observational study3 a
Background: There is a limited number of studies assessing the alterations in nerve function impairment (NFI) in leprosy over an extended period of time. To the best of our knowledge, no published study has evaluated neurological state longitudinally during treatment utilizing a combination of clinical, functional (activity limitation), electrophysiological, and patient‐reported quality of life (QOL) outcomes.
Methods: This prospective, observational study included leprosy patients of all spectra. Over 1 year of treatment, cutaneous and neurological examinations were done in addition to a nerve conduction study (NCS) and sympathetic skin response (SSR) assessment. QOL and activity limitation assessments using the World Health Organization Quality of Life brief version (WHOQOL–BREF) and Screening of Activity Limitation and Safety Awareness scale (SALSA), respectively, were also performed.
Results: Out of 63 leprosy patients, loss of sensation was noted in 43 (68.2%) at baseline. At the completion of treatment, proportionate change revealed no change in 18 (28.5%), restored function in 9 (14.2%), improved status in 34 (53.9%), and deteriorated NFI in only 2 (3.1%) cases. The association between NCS‐SSR abnormalities was significant for a longer duration of disease at presentation (P = 0.04), in multibacillary cases [OR 9.12 (95% CI, 1.22–67.93)], in those in reaction [OR 3.56 (95% CI, 0.62–20.36)] and in those aged over 40 [OR 1.93 (95% CI, 0.28–13.41)]. There was an improvement in WHOQOL‐BREF and SALSA scores at release from treatment (P = 0.005 and P = 0.01, respectively).
Conclusion: The majority of leprosy patients on treatment show improvement in NFI at the completion of therapy. However, change is influenced by critical factors such as bacillary load, disease duration, age, and the presence of reaction(s).
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