Clinico-epidemiological Profile of 2000 Leprosy Cases Treated at a Tertiary Care Centre of Rajasthan, India from 2011 to 2020
This retrospective study has been carried out to understand the clinico-epidemiological profile of leprosy treated at SMS Medical College Hospital, Jaipur a tertiary care center in Rajasthan from January 2011 to December 2020. The records of all patients diagnosed as leprosy at leprosy clinic of tertiary care hospital were collected and analyzed. Among 2000 enrolled patients, 71.7% were males with a male to female ratio of 2.53:1 of the patients (40.5%) were in the age group of 16-30 years, followed by 31-45 years (31.35%), 46- 60 years (14.35%), above 60 years (11.65%) and 2.15% patients were in less than 15 years age group. Most common clinical presentation was erythematous plaques, seen in 62.7% patients, followed by patch 22.05%, nodule and plaque 4.85%, nodule and ulcer 1.35%and patch with ulcer 1.25%. A total of 9.5% patients had grade 2 disability; claw hand was most common (8.5%) followed by amputation (1%). History of contact was seen in 1% of patients. Borderline tuberculoid leprosy was the most common form of leprosy accounting for 25.2% patients followed by borderline-borderline leprosy (23.2%); lepromatous leprosy (18.2%); borderline lepromatous leprosy (13.3%) and tuberculoid leprosy (7%). Other variants were indeterminate leprosy constituting 5.8%; De-novo ENL 4%; pure neuritic leprosy (4%) and histoid leprosy (1.45%). Overall, more than half of cases belonged to multibacillary types. A total of 27.4% of patients reported leprosy reactions, in which Type 1 lepra reaction was observed in 5.3% and Type 2 lepra reaction was seen in 22.1% of patients. Eighty patients (4%) presented with De novo ENL without any previous history of leprosy or its treatment. Twenty patients received second line drugs and extended MDT due to lack of response to MDT MB. More than 50% (110/170) claw hand disabilities occurred during therapy indicating problems about timely reporting of complications like neuritis and their management. This data though may not exactly match with leprosy at community level, it would help in understanding the profile of leprosy cases in this area and is relevant for planning future interventions to eradicate leprosy.