Disabilities in leprosy patients ascertained in a total population survey in Karonga District, Northern Malawi

This paper describes the pattern of disability among 1 654 leprosy patients ascertained between 1 973 and 1 987 in Karonga District, Northern M alawi . Approximately 20% of patients identified prior to 1 980 had some disability at registration, but this percentage fell to approximately 1 0% with the introduction of total population surveys in the Lepra Evaluation Project. The proportion of patients with disabilities at registration increased with age, was higher among m ales than females, was higher among borderline and lepromatous than tuberculoid patients, and was higher for passively than for actively detected patients. The risk of developing disabilities among patients without any disabilities at registration was approximately 5 per 1000 person years, and appeared to be slightly higher after the completion of treatment than during treatment.