Nasal Endoscopic Findings of Leprosy Patients in Three Rural Areas in Indonesia
Introduction: Leprosy, a neglected tropical disease persisting in Indonesia, ranks third globally in prevalence. Despite national elimination status in 2000, the country faces ongoing challenges with new cases due to its complex geography. The causative agent, Mycobacterium leprae, affects various systems, with nasal involvement often preceding skin lesions. A study in rural Indonesian areas with high leprosy rates explores nasal endoscopy findings, emphasizing the nasal cavity as a crucial entry site for the bacilli. The research aims to systematically document manifestations amongst three rural areas in Indonesa: Lembata, Likupang, and Maluku, providing valuable insights for comprehensive patient evaluation and management, particularly in regions yet to achieve elimination status.
Method: The KATAMATAKU team, part of the University of Indonesia's Faculty of Medicine, conducted data collection in three rural Indonesian areas, Lembata, Likupang, and Maluku. The interdisciplinary team performed thorough physical examinations, including nasal endoscopy, collaborating with local health officers over two days in each location. All consenting leprosy-diagnosed patients were included in the study, with recorded nasal endoscopy results and leprosy types for subsequent analysis.
Result: This study examined 158 leprosy patients in Lembata, 58 in Likupang, and 130 in Maluku, revealing a predominance of multibacillary (MB) over paucibacillary (PB) cases. Nasal endoscopy identified nasal abnormalities in 109, 39, and 73 individuals in Lembata, Likupang, and Maluku, respectively. Common findings included inferior turbinate atrophy (27.84%) in Lembata, inferior turbinate hypertrophy (41.37%) in Likupang, and anterior nasal cavity crusting (24.61%) in Maluku, predominantly associated with MB leprosy cases.
Conclusion: Our study provides significant insights regarding the clinical effectiveness of nasal endoscopy for diagnosing leprosy, supporting its regular inclusion in healthcare protocols. The timely detection enabled by nasal endoscopy exams has the potential to positively impact patient outcomes, mitigate disability, and enhance the overall quality of life for individuals affected by leprosy.