Retrospective analysis of leprosy in elderly from India: observations and recommendations

Introduction: Data regarding disease characteristics of leprosy in the elderly population are limited in the published literature.

Aim: In this report we describe and analyse the clinico-epidemiological profile and management outcome of leprosy in the elderly population.

Methods: We have retrospectively reviewed and analysed the clinical records of leprosy patients aged ≥60 years, attending the leprosy clinic over a period of 12 years (2010–2021), in a tertiary care hospital in India. The data pertained to the clinical features of leprosy, diagnosis (histopathology and skin slit smear examination) and management outcome including compliance.

Results: Elderly patients constituted 9.9% (100/1011) of the total registered patients. There was a clear male predominance (62%). Of the clinical type, a majority had multibacillary forms according to the WHO classification. On the basis of the Ridley Jopling classification, the most common clinical spectrum consisted of borderline lepromatous disease (37%), followed by borderline tuberculoid in 33%, lepromatous leprosy in 20%, borderline borderline leprosy and pure neuritic leprosy in 5% each. Type 1 and Type 2 reactions were observed in 30% and 10% respectively. Leprosy associated deformity was observed in 40% at the time of diagnosis. Compliance was poor and 31% defaulted from treatment.

Conclusion: The elderly population is vulnerable to severe clinical forms of leprosy and associated physical disabilities. Therefore, early diagnosis and management, disability prevention and rehabilitation need special attention in this population. They may also represent hidden and continuing sources of infection in the community.