Palit Aparna, Inamadar Arun C, Desai Sanjay S, Sharma Puja
Lepr Rev. 2014 Jun;85(2):85-92.
Children with leprosy attending a tertiary care hospital during the post-elimination period, in the Karnataka state of south India, have been studied. Data on childhood leprosy collected by the field health workers from district leprosy office during the same period through community survey was also analysed.
In the hospital, 61 new childhood cases were diagnosed, 19.7% of the total leprosy cases (n = 309) examined during that period. Borderline tuberculoid leprosy was the commonest presentation in children. Twenty four (39.34%) were paucibacillary and 37 (60.65%) were multi-bacillary. Positive slit skin smear was obtained in 8.19%. Household contacts were identified in 18.2%. Reactions were seen in 16.4% (type 1 and 2) and 8.19% children had visible deformity. Analysis of the data collected by the field health workers showed 223 (21.25%) childhood cases (paucibacillary 69.50% and multi-bacillary 30.49%). Type 1 reaction was recorded in 4.93%. Deformities were seen in 5.82%, and 1.79% had WHO Grade 2 deformities.
More multi-bacillary cases were recorded in the hospital as compared to higher number of pauci-bacillary cases by the community survey. Cases with reactions and deformities were also higher in hospital. Type 2 reaction was not recorded in community survey and WHO Grade 2 deformities were low. Patients with more severe disease might have attended the hospital by choice, resulting in the difference in data. The results indicate that transmission of leprosy is continuing in India even in this state with low endemicity. Presence of household contacts, children with multi-bacillary disease and smear positivity in childhood cases are the aspects requiring special attention.
对印度南部卡纳塔克邦在消除麻风病阶段后在一家三级护理医院就诊的麻风病儿童进行了研究。还分析了同期现场卫生工作者通过社区调查从地区麻风病办公室收集的儿童麻风病数据。
在医院中，诊断出61例新的儿童病例，占该时期检查的麻风病病例总数（n = 309）的19.7%。界线类偏结核型麻风是儿童中最常见的表现形式。24例（39.34%）为少菌型，37例（60.65%）为多菌型。8.19%的患者获得阳性皮肤涂片结果。18.2%的患者发现有家庭接触者。16.4%的患者出现反应（1型和2型），8.19%的儿童有明显畸形。对现场卫生工作者收集的数据进行分析显示，有223例（21.25%）儿童病例（少菌型占69.50%，多菌型占30.49%）。记录到1型反应的比例为4.93%。5.82%的患者有畸形，1.79%的患者有世界卫生组织2级畸形。
与社区调查中较多的少菌型病例相比，医院记录的多菌型病例更多。医院中出现反应和畸形的病例也更多。社区调查中未记录到2型反应，世界卫生组织2级畸形较少。病情较重的患者可能会选择前往医院就诊，导致数据存在差异。结果表明，即使在这个低流行率的邦，印度的麻风病传播仍在继续。家庭接触者的存在、患有多菌型疾病的儿童以及儿童病例中的涂片阳性是需要特别关注的方面。
