Sasidharanpillai Sarita, Binitha Manikoth Payyanadan, Riyaz Najeeba, Ambooken Betsy, Mariyath Olasseri Kalathingal Reena, George Biju, Janardhanan Anisha Kanhirangattil, Sherjeena Pentam Veli Beegum
Lepr Rev. 2014 Jun;85(2):100-10.
To assess the profile and describe the clinical presentations and complications of childhood leprosy in a tertiary care hospital in North Kerala, South India during 2003-2012 and to analyse any change in the age-sex profile and the clinical pattern of leprosy in children below the age of 15 years over the 10-year study period.
A retrospective descriptive study of children less than 15 years of age diagnosed with leprosy and registered for treatment in a tertiary care institution from 2003 to 2012. Demographic, clinical, investigative and treatment data were collected using a pre-set proforma.
138 (12.1%) of the total 1143 leprosy cases registered for treatment during the 10-year period were below 15 years of age. The 10-year study period witnessed a statistically insignificant decrease in the new childhood leprosy cases registered for treatment in our tertiary care institution. The majority of cases belonged to the 6-12 year age group (61.6%) with a male predominance. Borderline tuberculoid (BT) was the commonest clinical type (65.9%) followed by indeterminate leprosy (18.8%); 101 patients required paucibacillary (PB) and 37 needed multibacillary (MB) treatment. The number of patients requiring MB treatment showed a statistically significant increase and there was a significant decline in number of cases requiring PB treatment. During the entire study period no Type 2 lepra reaction was documented in patients below Hema 15 years and only two patients manifested Type 1 reaction. Ten (7.2%) out of the 138 patients were cases of relapse. There was a clear female predilection among relapse cases with the majority belonging to the adolescent age.
Childhood leprosy still contributes to a significant proportion of the total case load denoting the continuing active horizontal transmission of leprosy. The rise in number of patients with more extensive disease in the background of declining disease prevalence is suggestive of the delay in diagnosis and treatment. A high relapse rate noted in the present study may be due to incorrect classification and treatment of MB as PB leprosy which in turn might have resulted in treatment failure due to inadequate treatment.
评估印度南部喀拉拉邦北部一家三级护理医院2003 - 2012年期间儿童麻风病的概况，描述其临床表现及并发症，并分析15岁以下儿童在10年研究期间麻风病的年龄 - 性别分布及临床模式的变化。
对2003年至2012年在一家三级护理机构诊断为麻风病并登记接受治疗的15岁以下儿童进行回顾性描述性研究。使用预先设定的表格收集人口统计学、临床、检查及治疗数据。
在10年期间登记接受治疗的1143例麻风病病例中，138例（12.1%）年龄在15岁以下。在我们的三级护理机构中，10年研究期间登记接受治疗的新儿童麻风病病例数出现了统计学上无显著意义的下降。大多数病例属于6 - 12岁年龄组（61.6%），男性占主导。边缘结核样型（BT）是最常见的临床类型（65.9%），其次是未定类麻风（18.8%）；101例患者需要少菌型（PB）治疗，37例需要多菌型（MB）治疗。需要MB治疗的患者数量显示出统计学上的显著增加，而需要PB治疗的病例数量则显著下降。在整个研究期间，15岁以下患者未记录到2型麻风反应，仅有2例患者出现1型反应。138例患者中有10例（7.2%）复发。复发病例中明显以女性居多，大多数属于青少年年龄组。
儿童麻风病在总病例数中仍占相当比例，表明麻风病仍在持续进行活跃的水平传播。在疾病患病率下降的背景下，病情更广泛的患者数量增加，提示诊断和治疗存在延迟。本研究中观察到的高复发率可能是由于将MB麻风病错误分类为PB麻风病并进行治疗，进而可能因治疗不足导致治疗失败。
