Palit Aparna, Inamadar Arun C
Lepr Rev. 2014 Jun;85(2):93-9.
Clinico-epidemiological pattern of childhood leprosy in India over the past two decades were analysed from the Indian studies conducted during the years 1990-2009.
Twelve studies on childhood leprosy were included. Ten were conducted in health institutions and one was a community-based survey. Voluntary reporting was the principal method of case detection; community survey was adopted in two studies. Occurrence of childhood leprosy in tertiary care hospitals varied from 5.1-11.43%, in one urban clinic and the three leprosy referral hospitals it was 9.81-31.3% and peripheral surveys recorded 7.06-35.5% cases. History of familial contact was present in 0.66-47% cases. Borderline tuberculoid was the commonest clinical type, majority with single lesion. Other types were indeterminate (3.48-10.1%), borderline lepromatous (1.9-19.4%), lepromatous (0.1 to 9.38%), and pure neuritic (3.48-10.1%). Single peripheral nerve trunk was involved in 13.63-40-62% cases and multiple nerve involvement was recorded in 4.54-59.38% cases. The majority of cases were paucibacillary (43.28-98%). Multibacillary (MB) cases ranged from 2-56.6%. Slit-skin smear positive cases ranged from 5.42-25%. Lepra reactions occurred in 0-29.7% cases. Relapse rate varied between 1.16-7.1%. Deformity occurred in 0-24% cases.
Multibacillary cases were common among Indian children, some of whom were smear positive. Probably these cases were the source of many new cases. Pure neuritic leprosy was frequent among Indian children, so also the lepra reactions and deformities. The presence of familial and extra-familial contact with leprosy cases may be a cause of concern, as it implies continuing transmission of the disease.
通过对1990年至2009年间印度开展的研究进行分析，探讨过去二十年印度儿童麻风病的临床流行病学模式。
纳入了12项关于儿童麻风病的研究。其中10项在医疗机构开展，1项为基于社区的调查。病例发现的主要方法是自愿报告；两项研究采用了社区调查。三级护理医院中儿童麻风病的发生率在5.1%至11.43%之间，在一家城市诊所和三家麻风病转诊医院中为9.81%至31.3%，周边调查记录的病例为7.06%至35.5%。0.66%至47%的病例有家族接触史。边缘结核样型是最常见的临床类型，多数为单个皮损。其他类型包括未定类（3.48%至10.1%）、边缘瘤型（1.9%至19.4%）、瘤型（0.1%至9.38%）和纯神经炎型（3.48%至10.1%）。13.63%至40.62%的病例累及单条外周神经干，4.54%至59.3%的病例有多条神经受累。大多数病例为少菌型（43.28%至98%）。多菌型（MB）病例占2%至56.6%。皮肤涂片阳性病例占5.42%至25%。麻风反应发生率为0%至29.7%。复发率在1.16%至7.1%之间。畸形发生率为0%至24%。
多菌型病例在印度儿童中较为常见，其中一些为涂片阳性。这些病例可能是许多新病例的来源。纯神经炎型麻风病在印度儿童中较为常见，麻风反应和畸形也是如此。与麻风病病例存在家族和非家族接触可能令人担忧，因为这意味着疾病仍在持续传播。
