Chhabra Namrata, Grover Chander, Singal Archana, Bhattacharya Sambit Nath, Kaur Ramandeep
Departments of Dermatology, Venereology and Leprology, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India.
Indian J Dermatol. 2015 Jan-Feb;60(1):55-9. doi: 10.4103/0019-5154.147793.
Leprosy has been officially eliminated from India since December, 2005; still, there are districts and blocks reporting high prevalence indicating ongoing transmission. The present study aimed at determining the current clinical profile of leprosy from a tertiary level hospital in Delhi.
A retrospective, record-based study was carried out on patients diagnosed and registered in the leprosy clinic of a tertiary level teaching hospital in East district of Delhi (April 2007 to March 2012). Data regarding demographic details, clinical features, treatment started and complications was analyzed.
A total of 849 patients were registered over a 5-year period, with M: F ratio of 2.3:1. 9.3% were children (≤14 years). 54.3% patients were immigrants from adjoining states. Multibacillary leprosy was the most common clinical type (86.9%). Borderline tuberculoid leprosy was the most frequent morphologic type, seen in 56.3% followed by borderline-borderline (1.5%), borderline lepromatous (24.9%), lepromatous leprosy (8.1%), pure neuritic (8.1%), histoid and indeterminate leprosy (0.5% each). 37.4% patients presented in reaction (Type I in 30.4% cases and Type II in 7% cases). WHO grade II deformities were diagnosed in 37.9% with claw hand being the most common paralytic deformity (23.3% cases).
Our study offers insight into the current status of the disease in an area of otherwise low prevalence. It is seen that despite statistical elimination, multibacillary disease, leprosy reactions and deformities are commonly seen as presenting manifestations, in contrast to national projected trends. Delhi's unique demography with a high degree of migrant workers, presenting to our center (near border location) could be a possible contributing factor towards these aberrations. It highlights the need for continuation of targeted leprosy control activities and active case detection.
自2005年12月起，印度已正式消除麻风病；然而，仍有一些地区和街区报告高患病率，表明疾病仍在传播。本研究旨在确定德里一家三级医院中麻风病的当前临床特征。
对德里东部地区一家三级教学医院麻风病诊所诊断并登记的患者进行了一项基于记录的回顾性研究（2007年4月至2012年3月）。分析了有关人口统计学细节、临床特征、开始的治疗及并发症的数据。
在5年期间共登记了849例患者，男女比例为2.3:1。9.3%为儿童（≤14岁）。54.3%的患者是来自毗邻邦的移民。多菌型麻风病是最常见的临床类型（86.9%）。边缘结核样型麻风病是最常见的形态学类型，占56.3%，其次是中间界线类（1.5%）、界线类偏瘤型（24.9%）、瘤型麻风病（8.1%）、纯神经炎型（8.1%）、组织样型和未定类麻风病（各占0.5%）。37.4%的患者出现反应（30.4%为Ⅰ型反应，7%为Ⅱ型反应）。37.9%的患者被诊断为世界卫生组织二级残疾，爪形手是最常见的麻痹性残疾（占23.3%）。
我们的研究为一个其他方面患病率较低地区的疾病现状提供了见解。可以看出，尽管在统计上已消除麻风病，但与国家预计趋势相反，多菌型疾病、麻风反应和残疾仍常见为主要表现形式。德里独特的人口结构，有大量农民工来到我们中心（靠近边境位置），可能是导致这些异常情况的一个因素。这突出了继续开展有针对性的麻风病控制活动和积极病例发现的必要性。
