Shravani Bada, Ganguly Satyaki, Shukla Arvind K, Chhabra Namrata, Prabha Neel, Sachdev Divya, Khare Soumil
Department of Dermatology, All India Institute of Medical Sciences, Chhattisgarh, India.
Department of Community and Family Medicine, All India Institute of Medical Sciences, Chhattisgarh, India.
J Family Med Prim Care. 2022 Apr;11(4):1416-1420. doi: 10.4103/jfmpc.jfmpc_1375_21. Epub 2022 Mar 18.
Deformities and disabilities in leprosy lead to significant morbidity to the individual and financial burden to the family. As the prevalence of leprosy is higher in central India, this study was conducted to know the burden of deformity and disability among leprosy patients in central India and the factors associated with it.
This was a hospital-based, cross-sectional study, conducted on 50 new or on treatment or released from treatment leprosy patients, attending the Dermatology OPD of a tertiary care institute in Central India. Disability was graded as per the WHO criteria for disability grading of hands and feet.
Grade 2 disability was found among 32% of the patients with leprosy, whereas a total of 60% of our patients had either grade 1 or grade 2 disabilities. Trophic ulcer was found among 20% and claw hand among 14% of leprosy patients. We found significant associations of lepromatous leprosy with trophic ulcer (p = 0.004) and grade 2 disability (p = 0.012). All patients with claw hands and 80% of the patients with trophic ulcers presented to the healthcare facility at least 6 months after the onset of symptoms.
We found very high rates of disability and deformity among leprosy patients indicating possible huge burden of morbidity among leprosy patients in central India. The significant association of lepromatous leprosy with trophic ulcer and grade 2 disability indicated delayed presentation and diagnosis of lepromatous leprosy patients. Our results underlined the need for large scale community-based studies on disability and deformity among leprosy patients in Central India. These results also call for better training of primary level healthcare workers for early detection and management of deformities and disabilities as well as better patient education for leprosy patients regarding hand and foot care.
麻风病导致的畸形和残疾给患者个人带来了严重的发病问题，并给家庭造成了经济负担。由于印度中部麻风病患病率较高，开展本研究以了解印度中部麻风病患者的畸形和残疾负担及其相关因素。
这是一项基于医院的横断面研究，对印度中部一家三级医疗机构皮肤科门诊的50例新诊断、正在接受治疗或已结束治疗的麻风病患者进行了研究。残疾程度根据世界卫生组织手足残疾分级标准进行评定。
32%的麻风病患者存在2级残疾，而共有60%的患者有1级或2级残疾。20%的麻风病患者出现营养性溃疡，14%的患者出现爪形手。我们发现瘤型麻风与营养性溃疡（p = 0.004）和2级残疾（p = 0.012）之间存在显著关联。所有爪形手患者和80%的营养性溃疡患者在症状出现后至少6个月才前往医疗机构就诊。
我们发现麻风病患者的残疾和畸形发生率非常高，这表明印度中部麻风病患者可能存在巨大的发病负担。瘤型麻风与营养性溃疡和2级残疾之间的显著关联表明瘤型麻风患者就诊和诊断延迟。我们的研究结果强调了在印度中部开展大规模基于社区的麻风病患者残疾和畸形研究的必要性。这些结果还呼吁对基层医护人员进行更好的培训，以便早期发现和处理畸形与残疾问题，并对麻风病患者进行更好的关于手足护理的患者教育。
