Sarkar Somenath, Sarkar Tanusree, Patra Aparesh C, Ghosh Arghyaprasun, Gorai Hirak, Mondal Soumyadeep
Department of Dermatology, B. S. Medical College, Bankura, West Bengal, India.
Department of Dermatology, Burdwan Medical College, Burdwan, West Bengal, India.
Indian J Dermatol. 2022 Sep-Oct;67(5):624. doi: 10.4103/ijd.ijd_227_22.
Leprosy is a chronic granulomatous disease mainly affecting the peripheral nerves and skin. Any communities including the tribals are susceptible to leprosy. Very few studies on clinico-epidemiological patterns of leprosy have been reported in the tribal population, especially in the Choto Nagpur plateau.
To observe clinical types of newly diagnosed leprosy cases among the tribal population and demonstrate bacteriological index, frequency of deformity, and lepra reaction at presentation.
An institution-based cross-sectional study was conducted with consecutive newly diagnosed tribal leprosy patients attending the leprosy clinic of a tribal-based tertiary care center of Choto Nagpur plateau of eastern India, from January 2015 to December 2019. Thorough history taking and clinical examination were done. A slit skin smear for AFB was performed to demonstrate the bacteriological index.
There was a steady rise in total leprosy cases from 2015 to 2019. Borderline tuberculoid (BT) was the commonest form of leprosy (64.83%). Pure neuritic leprosy was not uncommon (16.26%). Multibacillary leprosy was noted in 74.72% of cases and childhood leprosy was observed in 6.70% of cases. The commonest nerve involved was the ulnar nerve. Garde II deformity was noted in around 20% of cases. AFB positivity was observed in 13.73% of cases. A high bacteriological index (BI ≥3) was noted in 10.65% of cases. Lepra reaction was observed in 25.38% of cases.
BT leprosy, pure neuritic leprosy, childhood leprosy, grade II deformity, and higher AFB positivity were prevalent in this study. The tribal population required special attention and care for the prevention of leprosy amongst them.
麻风病是一种主要影响周围神经和皮肤的慢性肉芽肿性疾病。包括部落人群在内的任何社区都易患麻风病。关于部落人群中麻风病临床流行病学模式的研究报道极少，尤其是在乔托那格浦尔高原地区。
观察部落人群中新诊断麻风病病例的临床类型，并展示就诊时的细菌学指数、畸形发生率和麻风反应情况。
于2015年1月至2019年12月，在印度东部乔托那格浦尔高原地区一家以部落为基础的三级护理中心的麻风病诊所，对连续就诊的新诊断部落麻风病患者进行了一项基于机构的横断面研究。进行了详细的病史采集和临床检查。采集皮肤涂片进行抗酸杆菌检查以确定细菌学指数。
2015年至2019年期间麻风病病例总数稳步上升。界线类偏结核型（BT）是最常见的麻风病类型（64.83%）。纯神经炎型麻风病也并不少见（16.26%）。74.72%的病例为多菌型麻风病，6.70%的病例为儿童麻风病。最常受累的神经是尺神经。约20%的病例出现二级畸形。13.73%的病例抗酸杆菌呈阳性。10.65%的病例细菌学指数较高（BI≥3）。25.38%的病例出现麻风反应。
本研究中BT麻风病、纯神经炎型麻风病、儿童麻风病、二级畸形以及较高的抗酸杆菌阳性率较为普遍。部落人群在麻风病预防方面需要特别关注和护理。
