印度儿童与成人麻风病研究洞察：一项对比分析研究

Insight into Paediatric Versus Adult Leprosy: A Comparative, Analytical Study from India.

作者信息

Pandhi Deepika, Gupta Pratibha, Singal Archana, Gandhi Vijay, Grover Chander, Kumar Rajeev

机构信息

From the Department of Dermatology and STD, Guru Teg Bahadur Hospital, University College of Medical Sciences/University of Delhi, Delhi, India.

Department of Delhi Cancer Registry, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Delhi, India.

出版信息

Indian J Dermatol. 2025 Mar-Apr;70(2):75-81. doi: 10.4103/ijd.ijd_414_24. Epub 2025 Feb 27.

DOI:10.4103/ijd.ijd_414_24

PMID:40162354

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11952703/

Abstract

BACKGROUND

Pediatric leprosy, though relatively less common compared to adult cases, presents challenges in diagnosis, treatment, and management. Despite global efforts to eradicate leprosy, it remains endemic in certain regions, particularly low-resource settings.

OBJECTIVES

To analyse differences in clinical presentation of pediatric leprosy as compared to adult leprosy from leprosy clinic records of a tertiary care hospital and outline the clinical implications.

METHODS

A retrospective analysis of the records of all the registered paediatric (aged ≤ 18 years) and adult cases of leprosy from January 2010 to December 2021 (12-year period) who presented to the leprosy clinic of Guru Teg Bahadur Hospital in Delhi was carried out. History, examination, and investigation parameters were noted from standardised case record forms. The variables were compared between cases of childhood and adult leprosy.

RESULTS

Out of total 1006 recorded cases of leprosy, 16.8% were children and 83.2% were adults. Maximum cases (65.7%) were of borderline tuberculoid (BT) leprosy in children compared to 41.7% BT cases in adults. Type 1 and type 2 leprosy reactions were seen in 11.2% and 7.1% paediatric cases, respectively, compared to 9.8% and 12.3% cases in adults, respectively. Paralytic deformity was seen in 32.5% child cases and 35% adult cases. Claw hand and foot drop was seen in 17.2% and 3.6% cases of leprosy in children and 16.1% and 6.5% cases in adults. A total of 11.8% children developed facial palsy. Slit skin smear was positive in 15.4% paediatric and 30.1% adult cases. Treatment was completed in 65.1% child cases and 27.8% children defaulted. In adult cases, treatment was completed in 61.8% cases and 28.9% cases defaulted.

CONCLUSION

Paediatric leprosy in our study had a high number of cases of type 1 lepra reaction, paralytic deformities, disabilities, pure neuritic leprosy, and default rate. Our study highlights the need of early detection, timely intervention, and increasing community awareness to ensure early and adequate management of paediatric leprosy.

摘要

背景

儿童麻风病与成人病例相比相对少见，但在诊断、治疗和管理方面存在挑战。尽管全球致力于消除麻风病，但在某些地区，尤其是资源匮乏地区，它仍然是地方病。

目的

通过一家三级医院麻风病门诊记录分析儿童麻风病与成人麻风病临床表现的差异，并概述其临床意义。

方法

对2010年1月至2021年12月期间（12年）在德里古鲁·特格·巴哈杜尔医院麻风病门诊就诊的所有登记儿童（年龄≤18岁）和成人麻风病病例记录进行回顾性分析。从标准化病例记录表中记录病史、检查和调查参数。比较儿童和成人麻风病病例的变量。

结果

在总共1006例记录的麻风病病例中，16.8%为儿童，83.2%为成人。儿童中最大比例的病例（65.7%）为界线类偏结核样型（BT）麻风病，而成人中BT病例占41.7%。1型和2型麻风反应在儿童病例中的发生率分别为11.2%和7.1%，而成人病例中分别为9.8%和12.3%。32.5%的儿童病例和35%的成人病例出现麻痹性畸形。儿童麻风病病例中爪形手和垂足的发生率分别为17.2%和3.6%，成人病例中分别为16.1%和6.5%。共有11.8%的儿童出现面神经麻痹。儿童病例中皮肤涂片阳性率为15.4%，成人病例中为30.1%。65.1%的儿童病例完成了治疗，27.8%的儿童失访。在成人病例中，61.8%的病例完成了治疗，28.9%的病例失访。