Schipper A, Lubbers W J, Hogeweg M, De Soldenhoff R
NSL/Eastern Leprosy Control Project, Biratnagar, Nepal.
Lepr Rev. 1994 Sep;65(3):239-47. doi: 10.5935/0305-7518.19940023.
The objective of the study was to determine the magnitude of hand/feet/eye disabilities in newly diagnosed leprosy patients by examining all newly diagnosed leprosy patients who presented at the Eastern Leprosy Control Project (supported by The Netherlands Leprosy Relief Association), made up of a regional clinic in Biratnagar and 5 mobile clinics in surrounding districts. The study comprised of all new and previously untreated patients who presented at the clinics over a 10-week period who were diagnosed as leprosy sufferers. Of the 260 leprosy patients examined 12 (4.6%) had sight-threatening lesions (lagophthalmos, iris involvement, corneal anaesthesia); 3 patients were blind due to cataract; 96/260 patients (37.0%, 95% confidence interval 35.0-43.0%) had 1 or more disabilities of their hands and/or feet. The most frequently found disabilities were sensory loss of the hands and feet, claw hand and plantar ulcers. According to the WHO disability grading 60% had no disabilities, 19% had grade 1 and 21% had grade 2 disability. Disability assessment is very important not only to evaluate the effectiveness of the control programme but also for the patient, whose most important worry is the stigmatizing deformities leprosy patients suffer. The earlier detection of sensory loss might reduce these secondary deformities.
该研究的目的是通过检查所有新诊断的麻风病患者，来确定新诊断的麻风病患者中手/足/眼残疾的程度。这些患者来自东部麻风病防治项目（由荷兰麻风病救济协会资助），该项目由比拉特纳格尔的一家区域诊所和周边地区的5家流动诊所组成。该研究涵盖了在10周内到诊所就诊且被诊断为麻风病患者的所有新发病例和既往未接受过治疗的患者。在接受检查的260例麻风病患者中，12例（4.6%）有威胁视力的病变（兔眼、虹膜受累、角膜麻醉）；3例因白内障失明；96/260例患者（37.0%，95%置信区间35.0 - 43.0%）有1种或多种手和/或足残疾。最常见的残疾是手足感觉丧失、爪形手和足底溃疡。根据世界卫生组织的残疾分级，60%的患者无残疾，19%为1级残疾，21%为2级残疾。残疾评估不仅对于评估防治项目的有效性非常重要，对于患者也很重要，因为麻风病患者最担心的是遭受有辱人格的畸形。早期发现感觉丧失可能会减少这些继发性畸形。
