Trends of leprosy in pre and post elimination era - A statistical and clinical update

Introduction: Leprosy is an age old disease caused by Mycobacterium leprae, predominantly affecting skin and peripheral nerves leading to a plethora of clinical manifestations. The immense efforts to eliminate the disease led to a fruitful outcome in the year 2006 in India. Yet, we contribute more than 50% of world case load of leprosy. Materials and Methods: 1. A retrospective analysis of Leprosy cases, diagnosed and treated in the entire Belagavi District between 2000 and 2014 was done and the data was analyzed. 2. A retrospective analysis of all patients diagnosed and registered in our department between Jan 2013 to Dec 2014 was undertaken. Results: Between Jan 2000 to Dec 2014, a total of 6373 cases were treated for leprosy in Belagavi district. The annual new case detection rate (ANCDR) in this district fell from 26.2 to 4.22. The prevalence of leprosy also declined from 1.79 to 0.33. The child proportion among new leprosy cases fell to 8.21 from 22.06 indicating a containment of the infection. In our department, 132 new cases of leprosy were detected during the year 2013 and 2014. The male to female ratio was 2.14:1. 8.3% of the cases were children (<14 years). A overwhelming majority (91%) of the cases were multibacillary, which is in sharp contrast to the national average of 51.48%. In 23% of our patients, the presenting feature was a lepra reaction (Type I in 14% cases and Type II in 9% cases). We observed grade II deformities (as per WHO) in 19% of cases at the time of presentation. Conclusion: The leprosy programs have brought down the statistics but some pockets of active transmission exist. The focus should now be to bring the incidence of leprosy to zero.