A prospective observational study of deformities in leprosy in tertiary care center in South India

Introduction: The proportion of deformity cases among newly diagnosed leprosy patients and the grade 2 disability rate in a population indicate the efficiency of early detection of leprosy. They also invariably indicate the awareness levels of early signs of leprosy, and access to leprosy services in the community. Aim: To study the frequency and severity of grade 1 and grade 2 deformity among leprosy cases. To correlate the clinical and socioeconomical factors to emphasize the importance of the health education in prevention of disability. Materials and Methods: This was an observational study conducted in leprosy OPD of a tertiary care centre in south India between Jan' 2018 and Dec' 2018. About 62 diagnosed Hansen cases with deformities were included in the study after thorough clinical examination, routine and special investigations. Data was compiled and analyzed with percentages and ANOVA. Results: Out of 212 diagnosed leprosy cases, 62 had deformities, thus making disability and deformity index to be 29.2%. Among newly diagnosed leprosy cases, 2 had grade 1 and 3 had grade 2 deformity. Males (69.4%) with lower socioeconomic group (41.9%) were commonly affected than females (30.6%). Lepromatous type of leprosy (32%) and leprosy cases of more than 2 to 5 years duration (47%) were commonly involved. Among the leprosy cases, disability was seen more in Multibacillary type (80.6%) and those involved in manual occupation (70.1%). Hands (77.4%) were more involved than and feet (40.3%). Anaesthetic (82.2%) deformities were more common followed by specific (30%) deformities. Grade 1(56.4%) deformities were most common followed by Grade 2(43.6%) deformities. Conclusions: The study showed that deformities and disabilities occurred due to delay in early case detection of grade -1 disability, lack of treatment assess and health education. Training the health care workers on diagnosing nerve thickening and nerve function impairment will prevent the progression of grade 1 disability to visible grade 2 disability thereby reducing the number of new leprosy cases with G2D to less than one case per million population.