CLINICO-BACTERIOLOGICAL STUDY OF NEW LEPROSY CASES- AN EXPERIENCE AT A TERTIARY CARE CENTRE IN EASTERN NEPAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 48
Abstract
BACKGROUND Early detection of new cases is a major part of leprosy control programme. The diagnosis of leprosy is primarily clinical which is usually confirmed by demonstration of acid-fast bacilli (AFB) in slit-skin smear (SSS). There are very few studies on clinicobacteriological patterns of leprosy from Eastern Nepal at this post-elimination phase. Aim- This study was performed to know the clinical profile of new leprosy patients attending this tertiary centre and to determine the significance of SSS in confirming clinically diagnosed leprosy. MATERIALS AND METHODS This is a descriptive prospective study. All consecutive, new clinically diagnosed leprosy cases at the Department of Dermatology of B.P. Koirala Institute of Health Sciences (BPKIHS) over a period of 12 months were included. Detailed history was taken and systemic examination was done. SSS were obtained from the patients and sent to Microbiology Department. Presence of AFB and BI was calculated using Ridley’s logarithmic scale. RESULTS Borderline tuberculoid cases (BT) were the commonest types of leprosy 24 (48%). There were total 3 (6%) patients of paediatric age group. All the patients presented either with single type or mixed type of skin lesion. Nerve involvement was observed in 44 (88%) patients with ulnar nerve 33 (66%) being the commonest nerve. Grade 1 and grade 2 disability was found in 10 (20%) and 6 (12%) patients respectively. Skin smears were positive for AFB in 9 [18%; 95% CI, (9.54-31.02)] cases. Area under ROC curve of SSS is 0.906. CONCLUSION Cases of BT leprosy are predominant. Presence of leprosy in paediatric age group indicates continued transmission. Notable disabilities were observed in our study. Although the slit-skin smear has low sensitivity, AUC of SSS was 0.906 indicating it being a good diagnostic tool. Being a simple and rapid method with high specificity, SSS can be used to confirm the diagnosis in clinically suspected patients of leprosy.
Authors and Affiliations
Shraddha Siwakoti, Narayan Raj Bhattarai, Sudha Agrawal, Abhilasha Sharma, Basudha Khanal
Keywords
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