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
Related Articles
- EP ID EP218921
- DOI 10.14260/Jemds/2017/800
- Views 76
- Downloads 0
CORRELATION OF ULTRASONOGRAPHY FINDINGS OF WALL PATTERN AND DISCONTINUITY OF WALL WITH PER-OPERATIVE FINDING FOR PERFORATION OF APPENDIX
BACKGROUND Ultrasonography is widely used for diagnosis of appendicitis.[1-4] There have been not much literature for diagnosing perforated appendicitis by evaluating wall pattern and wall thickness by USG. In this study...
EFFECTS OF MALNUTRITION ON MOTOR NERVE CONDUCTION VELOCITY IN CHILDREN UNDER FIVE YEARS OF AGE
BACKGROUND Protein energy malnutrition is known to be a major health and nutrition problem in Indian paediatric population. The infancy and early childhood period of growths are critical for neurocognitive development an...
MANAGEMENT OF FRACTURES OF SHAFT OF HUMERUS WITH LOCKING COMPRESSION PLATE: A PROSPECTIVE STUDY
[b]BACKGROUND[/b]: The surgical treatment of fractures, according to A O principles has seen a change in the past decade, from anatomical reduction and rigid fixation to the current concept of Biological fixat...
IMPACT OF NUCHAL CORD ON INTRAPARTUM COMPLICATIONS, MODE OF DELIVERY AND PERINATAL OUTCOME
BACKGROUND Umbilical cord forms the connecting link between foetus and placenta through which blood flows to and from the placenta and is the lifeline of foetus. Cord accidents lead to 5-18% of all fatal foetal asphyxia...
EFFECT OF TWO TYPES OF DIETARY GHEE ON SERUM LIPID LEVELS IN RATS
Ghee is also known as clarified butter, utilized for thousands of years in Ayurveda as a therapeutic agent. Ghee which is known as “Gritha” in Ayurveda, described as the best among lipid media due to its quality...