Current issue Archive Submit your article Sign up for New issue alerts

Volume - 95, Issue - 4

Original Papers
ID: e2024050
  • Comparison of the clinical manifestations and histopathological results in leprosy: A 5-year retrospective study in a tertiary hospital

    • Agnes Rosarina Prita Sari
    • Agnes Sri Siswati
    • Paranita Ferronika
    • Hardyanto Soebono
    Volume 95, Issue 4

    | Published on December 2024

    Objectives

    Leprosy is a chronic disease affecting the skin and peripheral nerve system. Generally, clinical examination for signs of leprosy and a slit skin smear is sufficient to diagnose leprosy, while additional histopathological examination provided a more accurate diagnosis. This study evaluated the concordance of clinical findings and histopathological features of leprosy in an Indonesian tertiary hospital. A retrospective descriptive study with secondary data was conducted on patients who came to the Dermatology and Venereology outpatient clinic from July 2018 to June 2023. Leprosy was assessed clinically by dermatologists and histopathologically by pathology specialists.

    Results

    A total of 208 new cases of leprosy were reported and 121 biopsies were performed on these new patients. The percentage of agreement regarding classification from clinical examination and histopathological results was 25% for TT, 77% for BT, 75% for BB, 60% for BL, and 85% for LL. The minor disagreement for BT, BB, and BL was below 5%. For the WHO classification, there was 80% agreement between clinical findings and histopathological results in PB cases and 82% agreement in MB cases.

    Conclusion

    This study observed a high percentage of agreement between clinical examination and histopathological results. Accurate classification of leprosy decreases the burden of the disease.

Original Papers
ID: e2024069
  • Two former leprosy patients leading social transformation. A qualitative study

    • Kiran Jha
    • Ramesh Kumar Choudhary
    • Mamesh Shrestha
    Volume 95, Issue 4

    | Published on December 2024

    In this study, we explored the bold and inspiring journey of two former leprosy patients who not only overcame their personal difficulties but also led significant social transformation in their communities. They harnessed their challenging life experiences to promote empathy and combat the stigma associated with disease. This study investigates their strategy for outreach and the role their unique experiences played in shifting societal perspectives on leprosy.

    The personal experiences they share serve as powerful examples of human empowerment and leadership, providing useful lessons for Self Help Group (SHG) programs globally. Utilizing these inspiring stories could significantly enhance community-driven projects and promote long-lasting change.

    Their stories serve as a powerful source of motivation for other people affected by leprosy, encouraging them to overcome hindrances, and exceed societal limitations. Their stories demonstrate that they are now recognized and heard at both national and international levels. They are champions not just for leprosy-affected communities, but also for individuals who are disabled and marginalized. Their stories compellingly illustrate how individuals affected by leprosy can actively contribute to reducing leprosy within their communities; and significantly drive transformative societal changes.

    In this study, we adopted a qualitative approach, conducting in-depth interviews (IDIs) with these individuals and examining their steps, from their own recovery to their distinctive roles in provoking change, to gain a comprehensive understanding of their unique contribution to society.

Original Papers
ID: e2024032
  • Tackling the unseen consequences: The COVID-19 pandemic’s impact on new paediatric leprosy cases in Brazil

    • Carlos Dornels Freire de Souza
    • Juliana Oliveira Santos
    • Thais Silva Matos
    • Tarcísio Fulgêncio Alves da Silva
    • Tânia Rita Moreno de Oliveira Fernandes
    • Rodrigo Feliciano do Carmo
    Volume 95, Issue 4

    | Published on December 2024

    The COVID-19 pandemic has impacted global health with the reorganisation of health services and some disruption of routine work. This paper aims to quantify the impact of the COVID-19 pandemic on the detection of new leprosy cases in children under 15 years old in the state of Pernambuco, northeastern Brazil. The analysis included all new leprosy cases reported in children under 15 years old in the state of Pernambuco from 2015 to 2021. The leprosy detection coefficient in the age group was calculated, and the degree of endemicity was classified in the municipalities, regions and micro-regions of the state. To quantify the impact of the pandemic on the detection of new cases, the percentage change in the years 2020 and 2021 was calculated. The study showed a reduction in the detection of leprosy cases in children under 15 years old in Pernambuco in the period 2020 to 2021 (56.4% and 65.3% reductions, respectively). Among the health macro-regions, in 2020, the greatest decline was observed in the Sertão region (81.5% reduction) and, in 2021, in Sertão (83.6% reduction) and Agreste (83.6% reduction). The number of municipalities with no leprosy records in the population studied in the first two years of the pandemic was higher than that observed in previous years, reaching 88.1% in 2021. The findings show that the COVID-19 pandemic has had a negative impact on the fight against leprosy in Pernambuco. Strategies should be adopted to reduce underdiagnosis in the state.

Original Papers
ID: e2024059
  • Challenges of delay in diagnosis and high disability rate among newly diagnosed leprosy patients in Karachi, Pakistan

    • Ali Murtaza
    • Muhammed Iqbal
    • Abdul Salam
    • Thomas Hambridge
    • Constanze Vettel
    • Felicitas Schwermann
    • Christa Kasang
    • Anil Fastenau
    Volume 95, Issue 4

    | Published on December 2024

    Objectives

    Early case detection and thus prevention of disability among new leprosy cases remain a global challenge. This study aims to identify factors contributing to the delayed case detection and persistently high disability rates found among newly diagnosed leprosy patients in Karachi, Pakistan.

    Methods

    A mixed-methods approach was utilised, combining quantitative data analysis of case detection delays and grade 2 disability (G2D), as well as qualitative data collection from patients and healthcare providers. A total of 150 new leprosy cases diagnosed from 2019 to 2021 were included in the quantitative analysis.

    Results

    There was a high proportion of disability reported, with 51 (34.0%) cases presenting with G2D. The mean case detection delay reported by leprosy patients was 42.3 months (95% CI: 34.5–50.0 months) with a median of 24.0 months (IQR: 7.0–60.0 months). Case detection delay was notably longer in males, older individuals, those with multibacillary leprosy (MB) and higher grades of disability. Contact tracing emerged as a significantly more effective method of early detection, with cases identified through this approach showing a substantially lower incidence of G2D compared to those detected passively (OR: 0.22, 95% CI: 0.10–0.49, p < 0.001). Females and younger patients presented with less G2D than males and older patients. The qualitative analysis highlighted patient neglect of symptoms, poverty and lack of knowledge as primary factors leading to delayed leprosy diagnosis.

    Conclusions

    Our study found that males, older individuals and those with MB experienced more prolonged diagnostic delays and severe disability in Karachi. Early detection through active case finding, particularly contact screening, substantially reduces disability rates and accelerates diagnosis. Training healthcare providers, engaging in community awareness and active case finding efforts will reduce case detection delay and disability, further supporting the goal of achieving zero leprosy in Pakistan.

Case Report
ID: e2024112
  • Acute worsening of lower limb weakness in a treated case of Hansen’s disease – a diagnostic challenge

    • Sucheta Sanjeev Chikodi
    • Kiran
    • Ramesha M Bhat
    • Jacintha Martis
    • Vinoda Kumar
    • Christina Goveas
    Volume 95, Issue 4

    | Published on December 2024

    Hansen’s disease (HD), a chronic mycobacterial infection, primarily affects the skin and peripheral nerves. The neurocutaneous symptoms may be the initial presentation or may develop during or after the completion of therapy. However, not all neurological abnormalities in a diagnosed case can be implicated to HD. Through this case we highlight the importance of considering alternative causes and detailed evaluation for neurological impairments in such patients.

Click to load more