scholarly journals Visible disability as a presenting feature of leprosy: a rare but real concern in post-elimination phase in India

2021 ◽  
Vol 7 (3) ◽  
pp. 457
Author(s):  
Vasudha A. Belgaumkar ◽  
Ravindranath B. Chavan ◽  
Nitika S. Deshmukh ◽  
Dhanshri D. Gangode
Keyword(s):  
Social Stigma ◽  
Delayed Diagnosis ◽  
Motor Impairment ◽  
Careful Examination ◽  
Easy Access ◽  
Saddle Nose ◽  
Global Rate ◽  
Rare Manifestation ◽  
Leprosy Patients ◽  
Health Significance

<p class="abstract">Leprosy (Hansen's disease) is a chronic infectious disease caused by <em>Mycobacterium leprae</em>, affecting mainly peripheral nerves and skin. Delayed diagnosis contributes to sensory-motor impairment leading to deformity and disability, thereby imposing a major impact on the physical, social, economic and psychological domains of the quality of life of affected individuals. Deformities and disabilities are largely preventable complications associated with tremendous social stigma and discrimination, assuming public health significance. India declared elimination of leprosy more than a decade and half ago in 2005. Hence, grade 2 disability is expected to be a rare manifestation in the post-elimination era. However, to the contrary, the proportion of new leprosy patients with visible disability recorded in India exceeds the global rate. Herein we report a middle-aged female presenting with saddle nose, bilateral fixed ulnar and mobile median claw hands (grade 2 disability) with multiple trophic ulcers. This case emphasizes that clinical suspicion after careful examination of skin and neural manifestations is of utmost importance for the early diagnosis of leprosy. Timely self-reporting and management with WHO-multi drug therapy (MDT) remains the key to minimize the risk of deformity and disability. Above all, it is essential to create awareness amongst the community regarding prompt recognition of symptoms and easy access to appropriate care along with intensified efforts to address the associated stigma.</p>

scholarly journals Risk factors for physical disability in patients with leprosy disease in Yunnan, China: Evidence from a retrospective observational study

2021 ◽  
Vol 15 (11) ◽  
pp. e0009923
Author(s):  
Xiaohua Chen ◽  
Hong-bing Liu ◽  
Tie-Jun Shui ◽  
Shun Zha
Keyword(s):  
Risk Factors ◽  
Physical Disability ◽  
Physical Disabilities ◽  
Delayed Diagnosis ◽  
Skin Lesions ◽  
Nerve Damage ◽  
Advanced Age ◽  
Han Ethnicity ◽  
Leprosy Patients ◽  
Male Sex

Background Leprosy is potentially debilitating. The risk factors related to physical disabilities associated with leprosy disease in Yunnan, China was not clear. Methodology/Principal findings We studied 10644 newly detected leprosy patients from Yunnan, China, from 1990 to 2019. Factors associated with Grade 1 (G1D) and Grade 2 (G2D) physical disabilities or overall physical disabilities (combined G1D and G2D) associated with leprosy were analyzed using multinomial and ordinal logistic regression analyses. The following factors were associated with the development of physical disability in these patients with leprosy: delayed diagnosis [odds ratio (OR): 5.652, 4.399, and 2.275; 95% confidence intervals (CIs): 4.516–7.073, 3.714–5.212, and 2.063–2.509; for ≥ 10, 5–10 y, and 2–5 years, respectively], nerve damage (OR: 3.474 and 2.428; 95% CI: 2.843–4.244, and 1.959–3.008; for 2 and 1 damaged nerves, respectively), WHO classification of PB (OR: 1.759; 95% CI: 1.341–2.307), Ridley-Jopling classification (OR: 1.479, 1.438, 1.522 and 1.239; 95% CI: 1.052–2.079, 1.075–1.923, 1.261–1.838, and 1.072–1.431; for TT, BT, BB, and BL when compared with LL, respectively), advanced age (OR: 1.472 and 2.053; 95% CI: 1.106–1.960 and 1.498–2.814; for 15–59 and over 60 years old, respectively), zero skin lesions (OR: 1.916; 95% CI: 1.522–2.413), leprosy reaction (OR: 1.528; 95% CI: 1.195–1.952), rural occupation (OR: 1.364; 95% CI: 1.128–1.650), Han ethnicity (OR: 1.268; 95% CI: 1.159–1.386), and male sex (OR: 1.128; 95% CI: 1.024–1.243). Conclusions Delayed diagnosis, nerve damage, no skin lesions, WHO and Ridley-Jopling classifications, leprosy reactions, advanced age, rural occupation, Han ethnicity, and male sex were associated with disability in leprosy patients. Identifying risk factors could help to prevent physical disability.

scholarly journals Profil Dehabilitasi Pasien Kusta di Rumah Sakit Kusta Alverno Singkawang: Studi Pendahuluan

2021 ◽  
Vol 9 (1) ◽  
pp. 30
Author(s):  
Sri Linuwih Susetyo Wardhani Menaldi ◽  
Valensia Vivian The ◽  
Inosensia Diajeng Kusumo ◽  
Melani Marissa
Keyword(s):  
Quality Of Life ◽  
Social Stigma ◽  
Cross Sectional ◽  
Permanent Disability ◽  
Treatment Type ◽  
Chinese Ethnicity ◽  
Leprosy Patients ◽  
Preliminary Study ◽  
Multibacillary Leprosy

Abstrak Kusta dapat menyebabkan disabilitas permanen yang memengaruhi fisik dan psikis pasien. Stigmadiri dan stigma sosial menyebabkan pasien mengalami dehabilitasi yang dapat menurunkan kualitashidup penyandangnya. Penelitian ini merupakan studi pendahuluan yang bertujuan untuk mendapatkanprofil dehabilitasi pasien kusta termasuk orang yang pernah mengalami kusta (OYPMK). Penelitian inimenggunakan metode potong lintang untuk menilai profil dehabilitasi pasien kusta dan OYPMK menggunakanskala dehabilitasi Anandaraj di RS Kusta Alverno Singkawang, bulan Juli 2019. Delapan puluh delapan subjekdiikutkan dalam penelitian ini. Analisis data dilakukan menggunakan uji Mann Whitney untuk menilai hubungantipe kusta dan derajat dehabilitasi, serta uji Kruskal Wallis untuk melihat hubungan antara reaksi kusta danderajat disabilitas terhadap skala dehabilitasi. Analisis dilakukan menggunakan perangkat lunak SPSS formac. Subjek terbanyak adalah laki-laki, usia produktif, bekerja sebagai petani, berpenghasilan kurang dari 1,5juta per bulan, tidak bersekolah, sudah menikah, etnis Tionghoa, tinggal di dalam rumah yang padat, memilikikeluarga serumah yang menderita kusta, terdiagnosis kusta tipe multibasiler, pernah mengalami reaksi dantelah menyelesaikan pengobatan. Dari penelitian ini didapatkan bahwa tipe kusta dan disabilitas derajat noldan dua berhubungan dengan skala dehabilitasi Anandaraj (p<0.05). Stigma terhadap kusta hingga kinimerupakan masalah yang belum dapat diatasi. Stigma dan disabilitas akibat kusta berperan penting terhadapkejadian dehabilitasi yang menyebabkan penurunan kualitas hidup pasien kusta dan OYPMK. Kata kunci: Anandaraj, dehabilitasi, kusta, Singkawang.   Dehabilitation Profile of Leprosy Patients in Alverno Singkawang Hospital: a Preliminary Study Abstract Leprosy causes permanent disability that affects both physical and psychological aspect of the patient.Self-stigma and social stigma cause dehabilitation; therefore, reducing the quality of life of the patients. Thisresearch is a preliminary study to assess the dehabilitation profile of leprosy patients, including people whohave had leprosy (OYPMK). A cross-sectional method was used to assess the dehabilitation scale of leprosypatients in Alverno Leprosy Hospital, Singkawang, using the Anandaraj dehabilitation scale. Eighty-eightsubjects were included in the analysis. Mann-Whitney test was done to analyze the association betweentype of leprosy and dehabilitation scale, and Kruskal Wallis test was done to analyze the association betweenleprosy reaction and grade of disability with dehabilitation scale. Most subjects are male, productive age,farmers, less than 1.5 million wages per month, uneducated, married, Chinese ethnicity, living in a crowdedhouse, had a family with leprosy, diagnosed with multibacillary leprosy, had an episode of leprosy reaction danreleased from treatment. Type of leprosy and WHO disability grade 0 and 2 are related to the dehabilitationscale. Leprosy stigmatization is still a worrisome problem. Together with the disability, stigmatization affectsthe dehabilitation scale of leprosy patients leading to reduced quality of life. Keywords: Anandaraj, dehabilitation, leprosy, Singkawang.

scholarly journals Clinico-epidemiological pattern of determinants of visible disabilities among patients affected with leprosy in Raipur district, Chhattisgarh

2020 ◽  
Vol 7 (4) ◽  
pp. 1565
Author(s):  
Aashish Verma ◽  
Ashish Kumar Sinha ◽  
Kamlesh Kumar Jain ◽  
Nirmal Verma ◽  
Smita Verma ◽  
...  
Keyword(s):  
Delayed Diagnosis ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Leprosy Patients ◽  
Grade Ii ◽  
Epidemiological Pattern ◽  
Patient’S Information ◽  
Study Participants ◽  
Visible Disabilities

Background: Widespread implementation of MDT has been an extremely successful strategy for leprosy control across the world including India instead of it Chhattisgarh and Dadra & Nagar Haveli are yet to achieve elimination. Identifying the causes of delay in presentation remains a matter of concern, Hence the present study was conducted with intent to assess the clinico-epidemiological patterns of determinants of Leprosy patients with visible disabilities (Grade II disability) in Raipur District of Chhattisgarh.Methods: This community based cross sectional study was conducted in Raipur district during August 2017- October 2019. 87 Newly diagnosed leprosy patients with visible Grade II disabilities registered during 1st April 2016- 31st March 2017 were included in the study. Patient’s information was obtained from their treatment card and was tracked in the community; necessary information was obtained in a predesigned pretested proforma and clinical examination was carried out.Results: Out of 87 study participants, almost are all the subjects had multi-bacillary type of leprosy. The mean duration between appearance of 1st symptoms & diagnosis was 14.59±11.87 months.Conclusions: The current study has observed many gaps in patient care viz. Lack of supervision of treatment, follow up examination and assessment of disability during course of care. Ignorance of early signs and symptoms was found to be the commonest cause of delayed diagnosis.

scholarly journals Understanding non-compliance with WHO-multidrug therapy among leprosy patients in Assam, India

2010 ◽  
Vol 01 (01) ◽  
pp. 09-13 ◽  
Author(s):  
Sumit Kar ◽  
Ranabir Pal ◽  
Dharamvir Ranajan Bharati
Keyword(s):  
Social Class ◽  
Urban Areas ◽  
Social Stigma ◽  
Cohort Analysis ◽  
Educational Status ◽  
World Health ◽  
Multidrug Therapy ◽  
Leprosy Patients ◽  
Per Capita ◽  
Health Organization

ABSTRACT Objectives: The study was undertaken to assess the adherence to World Health Organization (WHO)-multidrug therapy (MDT) and its successful completion by the leprosy patients and the extent of such defaulting, its correlates and reasons. Design: Retrograde cohort analysis was conducted during the fi rst quarter of 2007 from the cases registered for WHO-MDT treatment during 2002 to 2005 in Kamrup district of Assam, India. Results: A total of 254 leprosy cases refl ected the treatment seeking behavior of registered cases during the study period. Majority of the cases were from urban areas and defaulter rate higher in urban areas. The study group consisted of 60.63% males and 39.37% females. Both the compliance and default was higher in the age group of 16 to 30 years. Majority of defaulters (32.28%) had passed the high school leaving certifi cate examination had per capita monthly income between Rs 500 - 749 (30.71%) and belonged to social class IV (33.86%) and V (30.71%). Signifi cant statistical association was found between gender, literacy status, per capita income per month and socioeconomic status with treatment outcome. On analysis for the reasons of defaulting treatment; majority (33.07%) defaulted treatment due to loss of occupational hours when they come for receiving drugs at health center, 25.98% defaulted due to adverse reactions of drugs and 18.11% feared social stigma among major causes. Conclusions: The causes of defaulting treatment were related to gender, educational status, income as well as social class, or some combination of these. Recommendations, on strategic interventions to obviate the cause for noncompliance, were presented.

Japanese leprosy patients continue to fight social stigma

The Lancet ◽  
2004 ◽  
Vol 363 (9408) ◽  
pp. 544 ◽  
Author(s):  
Justin McCurry
Keyword(s):  
Social Stigma ◽  
Leprosy Patients

scholarly journals Tuberculous Distal Biceps Tendon Rupture: Case Report and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Artit Boonrod ◽  
Hiroyuki Sugaya ◽  
Norimasa Takahashi ◽  
Arunnit Boonrod ◽  
Chat Sumananont
Keyword(s):  
Tendon Rupture ◽  
Biceps Tendon ◽  
Delayed Diagnosis ◽  
Rare Condition ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Distal Biceps Tendon Rupture ◽  
Biceps Tendon Rupture ◽  
Rare Manifestation ◽  
Antituberculosis Chemotherapy

Tuberculous distal biceps tendon rupture is a rare condition in orthopedics. Musculoskeletal tuberculosis usually presents with bursitis, synovitis, myositis, and osteomyelitis, conditions which demonstrate an excellent response to antituberculosis chemotherapy. Tendon rupture is often associated with delayed diagnosis and treatment. We report a rare manifestation of musculoskeletal tuberculosis in the distal biceps tendon with delayed diagnosis.

scholarly journals Delayed diagnosis and ongoing transmission of leprosy in the post-elimination era in Boru Meda hospital, Ethiopia

2020 ◽  
Vol 14 (06.1) ◽  
pp. 10S-15S
Author(s):  
Seid Getahun Abdela ◽  
Ermias Diro ◽  
Feleke Tilahun Zewdu ◽  
Fentaw Tadese Berhe ◽  
Wendimagegn Enbiale Yeshaneh ◽  
...  
Keyword(s):  
Delayed Diagnosis ◽  
Public Health Problem ◽  
Neurological Complications ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Standard Data ◽  
Dermatology Clinic ◽  
Leprosy Patients ◽  
Previously Treated ◽  
Collection Form

Introduction: Following the recommendation of the Global Leprosy Strategy, Ethiopia targeted to reduce the incidence of new leprosy cases, and the proportion with severe disability (grade 2) from 13.6% in 2016 to < 1% in 2020. This study assessed the clinical profile of new leprosy cases and the sequelae of previously treated ones 20 years after leprosy was eliminated as a public health problem in the country. Methodology: Hospital based cross sectional study was conducted  by reviewing the medical records of all leprosy patients seen at the dermatology clinic of Boru Meda Hospital from August to December 2018.The  data were captured using a standard data collection form. Results: Over the study period, 57 (27.4%) new cases and 151 (72.6%) previously treated cases were seen.The median age was 44 years (interquartile range 32-57). Among the newly diagnosed cases, two were under the age of 15 years , 51 (89.5%) were multibacillary and 34 (59.6%) had grade 2 disability. This included visual impairment in 10 (17.5%) and neurological complications in 44 (77.2%). Of the 151 previously treated cases, 104 (68.9%) presented with disabilities, including 97 (64.2%) with grade 2. Amongst previously treated cases, 130 (86.1%) had neurological complications. In addition, 53 (35.1%) had vision impairment. Conclusions: This study showed evidence of ongoing leprosy transmission and delayed diagnosis in the country. This calls for operational research to determine the underlying reasons and provide ways forward. At the same time, the high burden of disabilities in previously treated cases should be addressed.

scholarly journals The Psychosocial Experiences in Ex-Leprosy Patients: A Qualitative Study

2020 ◽  
Vol 9 (2) ◽  
pp. 733-742
Author(s):  
Mohammad Jufriyanto ◽  
Ah Yusuf ◽  
Mundakir Mundakir
Keyword(s):  
Social Life ◽  
Social Stigma ◽  
Social Activity ◽  
Stress Coping ◽  
Psychosocial Experiences ◽  
Leprosy Patients ◽  
Stress Coping Strategies ◽  
Response To Stress ◽  
Field Notes ◽  
Depth Interviews

Ex-leprosy is a leprosy patient who has undergone treatment and is declared cured from a medical examination. The ex-leprosy have psychological and social problems due to disability and community stigma, caused them difficulty in re-socializing with the community. The aim is to identify the psychosocial experiences of ex leprosy in living their social life. This research is a phenomenological descriptive qualitative research method. The number of participants in this study were twelve using purposive sampling. Data collection using in-depth interviews  and field notes, analyzed by the Collaizi method. This study produced six main themes, Social stigma, Support system, Able to do activities, Response to stress, Coping strategies, and Social support. Participants' social activity after recovering from leprosy has increased although there is still a stigma in some communities. Support from family and community is needed as well as good coping mechanisms for ex leprosy patients.

scholarly journals Health Seeking Processes of Leprosy Patients in a Hill District of Nepal

AMC Journal ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 1-24
Author(s):  
Ulla-Britt Engelbrektsson ◽  
Madhusudan Subedi
Keyword(s):  
Social Stigma ◽  
Field Research ◽  
Signs And Symptoms ◽  
Health Seeking ◽  
Beliefs And Practices ◽  
Services Sector ◽  
Hill District ◽  
Leprosy Patients ◽  
The Subject ◽  
Depth Interviews

To shorten delays in leprosy diagnosis, health-seeking processes have to be understood and documented. In 2015, the International Nepal Fellowship launched a three-year research project on the subject. One part of the project was a community study in which recent health-seeking efforts were to be studied in the light of earlier ones. The focus of this article is upon insights gained in field research in a village and its immediate surroundings in the district of Jajarkot, western Nepal. The research highlights the importance of a longitudinal, patient-focused study that covers the period from just before the start of leprosy services until late 2018. The research methods include participant observations, narratives, in-depth interviews, and documentary and statistical enquiries. The research shows that the introduction of the Multi Drug Therapy (MDT) in the early 1980s has drastically changed the local leprosy situation. The number of new cases has declined, there are far less impairments and disabilities, and those recognized as affected are no longer excommunicated. However, the delays before diagnosis tend to be long. A lack of leprosy diagnosing skills within the health services sector is one reason. The residents not recognizing early signs and symptoms is another. An expectation of leprosy endemic in certain kinship groups, and not in others, is yet another. And, for some, so is the fear of social stigma. Moreover, there is the delaying factor of more than one set of beliefs and practices in relation to leprosy:a traditional, mainly magic-religious outlook and approach which co-exists with allopathic (biomedical) views and methods.

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