后消亡时代北印度的麻风病:回顾性研究

N. Hazarika, R. Bhatia, C. Divyalakshmi
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摘要

2005 年 12 月,印度实现了消灭麻风病的目标。然而,印度许多地区仍报告有大量麻风病例。 这项研究的目的是了解在消灭麻风病的后时期,北印度一家三级医院麻风病病例的概况。 研究在汉森氏病诊所进行。研究设计为回顾性观察研究。研究人员对2018年1月1日至2019年12月31日期间入院接受治疗的麻风病人进行了病历回顾。研究分析了有关人口统计学特征、麻风病临床谱系、裂隙皮肤涂片(SSS)和组织病理学结果的数据。 统计分析采用社会科学统计软件包(SPSS)第 23 版软件(SPSS Inc.)数据以范围、平均值 ± 标准差、频率(病例数)和相对频率(百分比)进行统计描述。 在总共 115 名患者中,男性(68%,n = 79/115)多于女性。儿童(小于15岁)占0.86%(1/115),50岁以上占26%(30/115)。多脓疱型麻风病(73%,n = 84/115)更为常见。边缘型麻风病(41.7%,n = 48/115)是最常见的麻风病临床类型,而0.05%的患者(n = 6/115)在就诊时发现有2级残疾。60%的病例(69/115)SSS呈阳性。 本研究显示,年龄较大的病例明显增多,而儿童新病例则有所减少。此外,多发性病例多于少发性病例。据报道,在消灭了麻风病的国家中,类似趋势是麻风病发病率下降的一个指标。我们推测,印度可能正在进入麻风病社区传播减少的阶段。此外,在全国范围内开展多中心研究可能会带来更多启示。
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Leprosy in North India in Post-Elimination Era: A Retrospective Study
India achieved elimination target for leprosy in December 2005. However, many pockets in the country continue to report significant number of cases. The aim of the study was to study the profile of leprosy cases presenting to a tertiary care hospital in North India in post-elimination era. The study was conducted at Hansen’s disease clinic. The study design was a retrospective observational study. Chart review of treatment naive leprosy patients enrolled between 1st January 2018 and 31st December 2019 was done. Data regarding demographic profile, clinical spectrum of leprosy, slit-skin smears (SSSs) and histopathological findings were analysed. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 23 (SPSS Inc., Chicago, IL, USA). Data were statistically described in terms of range, mean ± standard deviation, frequency (number of cases), and relative frequency (percentages). Amongst a total of 115 patients, males (68%, n = 79/115) outnumbered females. Children (<15 years) constituted 0.86% cases (n = 1/115) and 26% cases (n = 30/115) were above 50 years of age. Multibacillary leprosy (73%, n = 84/115) was more common. Borderline lepromatous (41.7%, n = 48/115) was the most common clinical type of leprosy, whereas Grade 2 disability was noted amongst 0.05% (n = 6/115) patients at presentation. SSS were positive in 60% (69/115) cases. The present study showed a significant increase in cases in the older age group and decrease in new cases in children. Furthermore, multibacillary cases outnumbered the paucibacillary cases. Similar trends were reported to be an indicator of decreasing incidence of leprosy in countries that eliminated leprosy. We speculate that India may be entering a phase of decreased community transmission of leprosy. Further, multicentric studies across the country may throw more light.
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