Clinicopathologic study of childhood hansen’s disease

Priyadharshini, S (2013) Clinicopathologic study of childhood hansen’s disease. Masters thesis, Tirunelveli Medical College, Tirunelveli.


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INTRODUCTION: Leprosy is one of the very old diseases to have afflicted man. After a great search for the etiology, it was attributed to a bacterium Mycobacterium leprae by Sir Gerhard Armauer Hansen in 1873 and he remarked wryly: “There is hardly anything on earth, or between it and heaven, which has not been regarded as the cause of leprosy; and this is but natural,since the less one knows, the more actively does his imagination works”. Leprosy is a disease with widely varied clinical manifestations and capable of affecting almost every organ of the body. The disease is considered important mainly because of its potential to cause permanent and progressive physical deformities. After a great struggle over many centuries, the disease has been brought under control. The credit goes to the advent of MDT therapy instituted from 1982. Most countries that were endemic for leprosy have achieved elimination. India achieved elimination in December, 2005. Though there is a drastic decline in the prevalence of leprosy among the endemic countries, the fall in the new case detection rate is still stable or shows increasing trends. The total number of new cases detected during the year 2011-2012 was 1.27 lakhs and children contributed 9.7% (12,305) of the new cases. Children are susceptible to leprosy as they are to many other diseases. Not all the hypopigmented skin lesions are due to leprosy. Children usually present with single hypopigmented patch especially over the face with intact or impaired sensation. Clinical features of leprosy among children are confusing and testing of sensation in them is difficult. Unless specifically looked for, the diagnosis may be missed and they will manifest in early adulthood with disabilities. The disease in children responds well to treatment if detected in early stages and the deformities can be prevented. Above all, childhood leprosy is an indicator for assessing the endemicity of the disease. The high child case rate indicates the continuous spread of the disease in the community. It is also a measure of the efficacy of the control programme. In view of the importance of detecting leprosy early among children, clinical and histopathologic profile of children who were diagnosed with leprosy at Tirunelveli medical college hospital were analysed in this study and the implications are discussed. AIMS & OBJECTIVES: This is a prospective study done on childhood leprosy patients below 14 years of age at Tirunelveli medical college hospital with the following objectives: 1. To study the incidence of childhood leprosy in Tirunelveli district. 2. To determine the age and sex distribution of the childhood leprosy cases. 3. To study the various clinical presentations, histopathological features and SSS status among children. 4. To study the incidence and pattern of nerve involvement, systemic involvement, reactions and deformity in the child cases of leprosy. 5. To find out the PB and MB proportion of child cases. MATERIALS AND METHODS: INCLUSION CRITERIA: 1. Children aged 0 – 14 years, 2. Both sexes, 3. Cases who are newly diagnosed as Hansen’s disease during the study period, 4. Both the direct and referred cases from the PHC s, ULC s and other hospitals in Tirunelveli district. EXCLUSION CRITERIA: 1. Children > 14 years, 2. Children who have taken anti-leprosy treatment in the past in the form of monotherapy or as MDT. Our study was a hospital based open prospective study conducted at Department of Dermatology in Tirunelveli Medical college hospital on Newly diagnosed childhood cases of Leprosy (includes the cases directly attending the OPD and those who are diagnosed in the field and referred to hospital) aged 0 –14 years to study and analyse the clinical profile and Histopathology in every aspect during the period from September 2010 to October 2012. CONCLUSION: Leprosy continues to be an important health problem in children. Though the incidence of childhood leprosy has become low, considerable proportions of children are presenting to health care at a late stage with deformities which indicates reluctance either to come forward or an inadequate detection which may be related to unawareness. Deformities occurring in children are more distressing both socially and psychologically, as they have to live their whole life with this stigma. It is imperative that our goal should be to bring all cases of leprosy in children under treatment at the earliest possible stage. Childhood leprosy reflects the status of disease control in the community and in turn efficacy of the control programme. Awareness should be raised in the society by all means including the media and the health services. Parental education, counselling, screening of household contacts of leprosy patients and school surveys form an integral part of early detection and treatment to achieve the goal of eradication of leprosy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: childhood hansen’s disease ; Clinicopathologic study.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Punitha K
Date Deposited: 21 Jun 2018 14:23
Last Modified: 22 Jun 2018 03:09

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