Epidemiological indicators and clinical profile of leprosy cases in Dhaka

Objective To evaluate epidemiological indicators and clinical profile of leprosy patients in Dhaka city. Methods In this cross-sectional observational study 722 new leprosy patients registered in six different clinics of The Leprosy Mission International – Bangladesh, Dhaka program over two and half years (January 2011 to June 2013) were included. Demographic details and clinical characteristics during diagnosis were recorded. Results Out of 722 patients, 390 (54%) were males and 332 (46%) were females. Proportion of cases under 15 year age was 8.7%. Borderline tuberculoid was the most common form of the disease (81.0%) followed by tuberculoid (9.3%), lepromatous (4.3%), borderline lepromatous (3.5%), borderline (1.8%) and pure neural (0.1%). Proportion of multibacillary leprosy was 22.4%. Most of the patients had duration of symptoms from 6 months to 1 year (53.0%). 12% of patients had history of contact with leprosy patients. Type 1 reaction was more prevalent than type 2 (7.6% and 2.9%, respectively). Proportion of cases with grade 2 disability was 5.9%. Most common presentation was with hypopigmented macule with obvious margin, marked anesthesia and mild infiltration. Ulnar nerve was the most common nerve to be involved (15.8%). Conclusion Leprosy cases are being frequently diagnosed in Dhaka city. Epidemiological indicators reflect that there may be ongoing disease transmission and relative delay in diagnosis despite a strong surveillance program.