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Epidemiological characteristics of leprosy reactions: 15 years experience from north India.
Int J Lepr Other Mycobact Dis. 2004 Jun; 72(2):125-33.IJ

Abstract

A retrospective analysis of patient's leprosy clinic records at PGIMER, Chandigarh, India for the period 1983 to 1998 was undertaken to study the frequency, time of onset, and risk factors for leprosy reactions. Of the 2600 cases analyzed, 1494 were multibacillary and 1106 had paucibacillary disease. Presentation with reaction was common with 30.9% of our patients having reactions at the time of first visit. The incidence of reversal reaction (RR) was highest during 6 to 12 months after starting multi-drug therapy (MDT), thereafter declining gradually. Late RR occurred in 9.5% of all cases and was noted up to 7 years after treatment. Female gender, widespread disease, and multibacillary disease were identified as risk factors for RR. Erythema nodosum leprosum (ENL) reactions were noted to occur mostly during second or third year after starting MDT. Of the total number of patients who experienced ENL, 64.3% had recurrent episodes which continued for up to 8 years after the start of treatment. Lepromatous leprosy, female gender, and high Bacterial Index (>/=3) were recognized as risk factors for developing ENL. Occurrence of recurrent and late reactions, even though of mild severity, highlights the importance of recognizing and treating them promptly to prevent or reduce morbidity, complications, and further deterioration in the disability status. Although it is hoped that leprosy will have been eliminated at all levels by 2005, the recognition and management of these reactions will continue to be the most essential/significant task in the post elimination era.

Authors+Show Affiliations

Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. kumarbhushan@hotmail.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15301592

Citation

Kumar, Bhushan, et al. "Epidemiological Characteristics of Leprosy Reactions: 15 Years Experience From North India." International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association, vol. 72, no. 2, 2004, pp. 125-33.
Kumar B, Dogra S, Kaur I. Epidemiological characteristics of leprosy reactions: 15 years experience from north India. Int J Lepr Other Mycobact Dis. 2004;72(2):125-33.
Kumar, B., Dogra, S., & Kaur, I. (2004). Epidemiological characteristics of leprosy reactions: 15 years experience from north India. International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association, 72(2), 125-33.
Kumar B, Dogra S, Kaur I. Epidemiological Characteristics of Leprosy Reactions: 15 Years Experience From North India. Int J Lepr Other Mycobact Dis. 2004;72(2):125-33. PubMed PMID: 15301592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Epidemiological characteristics of leprosy reactions: 15 years experience from north India. AU - Kumar,Bhushan, AU - Dogra,Sunil, AU - Kaur,Inderjeet, PY - 2004/8/11/pubmed PY - 2004/11/17/medline PY - 2004/8/11/entrez SP - 125 EP - 33 JF - International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association JO - Int J Lepr Other Mycobact Dis VL - 72 IS - 2 N2 - A retrospective analysis of patient's leprosy clinic records at PGIMER, Chandigarh, India for the period 1983 to 1998 was undertaken to study the frequency, time of onset, and risk factors for leprosy reactions. Of the 2600 cases analyzed, 1494 were multibacillary and 1106 had paucibacillary disease. Presentation with reaction was common with 30.9% of our patients having reactions at the time of first visit. The incidence of reversal reaction (RR) was highest during 6 to 12 months after starting multi-drug therapy (MDT), thereafter declining gradually. Late RR occurred in 9.5% of all cases and was noted up to 7 years after treatment. Female gender, widespread disease, and multibacillary disease were identified as risk factors for RR. Erythema nodosum leprosum (ENL) reactions were noted to occur mostly during second or third year after starting MDT. Of the total number of patients who experienced ENL, 64.3% had recurrent episodes which continued for up to 8 years after the start of treatment. Lepromatous leprosy, female gender, and high Bacterial Index (>/=3) were recognized as risk factors for developing ENL. Occurrence of recurrent and late reactions, even though of mild severity, highlights the importance of recognizing and treating them promptly to prevent or reduce morbidity, complications, and further deterioration in the disability status. Although it is hoped that leprosy will have been eliminated at all levels by 2005, the recognition and management of these reactions will continue to be the most essential/significant task in the post elimination era. SN - 0148-916X UR - https://www.unboundmedicine.com/medline/citation/15301592/Epidemiological_characteristics_of_leprosy_reactions:_15_years_experience_from_north_India_ L2 - https://ClinicalTrials.gov/search/term=15301592 [PUBMED-IDS] DB - PRIME DP - Unbound Medicine ER -