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Lepr Rev 2017 03;88(1):75-84

Introduction: Leprosy remains a serious public health problem due to its ability to cause disability. The prevention of leprosy ultimately lies in the early diagnosis and treatment of the individuals having leprosy, thereby preventing further transmission. In Sri Lanka, 46% of new cases identified in year 2013, were late presentations and this caused to 7-8% patients to present with deformities. Read More

Lepr Rev 2017 03;88(1):58-74

Introduction: Leprosy, a chronic infectious disease, poses a serious public health concern due to its impact on the wellbeing of affected people. This study, which was set in Ghana, explored stigmatisation and discrimination experiences of people affected by leprosy resident at the Weija Leprosarium in Accra.

Methodology: Using a qualitative research methodology, 26 participants were purposively selected and in-depth interviews conducted. Read More

Lepr Rev 2017 Mar;88(1):43-57

Objectives: The purpose of this study was to assess the stigma situation in Hansen’s disease from the perspective of both people affected by Hansen’s disease and those living in the surrounding community in southeast Nigeria.

Design: A cross-sectional survey was conducted among affected people and non-affected people using the xplanatory model interview catalogue stigma scale for the community adjusted for leprosy and for leprosy patients, internalised stigma of mental illness scale adjusted for leprosy, Participation Scale and the Social distance scale. Data obtained were analysed using descriptive statistics of frequency, distribution tables, mean and standard deviation as well as inferential statistics of Mann-Whitney U test, Kruskal-Wallis H test and Spearman rho correlation rank. Read More

Lepr Rev 2017 Mar;88(1):23-42

Background: There is a need for comprehensive, valid and reliable instruments to assess leprosy-related stigma. This paper presents the process of the cross-cultural validation of an instrument in Cirebon District, Indonesia initiated by the Stigma Assessment and Reduction of Impact (SARI) project.

Methods: The Berger Scale was initially developed to assess HIV/AIDS-related stigma. Read More

Lepr Rev 2017 Mar;88(1):2-22

Objectives: People affected by leprosy are often stigmatised, but stigma is rarely quantified and the effectiveness of interventions is often not evaluated. The SARI Project aimed to test and evaluate three interventions: counselling (involving peer counsellors), socio-economic development (SED) and contact between community members and affected people.

Results: This study used a controlled trial design in which pairs of the stigma-reduction interventions were randomly allocated to sub-districts in Cirebon District,Indonesia. Read More

Lepr Rev 2016 Dec;87(4):570-2

Lepr Rev 2016 Dec;87(4):564-9

Lepr Rev 2016 12;87(4):562-3

Lepr Rev 2016 Dec;87(4):553-61

Objectives: An expert group of peripheral nerve surgeons, reconstructive surgeons, and immunologists who have extensive experience with Hansen’s Disease convened to discuss the status of nerve decompression as a treatment for leprous neuropathy. The expert group recommended an international, multi-center randomised controlled trial (RCT). Subsequently, a study protocol called Decompression for Leprous Neuropathy (DELN) was designed and further refined by multiple investigators worldwide. Read More

Lepr Rev 2016 Dec;87(4):548-52

Adaptive shortening of long flexors is the common secondary impairment which can occur in patients with long standing claw hand, particularly in those who do not undergo any supervised physiotherapy programme.¹ The main purpose of this short report is to describe the current physiotherapeutic means which are commonly employed for the management of long flexor tightness. This report further gives an insight into the consequences of the delay in corrective surgery and ultimately describes the dire need for further research on this deformity. Read More

Lepr Rev 2016 Dec;87(4):543-7

Histoid leprosy is an unusual variant of lepromatous leprosy posing difficulties for diagnosis as well as treatment even to the experts. We report a case of a 73 year old male from the hilly region of Nepal, who presented with multiple asymptomatic scrotal nodules for 3 months. Though clinical diagnoses were pilomatricoma and steatocystoma multiplex; histopathological examination was consistent with that of histoid leprosy. Read More

Lepr Rev 2016 Dec;87(4):536-42

Background: Immunosuppresion caused by corticosteroids predisposes leprosy patients to Strongyloides stercoralis infection which if untreated can be fatal. Patients acquire infection by walking barefoot in infested soils and can be infected for life because of the auto infective cycle of the parasite. Corticosteroids have precipitated death in more than 60% of disseminated strongyloidiasis cases. Read More

Lepr Rev 2016 Dec;87(4):532-35

The incidence of leprosy is decreasing worldwide and it is considered a rare disease in developed countries. In Spain, leprosy is mainly an imported disease with only few autochthonous cases seen. The diagnosis is difficult because of a low index of suspicion and the absence of visualisation of fast-acid bacilli in the lesions. Read More

Lepr Rev 2016 Dec;87(4):526-31

Introduction: Lucio phenomenon is a rare type of reaction in untreated, diffusely infiltrative form of lepromatous leprosy type, characterised with ulcerative type of skin lesions.

Case: A 29 year old Indonesian female, 7th months primigravida with a four-month history of painful scarlet spots that darken and ulcerate on both of her hands and legs. The patient was experiencing fever. Read More

Lepr Rev 2016 Dec;87(4):516-25

Background: Mycobacterium leprae and HIV cause infectious diseases of great concern for the public health care sector worldwide. Both are especially worrisome diseases when patients become co-infected and exhibit the expected clinical exuberance. The objective of this study was to evaluate episodes of reversal reaction (RR) and the effect of the use of corticosteroids on the treatment of borderline tuberculoid leprosy patients co-infected with the human immunodeficiency virus (HIV). Read More

Lepr Rev 2016 Dec;87(4):501-15

The extent of pathogenicity of the mycobacterial infections depends on virulence factors that mediate survival inside macrophages. Virulence factors are generally believed to be specific for pathogenic species and mutated/non-functional in nonpathogenic strains. Mycobacterial TlyA can modulate the phagolysosome maturation pathway, immediately after entry into macrophages. Read More

Lepr Rev 2016 Dec;87(4):486-500

Background: This study compares the strains of genotypes of M. leprae from nasal secretions (NS) and skin biopsy (SB) in the same patient, supplementing conventional epidemiology to gain insight into the infection of leprosy in Fortaleza, Brazil.

Methods: The sample consisted of 38 newly diagnosed leprosy patients attending the National Reference Center of Dermatology Dona Libania (CDERM), in Fortaleza, who tested positive for M. Read More

Lepr Rev 2016 Dec;87(4):476-85

Background: Despite achieving the WHO elimination target of less than 1/10,000 population in 1998 at the national level, there are still pockets of relative high endemicity of leprosy in Nigeria. This study used spatial analytic techniques to determine the spatial distribution of leprosy in Nigeria.

Methods: The study is an ecological study of secondary data of new leprosy cases reported to the National TB and Leprosy Control Programme (NTBLCP) in Nigeria, 2010–2014. Read More

Lepr Rev 2016 Dec;87(4):464-75

Objectives: A prospective case control study was conducted to calculate normal dimensions of ulnar nerve and study the size, echotexture and morphologic alterations in ulnar nerve in patients with leprosy.

Methods: The study group included 48 patients diagnosed with leprosy on basis of clinical, bacteriologic and/or histopathologic evaluation. Sonographic measurements were taken at 3 levels around elbow. Read More

Lepr Rev 2016 Dec;87(4):456-63

Background: Clinical data on pure-neuritic leprosy (PNL) is limited.

Objective: To study the clinical and epidemiological features of PNL in the leprosy post-elimination era.

Methods: This was a retrospective analysis of the clinic records of leprosy patients from January 2006 to June 2013. Read More

Lepr Rev 2016 Dec;87(4):450-55

Lepr Rev 2016 Mar;87(1):132-43

Lepr Rev 2016 Mar;87(1):130-1

Lepr Rev 2016 Mar;87(1):129

Lepr Rev 2016 Mar;87(1):124-8

Lepr Rev 2016 Mar;87(1):122-3

Lepr Rev 2016 Mar;87(1):118-21

Introduction: Recommended fixed duration prednisolone regimen was not found effective in the treatment of chronic neuritis. Alternate effective treatment was being sought to reduce the deformity in the field of leprosy.

Objective: We wished to see whether a prolonged course of prednisolone and methotrexate could be of any help for them. Read More

Lepr Rev 2016 Mar;87(1):113-7

Lepr Rev 2016 Mar;87(1):109-12

The cross-immunity between tuberculosis and leprosy is unknown. The aim of this pilot study was to evaluate the occurrence of Mycobacterium tuberculosis and M. leprae infection in Marshallese adult volunteers in Springdale, Arkansas, U. Read More

Lepr Rev 2016 Mar;87(1):104-8

Eccrine syringofibroadenoma (ESFA) is a rare adnexal tumour of eccrine ductal proliferation. A 50 year old treated case of leprosy presented with a chronic non healing ulcer of 5 years duration on the deformity laden right foot. Multiple verrucous papules and plaques were seen surrounding the ulcer which showed histopathological findings consistent with ESFA. Read More

Lepr Rev 2016 Mar;87(1):101-3

Leprosy (Hansen's disease) is a chronic contagious granulomatous disease principally affecting the skin and peripheral nervous system, caused by Mycobacterium leprae. In this report, we present a case of autochthonous leprosy in a man from Florida as the first human case reported from this region. Authors believe dermatologists need to be aware of the possibility of autochthonous transmission of leprosy in the Eastern-Southern United States, and should consider leprosy in any patient with atypical skin lesions, even when a history of contact with armadillo is missing. Read More

Lepr Rev 2016 Mar;87(1):93-100

Background: Rifampicin is the major drug in the treatment of leprosy. The rifampicin resistance of Mycobacterium leprae results from a mutation in the rpoB gene, encoding the β subunit of RNA polymerase. As M. Read More

Lepr Rev 2016 Mar;87(1):78-92

Unlabelled: The working hypothesis is that, viable Mycobacterium leprae (M. leprae) play a crucial role in the precipitation of Type 1 reaction (T1R) in leprosy.

Material And Methods: A total of 165 new multibacillary patients were studied. Read More

Lepr Rev 2016 Mar;87(1):71-7

Background: Chronic planter ulcer, also known as trophic ulcer, shows no tendency towards healing. It is usually seen in sensory deficient foot. The clinical result of a sensory, motor or autonomic loss of a nerve function is frequently the same--ulceration, although the exact cause may vary. Read More

Lepr Rev 2016 Mar;87(1):60-70

Background: In leprosy, sensory function of nerves is evaluated with monofilaments test and the motor function with voluntary muscle test, however electroneuromyography is considered as the gold-standard tool.

Objectives: This study aimed: i) to evaluate the correlation between clinical tests and electroneuromyography for the diagnosis of leprosy neuropathy; and ii) to identify the prevalence of leprosy neuropathy and the most compromised peripheral nerves in leprosy.

Methods: We analysed the data from a nested case-control study that identified 166 patients diagnosed with leprosy neuropathy confirmed by electromyography. Read More

Lepr Rev 2016 Mar;87(1):53-9

Objective: To detect neuropathic pain in people who have had leprosy and correlate this association with the WHO Degree of Physical Disability classification (DPD-WHO).

Patients And Methods: Data were collected from medical records, interviews and physical examinations of patients treated in 2013 in a regional referral service that attends 102 municipals. Clinical and general data, the DPD-WHO classification and the Douleur Neuropathique 4 Questionnaire (DN4) were utilised to determine the profile and to diagnose neuropathic pain. Read More

Lepr Rev 2016 Mar;87(1):42-52

Lepr Rev 2016 Mar;87(1):32-41

Background: In Mato Grosso do Sul state, Brazil, the dry border shared with Paraguay is a territory marked by facilities in the flow of goods, services and people, bringing difficulties for surveillance of communicable diseases.

Purpose: The purpose of this study is to characterise leprosy epidemiologically in dry border municipalities of Mato Grosso do Sul in Brazil with contiguous urban areas with neighbouring Paraguayan counties, in the period 2001-2011.

Methods: This is an exploratory descriptive investigation that includes the four dry border municipalities of Mato Grosso do Sul (Coronel Sapucaia, Paranhos, Ponta Porã, and Sete Quedas) in Brazil whose urban areas are contiguous with Paraguay. Read More

Lepr Rev 2016 Mar;87(1):23-31

Although leprosy in China is controlled at a low endemic level, the number of new cases in Guizhou province has shown no significant decrease over the past 20 years. Guizhou remains the province with the second highest prevalence in China. The authors conducted a study in which the characteristics of newly detected leprosy cases, found between 2008 and 2012 in Guizhou, were analysed. Read More

Lepr Rev 2016 Mar;87(1):2-22

Introduction: Leprosy continues to be a global public health problem, but draws less attention because 'prevalence based elimination' has been misinterpreted as eradication. The ongoing transmission of M. leprae has renewed interest in complete elimination. Read More

Lepr Rev 2016 Jun;87(2):243-5

Lepr Rev 2016 Jun;87(2):264-66

Disability due to leprosy often lasts lifelong, so estimates of the burden of leprosy in a community based on ‘registered prevalence of leprosy cases’ or on ‘proportion with Grade 2 disability amongst new cases in past year’ will seriously underestimate the number of disabled people in the community needing support or services. In a previously highly endemic are of Bangladesh, the accumulated prevalence of disability due to leprosy amongst adults was 45·35/100,000 population. Read More

Lepr Rev 2016 Jun;87(2):260-3

Lepr Rev 2016 Jun;87(2):252-59

Leprosy, a disease of skin and peripheral nerves has varied manifestations which principally affect the immune status of the host. Leukemic skin infiltrations in patients with leukemia are referred to as leukemia cutis. It can be seen in all types of leukemia, especially in patients with acute myelomonocytic leukemia (AML). Read More

Lepr Rev 2016 Jun;87(2):246-51

Leprosy has been labelled as a great imitator since times immemorial. This mainly is because of the wide range of its clinical presentations. In endemic regions it is important to entertain the possibility of leprosy even in atypical presentations so as to avoid misdiagnosis. Read More

Lepr Rev 2016 Jun;87(2):239-42

A 26 year old male, treated case of lepromatous leprosy, presented with severe heat intolerance, loss of sensation and sweating over distal parts of both upper and lower limb of 12 years’ duration. On examination, there was definite sensory loss over the extremities in glove and stocking pattern and thickening of the bilateral ulnar, common peroneal and radial nerves. There were three trophic ulcers over the plantar aspect of the right foot, atrophy of the small muscles of hand, reabsorption of the distal index, middle and ring fingers along with total clawing of both hands. Read More

Lepr Rev 2016 Jun;87(2):211-20

Background: Thalidomide is well known as a steroid sparing drug in Erythema Nodosum leprosum (ENL) reaction in leprosy. There is no guideline as to when it should be offered to patients. Documentation of ENL presentation with its morbidity before and after with patient profile can be a baseline to develop a selection criteria as to when thalidomide should be started to reduce steroid related morbidly. Read More

Lepr Rev 2016 Jun;87(2):191-200

To investigate the relationship between the WHO disability grading system for leprosy with the limitations to perform daily functional activities and the decrease in social participation in participants with leprosy. Participants with a diagnosis of leprosy were recruited at the dermatology ambulatory clinic of the University Hospital of Sergipe. In order to investigate the association of WHO disability grading system for leprosy with activities of daily living measured with the Screening Activity Limitation and Safety Awareness (SALSA) scale and with the social participation (P-scale), we performed an analysis with the Kruskal-Wallis test and the Spearman coefficient. Read More

Lepr Rev 2016 Jun;87(2):183-90

Background: India achieved the goal of ‘leprosy elimination’ by reducing the burden of leprosy to less than one case per 10,000 inhabitants in 2005. Sustained and committed efforts by national programmes have led to a decline in the burden of leprosy to a great extent.

Purpose: To examine the spatial clustering of leprosy case detection and spatiotemporal trend using Bayesian space period model. Read More

Lepr Rev 2016 Jun;87(2):171-82

Introduction: Duration of leprosy treatment remains long and difficult to complete in resource poor areas. Studies suggest that shortening duration of therapy for MB patients to 6 months may be possible.

Methods: New MB patients in 2005 in two NGO projects in Bangladesh were treated with 6 months WHO MB MDT and the rate of relapse and fall in BI on slit skin smear during follow up to date were compared with a control group treated for 12 months the previous year. Read More