Disability among new leprosy patients, an issue of concern: An institution based study in an endemic district for leprosy in the state of West Bengal, India

Background: Both magnitude and severity of disability in new leprosy patients measure indirectly the disease transmission in the community and rapidity of case detection. Various factors might be associated with the presence of impairment at registration. Aims: To find out the prevalence of both grade 1 and grade 2 disability among new leprosy patients along with association of some clinical and sociodemographic factors. Methods: A cross-sectional study was carried out in the Skin out patient department (OPD) of a Tertiary care hospital in West Bengal, which is situated in a highly endemic district of leprosy (prevalence was 6.5/10000, year 2007). About 244 new leprosy patients were interviewed and clinically examined during Aug'06-Jun'07. Data was analysed in percentages, chi(2) test, Anova. Results: Proportion of disability was quite high among the studied new leprosy patients, 11.5% had grade-1 and 8.6% had grade-2. Disability was more among the patients with pure neuritic type of leprosy (<0.001), multibacillary leprosy (P=0.000), patients with delayed registration (P=0.000) and who were engaged as manual laborers (P=0.001). Feet were commonly involved site and nerve function impairment, both sensory and motor were the commonest nature of disability found in this study. Conclusion: To reduce new leprosy cases with grade-2 disability, early diagnosis of the leprosy patients and searching for grade-1 disability should be routine procedure in our health system, for which thorough neurological examination along with appropriate preventive measures is the need of the hour.