Leprosy, also known as Hansen's disease, is a chronic infectious disease caused by Mycobacterium leprae, a microorganism that has a predilection for the skin and nerves. The disease is clinically characterized by one or more of the three cardinal signs: hypopigmented or erythematous skin patches with definite loss of sensation, thickened peripheral nerves, and acid-fast bacilli detected on skin smears or biopsy material. M. leprae primarily infects Schwann cells in the peripheral nerves leading to nerve damage and the development of disabilities. Despite reduced prevalence of M. leprae infection in the endemic countries following implementation of multidrug therapy (MDT) program by WHO to treat leprosy, new case detection rates are still high-indicating active transmission. The susceptibility to the mycobacteria and the clinical course of the disease are attributed to the host immune response, which heralds the review of immunopathology of this complex disease.

Introduction. Leprosy, a statistically “eliminated” disease from the globe, continues to linger around in its endemic countries including India. Objective. This study describes the epidemiological and clinicopathological pattern of the disease seen in children over a period of 8 years following its elimination in India. Materials and Methods. Medical records of all leprosy cases up to 14 years of age registered between April 2005 and March 2013 were retrospectively analyzed. Data were retrieved using a predesigned proforma and entered into the database system for analysis. Results. Child proportion of newly registered leprosy cases did not show a significant decline in the years following its elimination. The disease seemed to manifest frequently in older children with an insignificant gender predilection. More than half of child cases had a history of household contact. Paucibacillary leprosy dominated in them with a solitary skin lesion as the most frequent presentation. Although nerve thickening was seen in nearly half of these children, neuritis and lepra reactions were less common. Deformity at the time of diagnosis was noted in 13.89% of cases. Although smear positivity was not a common feature in children affected with leprosy, a good clinicohistopathological correlation was observed in those who underwent biopsy. Conclusion. Our study and reports from different parts of the country depict the unturned curves in the epidemiology of childhood leprosy which mirrors active transmission in the community, lacunae in diagnosis, and the need to strengthen contact screening activities in the pediatric population to sustain elimination.

Background. Leprosy, a disabling infectious disease, is a major public health problem in some regions, requiring knowledge of its epidemiological variations so that strategies for case detection and disease control can be subsidized. Objectives. This study aims to evaluate the clinical and epidemiological profiles of leprosy patients attending a referral hospital in South India between 2011 and 2012. Methods. Medical records of newly diagnosed leprosy cases between April 2011 and March 2012 were analysed at the Department of Dermatology, Venereology and Leprosy, Father Muller Medical College Hospital, Mangalore, India. Data were obtained using a specific questionnaire and entered into the database system. Results. Adult males outnumbered females in our study. Detection rate among women and children under 15 years seems to be on the rise. Multibacillary leprosy was more frequent among the new cases with borderline tuberculoid as the predominant type, although smear positivity was seen in less than half of these clinical multibacillary cases. A higher occurrence of lepra reactions, neuritis, and deformities at the time of diagnosis was observed. Conclusion. The results of this study point to a high circulation of lepra bacilli in the community in the “elimination era” and also highlight the need for early diagnosis and appropriate treatment at the field level to prevent spread of bacilli and development of disabilities.

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