Disability among leprosy patients in the lustrum 2016-2020: Retrospective study from a tertiary care centre in Southern Kerala

Background: The stigma surrounding leprosy in the community is due to grade 2 disability (G2D). The current global leprosy project aims towards a 90% reduction in G2D by 2030. This research was done to estimate the proportion of leprosy patients who had G2D at the time of diagnosis and to identify the clinical and demographic factors that predicted G2D. Materials and Methods: Design -Hospital-based retrospective cross-sectional study. The outcome variable was G2D and the determinants were demographic and clinical characteristics. Results: G2D was seen in 22.3% and G1D in 17.5%. The M:F ratio of G2D was 5:1. G2D was highest in the hands (62.1%), followed by the feet (59.4%), and the eyes (16.2%). The claw hand was the most common deformity in the hand and the plantar ulcer was the most common deformity in the feet. Age >45 (OR 2.27, 95% CI 1.1–4.8), males (OR 3.3,95% CI 1.3–8.5), multibacillary type (OR 6.95,95% CI 1.6–30.6), pure neuritic type (OR 3.6,95% CI 1.1–12.3), and thickened nerves (OR 14.3, 95% CI 1.9–108.7) were the significant determinants. Conclusion: Being male, being older than 45, having multibacillary leprosy, having pure neurotic leprosy, and having a thicker nerve trunk predicted G2D. Training primary care health workers in recognising the subtle early symptoms and raising community awareness are the need of the hour. Frequent leprosy case detection programmes should be held to identify undiagnosed cases