Epidemiology of child leprosy in Sri Lanka

Abstract

Percentage of child leprosy cases in a country is a proxy indicator for the transmissibility of the disease and shows the effectiveness of the control programs. Even though Sri Lanka has eliminated leprosy as a public health problem in 1995, the percentage of child leprosy cases has been found to be high (around 10%) and static for the past two decades. Hence, it is of important to know the epidemiology of the child leprosy for planning successful control activities. Objective of the study was to evaluate the epidemiology of child leprosy for the past two decades in Sri Lanka. Anti Leprosy Campaign (ALC) national database was used to identify the child leprosy patients from 2000 to 2019. Results were present in percentages. A total of 39,276 leprosy patient entries were identified. Among them, 3,938 (10%) were children. After removing the missing values, 3,697 child patient data were analyzed. Fifty four percent were male and majority (54%) were in the age group of 10 to 14 years. Fifty percent of the children were detected from the western province and 27% were reported from the Colombo district. Higher proportion of children were Sinhalese and 81% of children were found to have Paucibacillary leprosy which is noninfectious. Out of the total child cases 7% had disabilities at the time of starting the treatments and 1.7% had Grade two disabilities. Majority (54%) of the child leprosy patients had no delay in diagnosing in Sri Lanka. However, 12% were correctly diagnosed two years after the initial symptoms and another 12% were diagnosed after one year. Western province has to be targeted in planning preventive programs. Awareness programs has to be conducted to minimize the delay in diagnosing the child leprosy patients as it will minimize the development of disabilities.