Reactions in leprosy: an epidemiological study of 386 patients in west Nepal

Leprosy Review
W H van BrakelS B Lucas

Abstract

This paper presents epidemiological data on reversal reaction (RR) and erythema nodosum leprosum reaction (ENL) from a retrospective study of 386 leprosy patients newly registered at Green Pastures Hospital, Pokhara, West Nepal. The average follow-up time was 21 months. The prevalence of RR at first examination was 28% (23-32), and the prevalence of ENL reaction was 5.7% (2.3-9.2). The overall incidence rates among the 335 patients that were available for follow-up were 8.7 (6.5-12)/100 person years at risk (PYAR) for RR and 3.2 (1.5-6.7)/100 PYAR for ENL. Relapse of RR was common (1.4/patient). In all, 52% of RR were complicated by new nerve function impairment, against 59% of ENL reactions. The finding of other investigators that most RRs occur during the first year of treatment was confirmed by this study. The most significant risk factor for RR was extent of clinical disease measured by a count of body areas with clinical signs of leprosy. The risk of developing a RR for patients with 'extensive disease' (3 or more out of 9 body areas involved) was 10 times that of patients with limited disease (Rate Ratio 10 (1.3-76), p = 0.026). The study indicated that the following categories of patients in Nepal are at high or increase...Continue Reading

Citations

Dec 15, 2011·BMC Infectious Diseases·Luciana Silva RodriguesMaria Cristina Vidal Pessolani
Dec 11, 2008·Journal of Medical Case Reports·Sherine G NashedAlaa A Abd-Elsayed
Oct 8, 2013·PLoS Neglected Tropical Diseases·Carlijn G N Voorend, Erik B Post
Jul 23, 2013·PLoS Genetics·Marianna OrlovaErwin Schurr
Nov 5, 1998·International Journal of Dermatology·A D MoubasherD D Raheem
Mar 15, 2019·PloS One·Marlice Fernandes de OliveiraIsabela Maria Bernardes Goulart
Jul 18, 2020·PLoS Neglected Tropical Diseases·Douglas Eulálio AntunesLuiz Ricardo Goulart
Apr 29, 2014·Anais Brasileiros De Dermatologia·Maria Stella de Mello Ayres PutinattiCarlos Roberto Padovani

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