Date of Award

11-10-2006

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Miguel Reyes-Mugica

Abstract

Background: Several aspects concerning the biology and epidemiology of leprosy remain unknown. It has been recognized that the study of children with leprosy could provide important insight into unanswered questions, particularly if disease manifestations are carefully observed. Methods: A retrospective chart review of 308 cases of children aged 0-14 y/o was conducted at the Ministry of Health Leprosy Department in Asuncion, Paraguay. Data regarding age, gender, leprosy classification, transmission, detection, clinical presentation, presence and class of reaction, and disability were abstracted. Results: The study group ranged from 2 to 14 years of age. The incidence rate and the risk of having leprosy were shown to increase with age. The gender ratio of males to females was 1:1. A positive contact history was documented in 86.4% of cases, with intrafamilial contact type accounting for 98.9% of known cases. The average time to diagnosis was 1.1 years. Paucibacillary leprosy was more common than multibacillary leprosy in this study population. 16.9% of children experienced some type of nerve involvement. 1.9% of all children presented with hypersensitivity reactions, with Type 2 erythema nodosum leprosum reaction being the most common. Conclusions: The minimum incubation period could be two years. Children may be less likely to develop severe forms of leprosy. Males and females may be equally susceptible to contracting the disease from a biological perspective. Close and prolonged contact appears to be necessary for transmission. Nerve involvement and hypersensitivity reactions are relatively uncommon in children.

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This is an Open Access Thesis.

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