Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study
Background. Although leprosy, a neglected tropical disease, has been eliminated (<1 case per 10 000 population) in South Africa (SA) since 1926, according to the World Health Organization, new cases continue to be reported. The management of leprosy poses several challenges, including patien...
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South African Medical Association
2024-05-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1630 |
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| author | J S Sons Z N Mkhize N C Dlova C Aldous P R Bhat A V Chateau |
| author_facet | J S Sons Z N Mkhize N C Dlova C Aldous P R Bhat A V Chateau |
| author_sort | J S Sons |
| collection | DOAJ |
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Background. Although leprosy, a neglected tropical disease, has been eliminated (<1 case per 10 000 population) in South Africa (SA) since 1926, according to the World Health Organization, new cases continue to be reported. The management of leprosy poses several challenges, including patient adherence, education and insufficient training of healthcare practitioners.
Objectives. To describe the biographical profile, clinical manifestations and treatment outcomes in patients with leprosy in KwaZulu-Natal Province.
Methods. This retrospective study aimed to analyse the clinical data of leprosy patients in SA from 2002 to 2022. Data collected included patient demographics, comorbidities, cutaneous and neurological manifestations of leprosy, complications, treatment and adverse reactions. Descriptive statistics were used to summarise the data.
Results. The study analysed the clinical data of 194 leprosy patients from 2002 to 2022. The majority of patients were male and middle aged, with a disproportionate representation of black South Africans. Regarding socioeconomic status, 80% were unemployed and 40% were social grant recipients. Most cases were clustered in urban centres and diagnosed at secondary care facilities, with 15% being HIV positive. The majority of patients (90%) were classified as having multibacillary leprosy. Common symptoms included upper respiratory tract involvement, hair loss and painful nerves, with the face and limbs being most frequently affected. Cutaneous morphology predominantly included plaques and hypopigmented patches, while neurological signs included ulnar nerve tenderness, muscle weakness and sensory deficits. Debilitating neurological complications were found in one-fifth of patients. Despite initiation of multidrug therapy in most patients, a significant proportion (27.3%) did not complete the full course of treatment, and treatment reactions were noted in 33.5% of patients.
Conclusion. These findings emphasise the urgent need for enhanced patient and healthcare worker education, particularly in primary healthcare settings, to improve adherence to treatment, advocate for prophylactic measures and prevent new cases. Achieving leprosy-free status in SA requires the collaboration of many role-players to address these challenges and improve healthcare practices.
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| format | Article |
| id | doaj-art-bd0768b5624f45a7b7bae7c61afc481c |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-bd0768b5624f45a7b7bae7c61afc481c2025-02-10T12:26:10ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-05-01114510.7196/SAMJ.2024.v114i5.1630Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective studyJ S Sons0https://orcid.org/0000-0002-6559-8491Z N Mkhize1https://orcid.org/0000-0002-7040-3660N C Dlova2https://orcid.org/0000-0002-2425-3905C Aldous3https://orcid.org/0000-0002-7199-9160P R Bhat4https://orcid.org/0000-0003-2566-5765A V Chateau5https://orcid.org/0000-0001-9825-6191Department of Dermatology, King Edward VIII Hospital, University of KwaZulu-Natal, Nelson R Mandela School of Clinical Medicine, Durban, South AfricaDepartment of Dermatology, Harry Gwala Regional Hospital, Pietermaritzburg, Nelson R Mandela School of Medicine, University of KwaZulu- Natal, Durban, South AfricaDepartment of Dermatology, King Edward VIII Hospital, University of KwaZulu-Natal, Nelson R Mandela School of Clinical Medicine, Durban, South AfricaDepartment of Clinical Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South AfricaDepartment of Dermatology, Father Muller Medical College, Mangalore, Karnataka, IndiaDepartment of Dermatology, Grey’s Hospital, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, South Africa Background. Although leprosy, a neglected tropical disease, has been eliminated (<1 case per 10 000 population) in South Africa (SA) since 1926, according to the World Health Organization, new cases continue to be reported. The management of leprosy poses several challenges, including patient adherence, education and insufficient training of healthcare practitioners. Objectives. To describe the biographical profile, clinical manifestations and treatment outcomes in patients with leprosy in KwaZulu-Natal Province. Methods. This retrospective study aimed to analyse the clinical data of leprosy patients in SA from 2002 to 2022. Data collected included patient demographics, comorbidities, cutaneous and neurological manifestations of leprosy, complications, treatment and adverse reactions. Descriptive statistics were used to summarise the data. Results. The study analysed the clinical data of 194 leprosy patients from 2002 to 2022. The majority of patients were male and middle aged, with a disproportionate representation of black South Africans. Regarding socioeconomic status, 80% were unemployed and 40% were social grant recipients. Most cases were clustered in urban centres and diagnosed at secondary care facilities, with 15% being HIV positive. The majority of patients (90%) were classified as having multibacillary leprosy. Common symptoms included upper respiratory tract involvement, hair loss and painful nerves, with the face and limbs being most frequently affected. Cutaneous morphology predominantly included plaques and hypopigmented patches, while neurological signs included ulnar nerve tenderness, muscle weakness and sensory deficits. Debilitating neurological complications were found in one-fifth of patients. Despite initiation of multidrug therapy in most patients, a significant proportion (27.3%) did not complete the full course of treatment, and treatment reactions were noted in 33.5% of patients. Conclusion. These findings emphasise the urgent need for enhanced patient and healthcare worker education, particularly in primary healthcare settings, to improve adherence to treatment, advocate for prophylactic measures and prevent new cases. Achieving leprosy-free status in SA requires the collaboration of many role-players to address these challenges and improve healthcare practices. https://samajournals.co.za/index.php/samj/article/view/1630LeprosyDermatologyInfectious diseases |
| spellingShingle | J S Sons Z N Mkhize N C Dlova C Aldous P R Bhat A V Chateau Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study South African Medical Journal Leprosy Dermatology Infectious diseases |
| title | Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study |
| title_full | Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study |
| title_fullStr | Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study |
| title_full_unstemmed | Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study |
| title_short | Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study |
| title_sort | characteristics clinical manifestations and management of leprosy in kwazulu natal south africa a 20 year retrospective study |
| topic | Leprosy Dermatology Infectious diseases |
| url | https://samajournals.co.za/index.php/samj/article/view/1630 |
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