Background:
Leprosy, or Hansen’s disease (HD), is a chronic infection of the skin and peripheral nerves caused by Mycobacterium leprae (M. leprae) and Mycobacterium lepromatosis. The disease also affects other organs, including the eyes, mucosae, bones, and testes. The complications from neurological damage result in permanent deformities and disabilities. South Africa is in a post-elimination phase of leprosy, but lingering pockets of infection may reverse such gains if they continue to grow unchecked.
Objectives:
To study the epidemiology and clinical characteristics of leprosy patients at Mankweng Hospital, the referral treatment centre for leprosy in Limpopo Province, South Africa.
Methods:
This study was a retrospective cross-sectional study of the records of all leprosy patients from 2007 to 2020. Secondary data was obtained from patient hospital files and dermatology departmental records. Descriptive methods were used to analyse the epidemiology and clinical characteristics of leprosy patients.
Results:
A total of 36 records were evaluated. There were more females (n = 20, 56%) than males (n = 16, 44%). The median age was 35 years (range: 8 to 85). The majority of the patients, 22 (62%), were young adults between 20 and 50 years of age. There were only five (n = 5, 14%) children under 15 years of age. Vhembe district had the greatest number of patients at 16, representing 44% of all cases (though some (11%) cases were originally from outside South Africa). Half of the patients (n = 18, 50%) were diagnosed at tertiary hospitals. There was high transmission among family members, representing 21 cases (57%). Seventeen (n = 17, 47%) had skin lesions for less than 1 year, while nine (25%) had lesions for 2 to 5 years before the diagnosis was made. Fifteen (n = 15) new cases were diagnosed during a 10-year period. Thirteen (36%) patients had the lepromatous leprosy type, which was the most common. Most cases, 29 (80%), had disabilities. Twenty-eight (28) patients completed multidrug therapy, translating to a 77% treatment completion rate.
Conclusions:
The clustering of leprosy cases in Vhembe district and the high transmission rate among family members are issues of concern. The high prevalence of the highly infectious lepromatous leprosy, along with delays in seeking treatment, is likely to hamper control efforts, leading to possible resurgence. This study calls for streamlined efforts to increase awareness among health professionals and other stakeholders in order to intensify contact tracing and prophylactic treatment to prevent the spread of leprosy and the disabilities associated with this disease.
Author Contributions
Conceptualization, A.R.S.-R. and M.A.L.; methodology, A.R.S.-R., M.A.L. and R.M.; software, A.R.S.-R., M.A.L. and R.M.; validation, M.A.L.; formal analysis, A.R.S.-R., M.A.L. and R.M.; investigation, A.R.S.-R., resources, A.R.S.-R., M.A.L. and R.M.; data curation, A.R.S.-R., and R.M.; writing—original draft preparation, A.R.S.-R., and R.M.; writing—review and editing, A.R.S.-R. and M.A.L.; visualization, A.R.S.-R., M.A.L. and R.M.; supervision, M.A.L.; project administration, A.R.S.-R. and R.M. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of PIETERSBURG/MANKWENG COMPLEX RESEARCH ETHICS COMMITTEE (PMREC 25 AUGUST UL 2021/C, 25 August 2021).
Informed Consent Statement
Waiver of consent was granted by Polokwane/Mankweng Complex Research Ethics Committee for this retrospective study (secondary data).
Data Availability Statement
Data will be available from the corresponding author on request.
Conflicts of Interest
The authors declare no conflicts of interest.
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