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| | ORIGINAL CONTRIBUTIONS | | | | | Year : 1990 | Volume : 56 | Issue : 3 | Page : 213-215 | Age of onset of leprosy
K Pramod Nigam, Uttera Sehgal, V Ramesh, RS Misra
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Correspondence Address:
K Pramod Nigam
The age of onset of leprosy was studied in 1012 consecutive patients. Although no age was exempt, majority of the patients had onset of their disease during the 10-29 years of age. There was no significant difference in the mean age pf onset of leprosy among males and females. The paucibacillary group had significantly lower age of onset as compared to multibacillary cases. The comparison of other studies on age of onset from India and elsewhere showed that this varies in different regions within the country, on different times at the same place, as well as from country to country.
Keywords: Age of onset, Variations, Leprosy.
How to cite this article:
Nigam K P, Sehgal U, Ramesh V, Misra R S. Age of onset of leprosy. Indian J Dermatol Venereol Leprol 1990;56:213-5 |
Although study of the age of onset of leprosy is merely a subjective information based upon the memory, awareness and intelligence of the patient and his attendants, it is an important epidemiological tool to study the incubation period of this disease. There are conflicting reports regarding the age of onset of leprosy. Although it is widely accepted that younger people have a greater chance of contracting the disease, both infants and old people are known to be affected with leprosy. This is interesting as regional variations do characterize the disease. An attempt was made to determine the age of onset of leprosy in its different clinical forms and sex in a large number of leprosy patients.
| Material and Methods | |  |
One thousand and twelve consecutive leprosy patients attending our leprosy clinic during the years 1984 to 1987 were included in the study. The patients were briefed about the usual clinical manifestations and mode of onset of different types of leprosy and their reactional episodes. They were asked to recall the time of appearance of the earliest manifestation of the disease. Also, the help of one or more persons such as the parent, guardian, a close family member or a close friend was taken especially when the patient was a minor. Since majority of the patients in our study belonged to the neighbouring and distant states, domiciliary visits were not possible. On the basis of the clinical findings, slit smear examination for AFB and histopathological features, the patients were categorized into eight groups : 1. Indeterminate (I), 2. Neuritic (N), inclusive of both mono and polyneuritic, 3. Maculo-anaesthetic (MA), 4. Tuberculoid (TT), 5. Borderline tuberculoid leprosy forming the paucibacillary group, and 6. Borderline or Dimorphous (BB), 7. Borderline lepromatous (BL), and 8. Lepromatous leprosy (LL) comprising the multibacillary group. The data was analysed using the Student's 't' test.
| Results | | |
The distribution of the various groups of the age of onset in the different types of leprosy among the patients is shown in [Table - 1]. One thousand and twelve patients comprised of 852 males and 160 females. The borderline tuberculoid (BT) group comprised the largest group with 242 patients while maculo-anaesthetic (MA) group was the smallest group with 20 subjects. The age of onset of leprosy ranged from 2 years to 81 years (Mean ± SD - 29.96 ± 14.57 years). The mean age of onset wa 29.78 ± 13.08 years in the males and 30.9215.49 years in the females. There was n significant difference in the sex and the mean age of onset of leprosy (t = 0.981; p > 05,
The mean age of onset in the different clinical groups is shown in [Table - 2]. Majority (62%) of the patients among the paucibacillary cases had onset of their disease during the 10-29 years of age while multibacillary group most (50%) of the patients acquired the disease in the 20-39 years of age. The mean age of onset for paucibacillary and multibacillary groups was 27.36 ± 12.78 years and 32.60 ± 15.05 years respectively. The difference in the mean age of onset between these two groups was statistically highly significant ( t = 5.97; p < 0.001).
| Comments | | |
The present study showed that leprosy occurs at all ages, though the maximum number of our patients got their disease between 10 and 29 years. The paucibacillary type of leprosy was contracted at a significantly earlier age as compared to the multibacillary disease. The mean age of onset for the neuritic type (30.54 years) was different from the other previous reports where it appeared much later.[1],[2]
The results of this study are similar to some of the other Indian studies,[1],[3] tough involvement of the older age-group[4],[5] and children[6] has also been reported. This indicates that the age of onset differs from place, to place in the same country. In addition, the age of onset has shown variations when the studies were conducted at different times in the same area of Chingleput.[6],.[7] Similar variations were also seen when our results were compared with a previous study[8] conducted at New Delhi. Likewise variations are also seen when the comparison is made from different countries.[9],[10],[11],[12] A higher incidence of leprosy in children less than 10 years of age has been observed in Rangoon12 and Philippines.10
In our study only 20% of the patients were local inhabitants while nearly 80% of them belonged to the neighbouring non-endemic and distant endemic states who come to the city in search of better treatment facilities. Still, surprisingly when the age of onset of leprosy for the local inhabitants were studied separatelyt[13], the results were comparable to the whole study.
| References | | |
| 1. | Sehgal VN, Rege VL and Singh KP : The age of onset of leprosy, Internat J Leprosy, 1977; 45:52-55.  | | 2. | Noordenn SK : Epidemiology of neuritic type of leprosy, Leprosy India, 1972; 44 : 90-96. | | 3. | Verma AK and Prasad BG : Some observations on the age of onset of leprosy, Leprosy Rev, 1967; 38 : 238-241. | | 4. | Sehgal VN : A study of age at onset of leprosy, Internat J Dermatol, 1970; 9 : 196-199. | | 5. | Guha PK, Pandey SS, Singh G et al : Age of onset of leprosy, Leprosy India, 1981; 53 : 83-86. | | 6. | Mohamed Ali P : The age of onset of leprosy, Leprosy Rev, 1964; 35 : 193-197. | | 7. | Cochrane RG (Quoted in 11). | | 8. | Sehgal VN, Koranne RV, Sharma AK et al : Age of onset of leprosy (an analytical data from north India), Leprosy India, 1982 : 54 : 332-337. | | 9. | Innes JR : A leprosy survey in the island of Malaita, Br Soloman islands, Internat J Leprosy, 1938; 6 501-513. | | 10. | Guinto RS and Rodriguez JN : Field study of leprosy in Talisay Cebu, Philippines, Internat J Leprosy, 1941; 9 : 149-166. | | 11. | Badger LF : Epidemiology, in : Leprosy in Theory and Practice, 2nd Editors, Cochrane RG and Davey TF, John Wright, Bristol, 1964; p 76-77. | | 12. | Lewis RA and Edwards R : A statistical study of 1000 cases of leprosy observed in Rangoon for approx 2 years, Internat J Leprosy, 1958; 26 : 236-251. | | 13. | Misra RS and Ramesh V : Leprosy in the union territory of Delhi, Ind J Leprosy, 1987; 59 : 293-299. |
Tables [Table - 1], [Table - 2] |
