English summay of: "Leprosy in children in Pando Department, Bolivia"

Leprosy Mailing List, June 15th, 2008

Ref.: English summay of: "Leprosy in children in Pando Department, Bolivia"
From: Eggens H., Amsterdam, The Netherlands
Dear Salvatore,
I have translated the summary of Dr Villarreal's article on child leprosy in Pando Dept., Bolivia. Please find it below. A short comment of mine will follow with the next message. Greetings.
Henk
Henk Eggens, MD MPHSenior adviser public healthRoyal Tropical InstituteAmsterdam, The Netherlands


Epidemiological leprosy situation in children under 15 years of age in Pando Department, Bolivia
Villarreal,M.E*.; Bustillos,J**.; Rios, L***.; Iquize,C***.; Franco,M.C***.; Isita,D.***
(* Dermatologist COINFA,** Director COINFA,*** Personal SEDES Pando.)

Summary:
Leprosy in children is an infrequent disease; its diagnosis requires good clinical skills. It is difficult to diagnose in children under 14 years of age, because its appearance is limited to maculae that can be overlooked or can be confounded with another disease.

Objective:
The objective of this study was to analyse the epidemiological leprosy situation in children under 15 years in Pando Department. A retrospective descriptive study was used as study design, with clinical histories as basis for information. Fifty-eight clinical histories were studied; age, sex, initial skin lesion, patient delay and clinical appearance were analysed.

Results:
In the period of March 2007-February 2008, 202 new leprosy cases were registered in Pando Department. Fifty-eight of them were children under 15 years of age, 20 boys and 38 girls. Eighty-four percent presented maculae, most frequently in the face (33%). The most common clinical presentation was indeterminate (54%). Eighteen percent had Grade One disability and in 34 % a skin smear was taken. Clinical appearance and epidemiology were the pillars of diagnosis.

Conclusions:
Leprosy is among the re-emerging diseases in our country and worldwide. Child leprosy is not limited to clinical disease characteristics, but is linked to epidemiology, public health and health education. Child leprosy is a direct indicator of the magnitude of disease transmission and of the effectiveness of control programme activities, in the sense that it reflects an important active transmission and a low coverage of activities of case detection and early treatment.