Leprosy in Children: Epidemiological, Clinical, Therapeutic and Evolutionary Aspects in the Macompo Anti-Leprosy Center, Dubreka Health District, Guinea

Abstract

Introduction: Leprosy in children is closely correlated with recent diseases and active foci of transmission in the community, particularly in families living in the same household. The objectives of this study were to describe the demographic, clinical, therapeutic, and evolutionary epidemiological profiles of leprosy in children aged ≤ 17 years in the Macompo anti-leper center in the Dubreka health district.   Materials and Methods: This was a 6 years (January 2011 - December 2016) descriptive retrospective study of the records of child patients followed for the management of leprosy. Included in the study were records of patients aged ≤ 17 years diagnosed with leprosy regardless of sex and origin and who may or may not have benefited from antileprosy chemotherapy. Results: We collected 39 cases of leprosy out of 114 children identified, i.e. a prevalence of 34.2%. The annual detection rate in children varies ranging from 0.4 cases in 2011 to 0.8 cases in 2016 and has always remained below 1 case/10,000 inhabitants. The average age of children was 12 years with extremes of 5 and 17 years. The age group of 12 - 17 years (79.5%) was the most affected. There was no gender predominance (51.3% male) with a sex ratio of 1.1. Out-of-school children (53.8%) were the most affected and the majority lived in the urban commune (71.8%). The consultation time varied between 6 and 10 months (61.5%). No child had a history of leprosy.  Clinically the lesions were present in the form of macules (100%) plaques (56.4%) and infiltrations (23.1%). The type 2 leprosy reaction (61.5%) was the most common with 61.5% of degree 2 disability. Neurological signs were dominated by neuritis (17.9%) and nerve hypertrophy (5.1%).  Multibacillary leprosy (61.5%) was the most observed. All children (100%) were on Polychemotherapy (PCT) for 12 months after which 98.9% of the children were cured. Conclusions: The high proportion of children with leprosy and the predominance of multibacillary forms are factors in the spread of the disease.