Relevance of reporting leprosy related disability at the completion of multi drug therapy: A 5-year retrospective analysis of disability in persons affected by leprosy at ALERT Hospital Ethiopia

by Bereket Abebayehu Tegene, Thomas Asfaw Atnafu

Background

Leprosy is one of the neglected tropical diseases associated with significant morbidity in endemic regions. It causes disability affecting the daily activities and social participation of affected individuals. Understanding the prevalence and trend of leprosy-related disability throughout the world and the accuracy of disability data counted by WHO is crucial in guiding efforts to be made towards the targets set by WHO to be achieved by 2030. This study aims to show the significance of reporting leprosy-related disability at the end of MDT and critique how disability is counted in the context of WHO data.

Methods

This is a mixed method study with a 5-year retrospective analysis of outcomes of newly diagnosed leprosy patients at ALERT Hospital in Ethiopia from 2016 to 2020. A comparative review and analysis of leprosy related G2D (Grade 2 Disability), globally, regionally, and in Ethiopia using WHO data was also done. In addition, semi-structured interview of health workers (HCWs) and professionals working in the field of leprosy at various organizations was conducted.

Results

The trend of G2D among newly diagnosed leprosy patients shows no decline globally for the past 20 years. It is increasing in Africa and stable in the Southeast Asian and American regions where majority of leprosy patients are found showing the gap in early case identification and prompt treatment of leprosy cases. The total number of newly diagnosed leprosy cases at ALERT hospital between January 2016 and December 2020 were 1032 and among those patients who had completed treatment the prevalence of G2D was 33% at diagnosis and 23% at completion. The interview has also shown gaps in the completeness and quality of disability data reported to WHO and how disability is counted.

Conclusion

Leprosy related G2D among newly diagnosed patient is not declining worldwide and even increasing in endemic regions like Ethiopia. More training should be given to health professionals in assessing disability. WHO should make some changes in the way it counts disability as the current definitions are prone to interpretation bias and lacks uniformity among various programmes and health workers. Prospective studies are needed in assessing disability progression post MDT so as design interventions and strategies in preventing worsening of disability after patients are discharged from treatment centre.