The Demography, Clinical Characteristics, and White Blood Analysis of Leprosy Reactions in Multibacillary Leprosy: A Retrospective Study
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Background: Leprosy is a neglected tropical disease caused by chronic granulomatous infection of Mycobacterium leprae. Indonesia ranks third in new case findings, with 84% of the case being multibacillary (MB) leprosy. MB leprosy cases have a higher risk of leprosy reactions and physical disabilities that decrease quality of life. Purpose: To determine the demographic, clinical characteristics, and white blood analysis of newly diagnosed MB leprosy patients, especially concerning leprosy reactions. Methods: This is a descriptive retrospective study with a cross-sectional design that describe the following data: domicile, gender, age, treatment status, disabilities, body mass index (BMI); bacterial index (BI), morphological index (MI), white blood cell (WBC) and differential counts, and thrombocyte count. Result: This study included 176 adult MB cases, predominantly male aged 20–39 years old with average BMI, lived in Surabaya with negative history of multi-drug therapy, disability, BI, nor MI. The grade 2 disability (G2D) percentage in this study setting than in Indonesia (10.7% vs. 6.43%). The WBCs, especially neutrophil count, was higher in T2R group. Monocyte and lymphocyte counts were relatively similar. There was an increase in thrombocyte count in leprosy reaction groups. Conclusion: MB leprosy in the endemic area, which is more commonly found in productive-aged male, displayed higher G2D than global Indonesia population. Thus denotes the importance of active case findings. The difference in blood analysis characteristics between MB leprosy with and without reactions may serve as the foundation for future study.
World Helath Organization. Global leprosy (Hansen disease) update, 2019: time to step up prevention initiatives. Weekly Epidemiological Record 2020:36(95):417–40.
Dinas Kesehatan Provinsi Jawa Timur. Pengendalian penyakit, profil kesehatan Jawa Timur 2019. Surabaya: Dinkes Provinsi Jawa Timur. 2020.
van Brakel WH, Sihombing B, Djarir H, Beise K, Kusumawardhani L, Yulihane R, et al. Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination. Glob Health Action 2012; 1-11.
Gomes L, Morato-Conceiçí£o Y, Gambati A, Maciel-Pereira C, Fontes C. Diagnostic value of neutrophil-to-lymphocyte ratio in patients with leprosy reactions. Heliyon. 2020;6(2):1-6.
Kar HK, Chauhan A. Leprosy reactions: pathogenesis and clinical features. In: Kumar B, Kar HK, editors. IAL Textbook of leprosy. New Delhi: Jaypee Brothers Medical Publishers; 2017. p. 416–40.
de Paula HL, de Souza CDF, Silva SR, Martins-Filho PRS, Barreto JG, Gurgel RQ, et al. Risk factors for physical disability in patients with leprosy: a systematic review and meta-analysis. JAMA Dermatology 2019; 155(10): 1120–8.
Polycarpou A, Walker SL, Lockwood DNJ. A Systematic Review of Immunological Studies of Erythema Nodosum Leprosum. Front Immunol 2017; 8: 233:1-41.
Pratamasari MA, Listiawan MY. Retrospective study: type I leprosy reaction. Berkala Ilmu Kesahatan Kulit dan Kelamin 2015; 27(2): 137–43.
Fransisca C, Zulkarnain I, Ervianti E, Damayanti, Sari M, Budiono, et al. A retrospective study: epidemiology, onset, and duration of erythema nodosum leprosum in Surabaya, Indonesia. BIKKK 2021; 33(1): 8–12.
Listiyawati IT, Sawitri S, Agusni I, Prakoeswa CRS. Terapi kortikosteroid oral pada pasien baru kusta dengan reaksi tipe 2. BIKKK 2015; 27(1): 48–54.
Kementrian Kesehatan RI. Pusat Data dan Informasi Kementrian Kesehatan. Infodatin. Hapuskan stigma dan diskriminasi terhadap kusta. Jakarta: Kementrian Kesehatan Republik Indonesia. 2018.
Salgado CG, de Brito AC, Salgado UI, Spencer SJ. Leprosy. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, Mcmichael AJ, et al., editors. Fitzpatrick's Dermatology in General Medicine. New York: McGrawHill; 2019. p. 2892–925.
Nobre ML, Illarramendi X, Dupnik KM, Hacker M de A, Nery JA da C, Jerí´nimo SMB, et al. Multibacillary leprosy by population groups in Brazil: Lessons from an observational study. PLoS Negl Trop Dis 2017; 11(2): e0005364.
Suchonwanit P, Triamchaisri S, Wittayakornrerk S, Rattanakaemakorn P. Leprosy reaction in Thai population: a 20-year retrospective study. Dermatol Res Pract 2015; 253154.
Liu Y-Y, Yu M-W, Ning Y, Wang H. A study on gender differences in newly detected leprosy cases in Sichuan, China, 2000-2015. Int J Dermatol 2018; 57(12): 1492–9.
Porichha D, Natrajan M. Pathological aspects of leprosy. In: Kumar B, Kar HK, editors. IAL Textbook of leprosy. New Delhi: Jaypee Brothers Medical Publishers; 2017. p. 132–52.
Balagon MVF, Gelber RH, Abalos RM, Cellona R V. Reactions following completion of 1 and 2 year multidrug therapy (MDT). Am J Trop Med Hyg 2010; 83(3): 637–44.
Manandhar R, LeMaster JW, Roche PW. Risk factors for erythema nodosum leprosum. Int J Lepr Other Mycobact Dis 1999; 67(3): 270–8.
Shibuya M, Bergheme G, Passos S, Queiroz I, Ríªgo J, Carvalho LP, et al. Evaluation of monocyte subsets and markers of activation in leprosy reactions. Microbes Infect 2019; 21(2): 94–8.
Delves PJ, Martin SJ, Burton DR, Roitt IM. Roitt's essential immunology. 13th ed. Chichester: John Wiley & Sons, Ltd; 2017.
Yusuf I, Agusni I. Lymphocyte response to mycobacterium leprae antigens in reversal reaction state of leprosy. Indones J Trop Infect Dis 2015; 5(4): 96.
Gupta M, Bhargava M, Kumar S, Mittal MM. Platelet function in leprosy. Int J Lepr other Mycobact Dis Off organ Int Lepr Assoc 1975; 43(4): 327–32.
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