Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018.
<h4>Background</h4>Leprosy is rare in the United Kingdom (UK), but migration from endemic countries results in new cases being diagnosed each year. We documented the clinical presentation of leprosy in a non-endemic setting.<h4>Methods</h4>Demographic and clinical data on all...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-10-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0010799 |
| _version_ | 1797984785263493120 |
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| author | Diana N Lockwood Amy McIntosh Margaret Armstrong Anna M Checkley Stephen L Walker Angela McBride |
| author_facet | Diana N Lockwood Amy McIntosh Margaret Armstrong Anna M Checkley Stephen L Walker Angela McBride |
| author_sort | Diana N Lockwood |
| collection | DOAJ |
| description | <h4>Background</h4>Leprosy is rare in the United Kingdom (UK), but migration from endemic countries results in new cases being diagnosed each year. We documented the clinical presentation of leprosy in a non-endemic setting.<h4>Methods</h4>Demographic and clinical data on all new cases of leprosy managed in the Leprosy Clinic at the Hospital for Tropical Diseases, London between 1995 and 2018 were analysed.<h4>Results</h4>157 individuals with a median age of 34 (range 13-85) years were included. 67.5% were male. Patients came from 34 different countries and most contracted leprosy before migrating to the UK. Eighty-two (51.6%) acquired the infection in India, Sri Lanka, Bangladesh, Nepal and Pakistan. 30 patients (19.1%) acquired leprosy in Africa, including 11 from Nigeria. Seven patients were born in Europe; three acquired their leprosy infection in Africa, three in South East Asia, and one in Europe. The mean interval between arrival in the UK and symptom onset was 5.87 years (SD 10.33), the longest time to diagnosis was 20 years. Borderline tuberculoid leprosy (n = 71, 42.0%), and lepromatous leprosy (n =, 53 33.1%) were the commonest Ridley Jopling types. Dermatologists were the specialists diagnosing leprosy most often. Individuals were treated with World Health Organization recommended drug regimens (rifampicin, dapsone and clofazimine).<h4>Conclusion</h4>Leprosy is not a disease of travellers but develops after residence in an leprosy endemic area. The number of individuals from a leprosy endemic country reflect both the leprosy prevalence and the migration rates to the United Kingdom. There are challenges in diagnosing leprosy in non-endemic areas and clinicians need to recognise the symptoms and signs of leprosy. |
| first_indexed | 2024-04-11T07:08:11Z |
| format | Article |
| id | doaj.art-b460cae293c043909775dc924189480f |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-04-11T07:08:11Z |
| publishDate | 2022-10-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-b460cae293c043909775dc924189480f2022-12-22T04:38:21ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352022-10-011610e001079910.1371/journal.pntd.0010799Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018.Diana N LockwoodAmy McIntoshMargaret ArmstrongAnna M CheckleyStephen L WalkerAngela McBride<h4>Background</h4>Leprosy is rare in the United Kingdom (UK), but migration from endemic countries results in new cases being diagnosed each year. We documented the clinical presentation of leprosy in a non-endemic setting.<h4>Methods</h4>Demographic and clinical data on all new cases of leprosy managed in the Leprosy Clinic at the Hospital for Tropical Diseases, London between 1995 and 2018 were analysed.<h4>Results</h4>157 individuals with a median age of 34 (range 13-85) years were included. 67.5% were male. Patients came from 34 different countries and most contracted leprosy before migrating to the UK. Eighty-two (51.6%) acquired the infection in India, Sri Lanka, Bangladesh, Nepal and Pakistan. 30 patients (19.1%) acquired leprosy in Africa, including 11 from Nigeria. Seven patients were born in Europe; three acquired their leprosy infection in Africa, three in South East Asia, and one in Europe. The mean interval between arrival in the UK and symptom onset was 5.87 years (SD 10.33), the longest time to diagnosis was 20 years. Borderline tuberculoid leprosy (n = 71, 42.0%), and lepromatous leprosy (n =, 53 33.1%) were the commonest Ridley Jopling types. Dermatologists were the specialists diagnosing leprosy most often. Individuals were treated with World Health Organization recommended drug regimens (rifampicin, dapsone and clofazimine).<h4>Conclusion</h4>Leprosy is not a disease of travellers but develops after residence in an leprosy endemic area. The number of individuals from a leprosy endemic country reflect both the leprosy prevalence and the migration rates to the United Kingdom. There are challenges in diagnosing leprosy in non-endemic areas and clinicians need to recognise the symptoms and signs of leprosy.https://doi.org/10.1371/journal.pntd.0010799 |
| spellingShingle | Diana N Lockwood Amy McIntosh Margaret Armstrong Anna M Checkley Stephen L Walker Angela McBride Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018. PLoS Neglected Tropical Diseases |
| title | Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018. |
| title_full | Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018. |
| title_fullStr | Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018. |
| title_full_unstemmed | Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018. |
| title_short | Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018. |
| title_sort | diagnosing and treating leprosy in a non endemic setting in a national centre london united kingdom 1995 2018 |
| url | https://doi.org/10.1371/journal.pntd.0010799 |
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