The effect of leprosy-induced deformity on the nutritional status of indexcases and their household members in rural South India: a socio-economic perspective

Objectives: To determine whether the socioeconomic and nutritional status o f cured leprosy patients with residual deformity, and their household membe rs, was lower than that of cured leprosy patients without deformity. Design: Cross-sectional study. Subjects: One hundred and fifty-five index cases with deformity, 100 withou t deformity. Also 616 household members comprising 48% of the total members enumerated. Measurements: Nutritional status was evaluated using anthropometry. Disease characteristics, socio-economic parameters and household information were recorded using a questionnaire. Results: Index cases with deformity had lower community acceptance (P < 0.0 01), and employment (P < 0.001) than those cases without deformity. Househo lds of index cases with deformity had a lower income (P < 0.01) and a lower expenditure on food (P < 0.05). The presence of deformity (odds ratio (OR) : 2.1-3.2, P < 0.01), unemployment (OR: 2.3-4.3, P < 0.01) and female gende r (OR: 2.4, P < 0.01) significantly increased the risk of index cases being undernourished, as judged by body mass index (BMI) alone, or BMI and mid-u pper arm circumference. A low BMI ( <18.5) in the index case significantly increased the odds of other adults (OR 2.2), adolescents (OR 2.9-3.8) and c hildren (OR 2.2) in the household being undernourished. Conclusions: Cured leprosy index cases with physical deformity are more und ernourished than index cases without deformity. This is associated with a r educed expenditure on food, possibly brought on by increased unemployment, and a loss of income. Undernutrition in the index case increases the risk o f undernutrition in other members of the family.