New cases of leprosy at the Marchoux Institute: a comparative study 1988-1997.

Background, The prevalence of leprosy had declined greatly over the last de cade. The purpose of this work was to determine whether changes in the epid emiology, clinical and bacteriological patterns occurred among patients wit h leprosy treated at the Marchoux Institute in 1988 and in 1997 Patients and methods. We conducted a descriptive cross-sectional study, rev iewing retrospectively all tiles of patients with leprosy seen in 1988 in c omparison with a prospective series of leprosy patients seen in 1997. Only new cases of leprosy, prior to treatment and with skin and/or nervous lesio ns irrespective of the bacilloscopy results, were included in the two serie s. Results. We included 93 patients among 246 patient files in 1988. There wer e 119 new cases in 1997 The following variables showed changes: mean delay to consultation (41.2 months in 1988 versus 26.1 months in 1997; patient's suspicion of having leprosy (93 patients in 1988 venus 22 in 1997); notion of contact (35 cases in 1988 Versus 45 in 1997). Multibacilli leprosy predo minated over paucibacilli leprosy in 1988 (51 versus 42 cases). This trend was inverted in 1997 (44 versus 75) (p <0.009). Patients with grade 2 handi cap were more numerous in 1988 (20 cases versus 2 cases, p <0.001). Conclusion, These findings demonstrate a change in the epidemiology, clinic al and bacilloscopic pattern of patients with leprosy from 1988 to 1997.