Lockwood, Diana N, McIntosh, Amy, Checkley, Anna M, Walker, Stephen L and Mcbride, Angela (2022) Diagnosing and treating leprosy in a non-endemic setting in a national centre, London, United Kingdom 1995-2018. PLoS Neglected Tropical Diseases. pp. 1-13. ISSN 1935-2727

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Abstract

Background
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.

Methods
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.

Results
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).

Conclusion
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.

Item Type:	Article
Schools and Departments:	Brighton and Sussex Medical School > Global Health and Infection
SWORD Depositor:	Mx Elements Account
Depositing User:	Mx Elements Account
Date Deposited:	30 Sep 2022 09:50
Last Modified:	27 Apr 2023 10:54
URI:	http://sro.sussex.ac.uk/id/eprint/108239

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