Epidemiological and Clinical Features of Leprosy Reactions and Associated Risk Factors in Malagasy People from 2012 to 2021
Mendrika Fifaliana Rakotoarisaona,
Malalaniaina Andrianarison,
Onivola Raharolahy,
Fandresena Arilala Sendrasoa,
Volatantely Ratovonjanahary,
Naina Harinjara Razanakoto,
Moril Sata,
Irina Mamisoa Ranaivo,
Fahafahantsoa Rapelanoro Rabenja,
Lala Soavina Ramarozatovo
Issue:
Volume 6, Issue 1, June 2023
Pages:
1-9
Received:
3 February 2023
Accepted:
25 February 2023
Published:
9 March 2023
Abstract: Introduction: Leprosy is a transmissible infectious disease while cutaneous and neurological manifestations vary according to the patient's immunity. It is a chronic disease with acute immunological complication called leprosy reactions. Leprosy remains endemic in Madagascar. The objective of this study is to characterize the epidemiological and clinical profile of leprosy and leprosy reactions and to determine the risk factors for leprosy reactions. Methods: This was a retrospective, case-control study over a period of 10 years from January 2012 to December 2021 conducted among leprosy patients of the University Hospital Joseph Raseta Befelatanana. Univariate and multivariate logistic regression was used to determine the risk factors for leprosy reactions. Results: Of the 161 patients selected, 53 patients had a leprosy reaction. There were 91 males and 70 females with a mean age of 35.8 years (±15,47). The borderline lepromatous type was the most common clinical form. The prevalence of lepromatous reaction was 33%. Type 1 and type 2 reactions were found in 41.50% and 45.28% of cases respectively. The average time to develop leprosy reactions after the initiation of multidrug therapy was 5.80 months (±3.91). From multivariate analysis, the risk factors identified were: male gender [OR=2.64 (95% CI: 1.80-9.57), p=0.02], positive BI [OR=3.53 (95% CI: 2.41-48.98), p=0.02], MB treatment regimen [OR=8.87 (95% CI: 1.23-3.57), p=0.008)], and poor adherence to treatment [OR=1.97 (95% CI: 1.34-12.95), p=0.0354]. Conclusion: The knowledge of these risk factors allows for early diagnosis and treatment of leprosy reactions to prevent the morbidities due to leprae disease such as amputations and disabilities that are a source of stigma.
Abstract: Introduction: Leprosy is a transmissible infectious disease while cutaneous and neurological manifestations vary according to the patient's immunity. It is a chronic disease with acute immunological complication called leprosy reactions. Leprosy remains endemic in Madagascar. The objective of this study is to characterize the epidemiological and cl...
Show More
Donovanosis – A Case Report with a Review of Literature
Hristo Mangarov,
Valentina Broshtilova,
Atanas Batashki,
Yoanna Velevska,
Petar Vatov,
Svetlana Bezhanova,
Irina Iungareva,
Sonya Marina
Issue:
Volume 6, Issue 1, June 2023
Pages:
10-13
Received:
9 June 2023
Accepted:
28 June 2023
Published:
6 July 2023
Abstract: Donovanosis (Granuloma inguinale) is a sexually transmitted bacterial infection affecting the genital, perineal, and perianal regions. It is caused by Klebsiella granulomatis, formerly known as Donovania granulomatis and Calymmatobacterium granulomatis. Without treatment, the infection followed a chronic progressive course with the formation of ulcerations. Upon chronification, severe tissue destruction occurs and malignant transformation is possible. Healing is complete with timely diagnosis and treatment. Donovanosis has not been reported in Bulgaria and herein, we present the first clinical case of this "exotic" for our country sexually transmitted bacterial infection. Our patient was a 38-year-old man of Nigerian origin. The dermatological status is represented by papular and erosive-ulcerative lesions on the skin of the foreskin, the body of the penis, the scrotum and the lower abdomen. Upon Giemsa staining of ulcus material, Donovan corpuscles are found in monocytes. The histopathological examination a lesion demonstrated irregular acanthosis, focal dyskeratosis in the lower epidermal segment, moderate spongiosis, papillary oedema, edema swollen endothelium obstructing the vessels of small and medium caliber, abundant granulomatous tuberculoid infiltrate of epithelioid cells and lymphocytes around the blood vessels in the middle dermis and interstitial. Infectious granulomas are represented by tissue macrophages, epithelioid cells and lymphocytes located around areas of collagen necrosis. Based on the anamnesis, dermatological status and examinations, the diagnosis of donovanosis was made. Epithelialization of the ulks occurred after an extended course of systemic treatment with doxycyclin for 20 days, followed by azax for 7 days. The topical treatment included baths with potassium permanganate and fusidine cream.
Abstract: Donovanosis (Granuloma inguinale) is a sexually transmitted bacterial infection affecting the genital, perineal, and perianal regions. It is caused by Klebsiella granulomatis, formerly known as Donovania granulomatis and Calymmatobacterium granulomatis. Without treatment, the infection followed a chronic progressive course with the formation of ulc...
Show More
