Risk Factors of Type 1 Leprosy Reaction in Leprosy Patients attending Leprosy Division of Dermatology and Venereology Outpatient Clinic of Dr Soetomo General Hospital in 2017–2019: A Retrospective Study

Authors

  • Brigita Rosdiana Department of Dermatology and Venereology, Universitas Airlangga, Dr. Soetomo General Academic Teaching Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Linda Astari Department of Dermatology and Venereology, Universitas Airlangga, Dr. Soetomo General Academic Teaching Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Astindari Astindari Department of Dermatology and Venereology, Universitas Airlangga, Dr. Soetomo General Academic Teaching Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Cita Rosita Sigit Prakoeswa Department of Dermatology and Venereology, Universitas Airlangga, Dr. Soetomo General Academic Teaching Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Iskandar Zulkarnain Department of Dermatology and Venereology, Universitas Airlangga, Dr. Soetomo General Academic Teaching Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Damayanti Damayanti Department of Dermatology and Venereology, Universitas Airlangga, Dr. Soetomo General Academic Teaching Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
  • Budi Utomo Department of Public Health Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
  • M. Yulianto Listiawan Department of Dermatology and Venereology, Universitas Airlangga, Dr. Soetomo General Academic Teaching Hospital, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.7201

Keywords:

Leprosy, Mycobacterium leprae, Type 1 reaction, Cellular-mediated immunity

Abstract

BACKGROUND: Type 1 leprosy reaction is a delayed hypersensitivity reaction caused by increased response of cellular-mediated immunity to Mycobacterium leprae. Manifestations include skin and nerve lesions, edema, and permanent disabilities. There are several risk factors that should be recognized to prevent disabilities.

AIM: The aim of this study was to analyze the relationship of risk factors to the occurrence of type 1 leprosy reaction in leprosy patients treated at the Outpatient Clinic of Dr. Soetomo General Hospital.

METHODS: This study was an analytical study with retrospective observational study design. Data were secondary from the medical records of leprosy patients at the Outpatient Clinic of Dr. Soetomo General Hospital from January 2017 to December 2019.

RESULTS: Out of 364 patients in the Outpatient Clinic, 190 (52.2%) had leprosy without a reaction and 65 (17.9%) had type 1 reaction. Analysis showed that age, leprosy type, and treatment regimen were significantly associated with the incidence of type 1 reaction (p = 0.023; 0.003 and 0.004, respectively), with the leprosy type as the most dominant risk factor. Age 15–34 years old; leprosy types BB, BL, and BT; and the MB MDTL therapeutic regimen are risk factors for the occurrence of type I leprosy reaction.

CONCLUSION: There is a statistically significant correlation between the risk factor and the occurrence of type 1 leprosy reaction in leprosy patient. The risk factor that has significant correlation is age 15–34 years; leprosy types BB, BL, and BT; and the MB MDTL therapeutic regimen. The most significant risk factor for the occurrence of type 1 leprosy reaction from our study is the type of leprosy (BB, BL, and BT).

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Kar HK, Kumar B. IAL Textbook of Leprosy. New Delhi: Jaypee Brothers Medical Publishers; 2010.

da Nery JA, Filho FB, Quintanilha J, Machado AM, de Oliveira SS, Sales AM. Understanding the Type 1 reactional state for early diagnosis and treatment: A way to avoid disability in leprosy. An Bras Dermatol. 2013;88(5):787-92. http://doi.org/10.1590/abd1806-4841.20132004 PMid:24173185 DOI: https://doi.org/10.1590/abd1806-4841.20132004

Suchonwanit P, Triamchaisri S, Wittayakornrerk S, Rattanakaemakorn P. Leprosy reaction in Thai population: A 20-year retrospective study. Dermatol Res Pract. 2015;2015:253154. http://doi.org/10.1155/2015/253154 PMid:26508912 DOI: https://doi.org/10.1155/2015/253154

World Health Organization. Santé WHO O Mondiale de la. Global Leprosy Update, 2018: Moving towards a Leprosy-free World Situation de la Lèpre dans le Monde, 2018: Parvenir à un Monde Exempt de lèpre. Vol. 94, Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire. World Health Organization = Organisation mondiale de la Santé; 2019. p. 389-411.

Aisyah I, Agusni I. A retrospective study: Profile of new leprosy patients. Period Dermatol Venereol. 2018;30:40-7.

Martelli CM, de Maroja MF, Pardillo F, Stefani MM, Villahermosa L, Scollard DM, et al. Risk factors for leprosy reactions in three endemic countries. Am J Trop Med Hyg. 2015;92(1):108-14. http://doi.org/10.4269/ajtmh.13-021 PMid:25448239 DOI: https://doi.org/10.4269/ajtmh.13-0221

Ranque B, Nguyen VT, Vu HT, Nguyen TH, Nguyen NB, Pham XK, et al. Age is an important risk factor for onset and sequelae of reversal reactions in Vietnamese patients with leprosy. Clin Infect Dis. 2007;44(1):33-40. PMid:17143812 DOI: https://doi.org/10.1086/509923

Stanojcic M, Chen P, Xiu F, Jeschke MG. Impaired immune response in elderly burn patients: New insights into the immune-senescence phenotype. Ann Surg. 2016;264(1):195-202. http://doi.org/10.1097/SLA.0000000000001408 PMid:26649579 DOI: https://doi.org/10.1097/SLA.0000000000001408

Morey JN, Boggero IA, Scott AB, Segerstrom SC. Current directions in stress and human immune function. Curr Opin Psychol. 2015;5:13-7. http://doi.org/10.1016/j.copsyc.2015.03.007 PMid:26086030 DOI: https://doi.org/10.1016/j.copsyc.2015.03.007

Lastória JC, de Abreu MA. Leprosy: Review of the epidemiological, clinical, and etiopathogenic aspects-part 1. An Bras Dermatol. 2014;89(2):205-18. http://doi.org/10.1590/abd1806-4841.20142450 PMid:24770495 DOI: https://doi.org/10.1590/abd1806-4841.20142450

Rao PS, John AS. Nutritional status of leprosy patients in India. Indian J Lepr. 2012;84(1):17-22. PMid:23077779

Ribeiro de Jesus A. Micronutrientes que influyen en la respuesta inmune en la lepra. Nutr Hosp. 2014;1:26-36.

Hungria EM, Oliveira RM, Penna GO, Aderaldo LC, de Pontes MA, Cruz R, et al. Can baseline ML Flow test results predict leprosy reactions? An investigation in a cohort of patients enrolled in the uniform multidrug therapy clinical trial for leprosy patients in Brazil. Infect Dis Poverty. 2016;5(1):110. http://doi.org/10.1186/s40249-016-0203-0 PMid:27919284 DOI: https://doi.org/10.1186/s40249-016-0203-0

Antunes DE, Ferreira GP, Nicchio MV, Araujo S, da Cunha AC, Gomes RR, et al. Number of leprosy reactions during treatment: Clinical correlations and laboratory diagnosis. Rev Soc Bras Med Trop. 2016;49(6):741-5. http://doi.org/10.1590/0037-8682-0440-2015 PMid:28001221 DOI: https://doi.org/10.1590/0037-8682-0440-2015

Antunes DE, Araujo S, Ferreira GP, da Cunha AC, da Costa AV, Gonçalves MA, et al. Identification of clinical, epidemiological and laboratory risk factors for leprosy reactions during and after multidrug therapy. Mem Inst Oswaldo Cruz. 2013;108(7):901-8. http://doi.org/10.1590/0074-0276130222 PMid:24271045 DOI: https://doi.org/10.1590/0074-0276130222

de Brito MF, Ximenes RA, Gallo ME, Bührer-Sékula S. Association between leprosy reactions after treatment and bacterial load evaluated using anti PGL-I serology and bacilloscopy. Rev Soc Bras Med Trop. 2008;41(Suppl 2):67-72. http://doi.org/10.1590/s0037-86822008000700014 PMid:19618079 DOI: https://doi.org/10.1590/S0037-86822008000700014

Sousa AL, Stefani MM, Pereira GA, Costa MB, Rebello PF, Gomes MK, et al. Mycobacterium leprae DNA associated with Type 1 reactions in single lesion paucibacillary leprosy treated with single dose rifampin, ofloxacin, and minocycline. Am J Trop Med Hyg. 2007;77(5):829-33. PMid:17984336 DOI: https://doi.org/10.4269/ajtmh.2007.77.829

Fava VM, Manry J, Cobat A, Orlova M, Van Thuc N, Ba NN, et al. A missense LRRK2 variant is a risk factor for excessive inflammatory responses in leprosy. PLoS Negl Trop Dis. 2016;10(2):e0004412. http://doi.org/10.1371/journal.pntd.0004412 PMid:26844546 DOI: https://doi.org/10.1371/journal.pntd.0004412

Fischer M. Leprosy an overview of clinical features, diagnosis, and treatment: CME article. J Deutsch Dermatol Gesellschaft. 2017;15(8):801-27. DOI: https://doi.org/10.1111/ddg.13301

Spencer JS, Duthie MS, Geluk A, Balagon MF, Kim HJ, Wheat WH, et al. Identification of serological biomarkers of infection, disease progression and treatment efficacy for leprosy. Mem Inst Oswaldo Cruz. 2012;107 Suppl 1:79-89. PMid:23283458 DOI: https://doi.org/10.1590/S0074-02762012000900014

Oertelt-Prigione S. Immunology and the menstrual cycle. Autoimmun Rev. 2012;11(6-7):A486-92. http://doi.org/10.1016/j.autrev.2011.11.023 PMid:22155200 DOI: https://doi.org/10.1016/j.autrev.2011.11.023

Downloads

Published

2021-10-15

How to Cite

1.
Rosdiana B, Astari L, Astindari A, Rosita Sigit Prakoeswa C, Zulkarnain I, Damayanti D, Utomo B, Listiawan MY. Risk Factors of Type 1 Leprosy Reaction in Leprosy Patients attending Leprosy Division of Dermatology and Venereology Outpatient Clinic of Dr Soetomo General Hospital in 2017–2019: A Retrospective Study. Open Access Maced J Med Sci [Internet]. 2021 Oct. 15 [cited 2024 Nov. 22];9(B):1359-63. Available from: https://oamjms.eu/index.php/mjms/article/view/7201