A Case Report and Investigation of New Leprosy Patient in Non-Transmission Area, Songkhla Province

Abstract

This research aimed to 1) examine the new case of leprosy in non-transmission area 2) to find and monitor people exposed to leprosy and 3) provide preventive, control and surveillance measures of leprosy in non-transmission area. The study design was a case report and case investigation. The study subjects consisted of 1 new leprosy patient diagnosed and treated at Had Yai hospital, 6 household contacts and 20 social contacts in Kuanniang District, Songkhla Province. The study period was from 1 July 2022 – 31 May 2023. Research findings revealed that the new leprosy patient was diagnosed Mid-borderline Leprosy (BB), found bilaterally distributed lesions of the body and was classified as Multibacillary leprosy (MB) with a grade 2 disability (visible to the naked eye). The results of the examination for hand and foot deformity showed the highest degree of deformity equal to 1 and 2 on the hand and foot. Nerve examination and muscle strength test results of 11 items disclosed 6 abnormal items including 1) Great Auricular 2) Ulnar 3) Median 4) Radial 5) Common Peroneal 6) Posterior Tibial. These abnormalities and disabilities indicated the progression of the disease over many years without being diagnosed and treated. The results of the treatment evaluation showed that patients received continuous and regular treatment for 8 months resulting in fading of skin lesions, numbness decreased, but still had both hand weakness and neuropathic pain. The patient received supportive treatment by increasing the dose of Gabapentin, promoting continued treatment of leprosy and physical therapy coupled with taking care of the psychological and social dimensions. Leprosy screening among 6 household contacts and 20 social contacts unveiled no suspected cases of leprosy. These research findings can be used to develop guidelines and manuals for the diagnosis and treatment of leprosy patients as well as surveillance, prevention and control of leprosy for doctors, nurses, medical technologists, public health personnel and those involved.