High Transmission Of Leprosy Among Inhabitants In Two Former Isolated Leprosy Villages In Senegal

Background: In Senegal, endemic areas of leprosy are mainly concentrated in urban settings, and transmission occurs particularly among children. This study aims to determine the prevalence of leprosy in two highly endemic foci in Senegal as well as to evaluate the association between the detection of leprosy and the family history of leprosy.Methods: The study is a cross sectional study with cluster sampling in two former isolated leprosy villages, Mballing and Koutal. Informed consent was obtained, followed by a questionnaire and a clinical examination. The data collected included: demographics, family history of leprosy, relapse and treatment history. The analysis was done via chi-square or Fisher tests (with an agreed risk of 0.05 and a precision of 0.02).Results: A total of 1605 people over 2 years of age were examined, of whom 881 were female. Children between 2 and 15 years made up 44% (699/1605). Active leprosy was detected in 83 cases constituting a prevalence rate of 5.2%. Overall, a total of 69 new cases were confirmed, 41 being children. The median age was 20.4 years. Of the 69 newly detected cases, 59 (85.5%) were paucibacillary indicating early detection. The rate of grade 2 disability was 2.9%. Altogether 36 of the new patients (52%) had a family history of leprosy.Conclusion: A high level of Mycobacterium leprae is circulating within the study population and transmission is ongoing. In addition to the influence of the contact profile, genetic susceptibility to leprosy could explain the high number of familial leprosy cases in these special areas, isolated for many years. Further research is needed and additional measures for leprosy control, such as post exposure prophylaxis with single dose rifampicin, should be implemented to interrupt transmission.