Causes of Death among Persons Affected by Leprosy in Korea, 2010–2013

Young-Hwan Ahn Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea;

Search for other papers by Young-Hwan Ahn in
Current site
Google Scholar
PubMed Close
,
Hyungcheol Park Department of Preventive Medicine, Sorokdo National Hospital, Goheung-gun, Korea;

Search for other papers by Hyungcheol Park in
Current site
Google Scholar
PubMed Close
, and
Sun-Seog Kweon Department of Preventive Medicine, Chonnam National University, Hwasun-gun, Korea

Search for other papers by Sun-Seog Kweon in
Current site
Google Scholar
PubMed Close
DOI:
https://doi.org/10.4269/ajtmh.19-0401
Volume/Issue:
Volume 102: Issue 1
Page(s):
42–47
Restricted access
Get Permissions

In addition to the complications of leprosy, people affected by leprosy (PALs) can suffer from chronic diseases. We evaluated the recent pattern of deaths among Korean PALs and compared it with that in the general population. We analyzed the death certificate data of 1,359 PALs from 2010 through 2013. The all-cause and cause-specific standardized mortality ratio (SMR) and standardized mortality with 95% CI were calculated. Malignancy had the highest standardized mortality, with 130.9 deaths per 100,000 persons, followed by cardiovascular diseases (CVDs; 85.5 deaths) and respiratory diseases (38.2 deaths). Of malignancies, liver cancer caused the greatest number of cancer deaths (40.0 deaths). The all-cause mortality of PALs was significantly lower than that in the general population, corresponding to an SMR of 0.84 (95% CI 0.79–0.88). Deaths from malignancy and CVDs were significantly lower, corresponding to SMRs (95% CIs) of 0.88 (0.79–0.98) and 0.75 (0.67–0.84), respectively. The death rates for lung and stomach cancers were lower, whereas mortality due to liver cancer was higher, with an SMR of 1.79 (95% CI 1.43–2.22). Except for liver cancer and infection, the causes of mortality of PALs tend to be lower than that in the general population. The most common underlying cause of death in PALs was stroke, followed by ischemic heart disease, liver cancer, and pneumonia.

Author Notes

Address correspondence to Sun-Seog Kweon, Department of Preventive Medicine, Chonnam National University Medical School, 264 Seoyang-ro, Hwasun-gun 58128, Korea. E-mail: ujingogo@paran.com

Authors’ addresses: Young-Hwan Ahn, Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea, E-mail: ntop0329@naver.com. Hyungcheol Park, Department of Preventive Medicine, Sorokdo National Hospital, Goheung-gun, Korea, E-mail: kjdhc@hanmail.net. Sun-Seog Kweon, Department of Preventive Medicine, Chonnam National University, Hwasun-gun, Korea, E-mail: ujingogo@paran.com.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2020
Received:
25 May 2019
|
Accepted:
09 Oct 2019
|
Published Online:
25 Nov 2019
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
  • 1.

    Lee J, Kim J-P, Nishikiori N, Fine PE, 2015. The decline of leprosy in the Republic of Korea; patterns and trends 1977–2013. Lepr Rev 86: 316–327.

    • Search Google Scholar
    • Export Citation
  • 2.

    World Health Organization, 2018. Global leprosy update, 2018: moving towards a leprosy-free world. Wkly Epidemiol Rec 94: 389–412.

  • 3.

    Savassi LC, Bogutchi TR, Lima AC, Modena CM, 2014. Quality of life of leprosy sequelae patients living in a former leprosarium under home care: univariate analysis. Qual Life Res 23: 1345–1351.

    • Search Google Scholar
    • Export Citation
  • 4.

    Ferreira RC, Ribeiro MTF, Vargas-Ferreira F, Sampaio AA, Pereira ACM, Vargas AMD, de Jesus RM, Ferreira EFE, 2018. Assistive technologies for improving the oral hygiene of leprosy patients residing in a former leprosy colony in Betim, Minas Gerais, Brazil. PloS One 13: e0200503.

    • Search Google Scholar
    • Export Citation
  • 5.

    Van Brakel WH, Sihombing B, Djarir H, Beise K, Kusumawardhani L, Yulihane R, Kurniasari I, Kasim M, Kesumaningsih KI, Wilder-Smith A, 2012. Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination. Glob Health Action 5: 18394.

    • Search Google Scholar
    • Export Citation
  • 6.

    Moschioni C, Antunes CMdF, Grossi MAF, Lambertucci JR, 2010. Risk factors for physical disability at diagnosis of 19,283 new cases of leprosy. Rev Soc Bras Med Trop 43: 19–22.

    • Search Google Scholar
    • Export Citation
  • 7.

    Sales AM, Campos DP, Hacker MA, da Costa Nery JA, Düppre NC, Rangel E, Sarno EN, Penna MLF, 2013. Progression of leprosy disability after discharge: is multidrug therapy enough? Trop Med Int Health 18: 1145–1153.

    • Search Google Scholar
    • Export Citation
  • 8.

    Costa JEF, Morais VMS, Gonçales JP, Medeiros AADP, Barroso H, Compri AP, Fukasawa L, Moreira RC, Coêlho MRCD, 2018. Occult hepatitis B virus infection in patients with leprosy. J Med Virol 91: 775–780.

    • Search Google Scholar
    • Export Citation
  • 9.

    Saraya MA, Al-Fadhli MA, Qasem JA, 2012. Diabetic status of patients with leprosy in Kuwait. J Infect Public Health 5: 360–365.

  • 10.

    Rosa H, Martins R, Vanderborght B, 1996. Association between leprosy and hepatitis C infection: a survey in a region of central Brazil. A J Trop Med Hyg 55: 22–23.

    • Search Google Scholar
    • Export Citation
  • 11.

    Shen J, Liu M, Zhou M, Li W, 2011. Causes of death among active leprosy patients in China. Int J Dermatol 50: 57–60.

  • 12.

    Martins-Melo FR, Assunção-Ramos AV, Ramos AN Jr., Alencar CH, Montenegro RM Jr., Wand-Del-Rey de Oliveira ML, Heukelbach J, 2015. Leprosy-related mortality in Brazil: a neglected condition of a neglected disease. Trans R Soc Trop Med Hyg 109: 643–652.

    • Search Google Scholar
    • Export Citation
  • 13.

    Parkin DM, 2006. The global health burden of infection-associated cancers in the year 2002. Int J Cancer 118: 3030–3044.

  • 14.

    Korea Statistics, 2017. Annual Report on the Causes of Death Statistics from Korean Statistical Information Service. Available at: http://kosis.kr/index/index.do. Accessed March 11, 2019.

    • Search Google Scholar
    • Export Citation
  • 15.

    Cho SC, Park MC, Keam B, Choi JM, Cho Y, Hyun S, Park SC, Lee J, 2010. DDS, 4, 4′-diaminodiphenylsulfone, extends organismic lifespan. Proc Natl Acad Sci USA 107: 19326–19331.

    • Search Google Scholar
    • Export Citation
  • 16.

    Erstad BL, 1992. Dapsone-induced methemoglobinemia and hemolytic anemia. Clin Pharm 11: 800–805.

  • 17.

    Jollow DJ, Bradshaw TP, Mcmillan DC, 1995. Dapsone-induced hemolytic anemia. Drug Metab Rev 27: 107–124.

  • 18.

    Lee SY, Kim W, Park HW, Park SC, Kim IK, Chung SG, 2016. Anti-sarcopenic effects of diamino-diphenyl sulfone observed in elderly female leprosy survivors: a cross-sectional study. J Cachexia Sarcopenia Muscle 7: 322–329.

    • Search Google Scholar
    • Export Citation
  • 19.

    Tarantino U, Baldi J, Celi M, Rao C, Liuni FM, Iundusi R, Gasbarra E, 2013. Osteoporosis and sarcopenia: the connections. Aging Clin Exp Res 25 (Suppl 1): S93–S95.

    • Search Google Scholar
    • Export Citation
  • 20.

    Blazer DG, 1982. Social support and mortality in an elderly community population. Am J Epidemiol 115: 684–694.

  • 21.

    Kang KW et al. 2016. Cognitive function and activities of daily living in people affected by leprosy: a cross-sectional, population-based, case-control study. Neurol India 64: 656–660.

    • Search Google Scholar
    • Export Citation
  • 22.

    St John PD, Tyas SL, Griffith LE, Menec V, 2017. The cumulative effect of frailty and cognition on mortality–results of a prospective cohort study. Int Psychogeriatr 29: 535–543.

    • Search Google Scholar
    • Export Citation
  • 23.

    Cavalli-Björkman N, Qvortrup C, Sebjørnsen S, Pfeiffer P, Wentzel-Larsen T, Glimelius B, Sorbye H, 2012. Lower treatment intensity and poorer survival in metastatic colorectal cancer patients who live alone. Br J Cancer 107: 189–194.

    • Search Google Scholar
    • Export Citation
  • 24.

    Fischer M, 2017. Leprosy–an overview of clinical features, diagnosis, and treatment. J Dtsch Dermatol Ges 15: 801–827.

  • 25.

    Purtilo DT, Pangi C, 1975. Incidence of cancer in patients with leprosy. Cancer 35: 1259–1261.

  • 26.

    Oleinick A, 1969. Altered immunity and cancer risk: a review of the problem and analysis of the cancer mortality experience of leprosy patients. J Natl Cancer Inst 43: 775–781.

    • Search Google Scholar
    • Export Citation
  • 27.

    Tokudome S, Kono S, Ikeda M, Kuratsune M, Kumamaru S, 1981. Cancer and other causes of death among leprosy patients. J Natl Cancer Inst 67: 285–289.

    • Search Google Scholar
    • Export Citation
  • 28.

    Lee HJ, Yang HK, Ahn YO, 2002. Gastric cancer in Korea. Gastric Cancer 5: 177–182.

  • 29.

    Diamantopoulos EJ, Anthopoulos LP, Moulopoulos SD, 1992. Coronary heart disease risk factors in Hansen’s disease sufferers. Clin Cardiol 15: 436–440.

    • Search Google Scholar
    • Export Citation
  • 30.

    Park H, Kwon H, 2013. Cardiovascular risk factors in people affected by leprosy. J Sorokdo Natl Hosp 38: 7–20.

  • 31.

    Furuta M, Obara A, Ishida Y, Harada N, Ozaki M, 1990. Leprosy and malignancy: autopsy findings of 252 leprosy patients. Int J Lepr Other Mycobact Dis 58: 697–703.

    • Search Google Scholar
    • Export Citation
  • 32.

    Inoue M, Tsugane S, 2005. Epidemiology of gastric cancer in Japan. Postgrad Med J 81: 419–424.

  • 33.

    Lee S, Jun JK, Suh M, Park B, Noh DK, Jung KW, Choi KS, 2015. Gastric cancer screening uptake trends in Korea: results for the national cancer screening program from 2002 to 2011: a prospective cross-sectional study. Medicine (Baltimore) 94: e533.

    • Search Google Scholar
    • Export Citation
  • 34.

    Suh M, Song S, Cho HN, Park B, Jun JK, Choi E, Kim Y, Choi KS, 2017. Trends in participation rates for the national cancer screening program in Korea, 2002–2012. Cancer Res Treat 49: 798–806.

    • Search Google Scholar
    • Export Citation
  • 35.

    Jung KW, Won YJ, Oh CM, Kong HJ, Lee DH, Lee KH, 2017. Prediction of cancer incidence and mortality in Korea, 2017. Cancer Res Treat 49: 306–312.

  • 36.

    Bennett H et al. 2015. A review of the burden of hepatitis C virus infection in China, Japan, South Korea and Taiwan. Hepatol Int 9: 378–390.

  • 37.

    Kim J-P, Kang K-H, Park J-M, 2018. Seropositivity of hepatitis C virus among persons affected leprosy in Korea. Korean Lepr Bull 51: 13–21.

  • 38.

    Shiogama K, Teramoto H, Morita Y, Mizutani Y, Shimomura R, Inada K, Kamahora T, Makino M, Tsutsumi Y, 2010. Hepatitis C virus infection in a Japanese leprosy sanatorium for the past 67 years. J Med Virol 82: 556–561.

    • Search Google Scholar
    • Export Citation
  • 39.

    Machado PR, Johnson WD, Glesby MJ, 2012. The role of human T cell lymphotrophic virus type 1, hepatitis B virus and hepatitis C virus coinfections in leprosy. Mem Inst Oswaldo Cruz 107 (Suppl 1): 43–48.

    • Search Google Scholar
    • Export Citation
  • 40.

    Abdullah A, 2017. Leprosy and hepatitis C co-infection: epidemiological data from the leprosarium, Srinagar, Kashmir, India. Lepr Rev 88: 227–236.

    • Search Google Scholar
    • Export Citation
  • 41.

    Balakrishnan S, Bhatia VN, Harikrishnan S, 1983. Hepatitis-B-surface antigen (HBsAg) in leprosy patients. Lepr India 55: 45–48.

  • 42.

    Yvonnet B, Vincelot P, Millan J, Lesage G, Denis F, Languillon J, Mboup S, Coursaget P, Diop Mar I, Chiron JP, 1989. Hepatitis B virus infection in lepromatous and tuberculoid patients from Senegal. Acta Leprol 7: 63–66.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 63 63 6
Full Text Views 1536 141 1
PDF Downloads 714 45 0
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save