Pediatric Leprosy Profile in the Postelimination Era: A Study from Surabaya, Indonesia

Novianti Rizky Reza Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital Surabaya, Surabaya, East Java, Indonesia;
Leprosy Study Group, Institute of Tropical Disease, Surabaya, Indonesia;
Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands

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Bagus Hario Kusumaputro Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital Surabaya, Surabaya, East Java, Indonesia;
Leprosy Study Group, Institute of Tropical Disease, Surabaya, Indonesia;

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Medhi Denisa Alinda Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital Surabaya, Surabaya, East Java, Indonesia;
Leprosy Study Group, Institute of Tropical Disease, Surabaya, Indonesia;

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Muhammad Yulianto Listiawan Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital Surabaya, Surabaya, East Java, Indonesia;
Leprosy Study Group, Institute of Tropical Disease, Surabaya, Indonesia;

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Hok Bing Thio Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands

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Cita Rosita Sigit Prakoeswa Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital Surabaya, Surabaya, East Java, Indonesia;
Leprosy Study Group, Institute of Tropical Disease, Surabaya, Indonesia;

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ABSTRACT.

Children who live in leprosy-endemic areas are susceptible to infection due to early and frequent exposure to Mycobacterium leprae. Indonesia is on the verge of eliminating this disease (prevalence rate < 1/10,000 population), but pediatric leprosy continues to occur in low-endemic areas. This study aimed to evaluate pediatric leprosy over a decade in a tertiary hospital in Surabaya, Indonesia. A retrospective study of leprosy in children under 15 years old between 2010 and 2019 was conducted in the Morbus Hansen Division, Outpatient Clinic at Dr. Soetomo Hospital in Surabaya, Indonesia. Seventy pediatric leprosy cases were identified between 2010 and 2019, consisting of 58 multibacillary (MB)-type cases and 12 paucibacillary (PB)-type cases. Slit skin smear (SSS) was positive in 26 cases. There were two cases of grade-2 disability and 15 cases of leprosy reaction (erythema nodosum leprosum) in children at the time of diagnosis. There was an insignificant decline in the number of pediatric leprosy cases in the last 10 years. Cases and disabilities in children were found in some leprosy pocket areas even though the national elimination rate has been achieved. MB infections, disability, and treatment defaults were common problems in pediatric leprosy.

Author Notes

Address correspondence to Cita Prakoeswa, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga—Dr. Soetomo General Academic Hospital Surabaya, Surabaya 60131, East Java, Indonesia. E-mail: cita-rosita@fk.unair.ac.id

Financial support: The author received support from the Indonesia Endowment Fund for Education (LPDP), the Ministry of Finance of the Republic of Indonesia to conduct this work. This study was also supported by Riset Mandat Grant from Airlangga University (20/RM/Thp-I/2020). The funder had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.

Authors’ addresses: Cita Rosita Sigit Prakoeswa, Medhi Denisa Alinda, Muhammad Yulianto Listiawan, and Bagus Haryo Kusumaputra, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital Surabaya, Surabaya, East Java, Indonesia, and Leprosy Study Group, Institute of Tropical Disease, Surabaya, Indonesia, E-mails: cita-rosita@fk.unair.ac.id, medhi.denisa@fk.unair.ac.id, m.yulianto@fk.unair.ac.id, and bagushkputra@yahoo.com. Novianti Rizky Reza, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital Surabaya, Surabaya, East Java, Indonesia, Leprosy Study Group, Institute of Tropical Disease, Surabaya, Indonesia, and Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands, E-mail: novianti.rizky@fk.unair.ac.id. Hok Bing Thio, Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands, E-mail: h.thio@erasmusmc.nl.

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