Association of Intestinal Parasitic Infection in Development of Reaction in Leprosy Patients

Abstract

A hospital based study was conducted on intestinal parasitic co-infection in reaction and non reaction leprosy patients visiting at Lalgadh Leprosy Services Centre, Dhanusha, Nepal, during 2011/2012. The objective of the present study was aimed to determine the prevalence of intestinal parasites in leprosy reaction and non reaction patients and to analyze the association between leprosy reaction and gastrointestinal parasitic infection. Patients with leprosy reaction and non reaction were grouped according to their clinical form and as per the guidelines of the resident Dermatologist of LLSC. The total of 200 stool samples were collected from each patient and examined to identify the presence of intestinal parasites. Result of stool examination revealed that, the intestinal parasitic infection was significant (χ2 =16.324, p<0.05) in 51% of reaction leprosy patients when compared to 26% in non reaction leprosy patients. The most frequently observed intestinal protozoan parasites includes E. histolytica (25%) in leprosy reaction and (16%) in non reaction patients as well as Giardia lamblia (8%) in leprosy reaction and (9%) in non reaction patients. Among the protozoan parasites, T. hominis was observed only (4%) in reaction leprosy patients. The frequency of intestinal helminths observed in the study includes Nematode and Cestode group. The nematode group includes S. stercoralis and hookworm which were found only in leprosy reaction patients (4.5%). Similarly least infection with H. nana, only species belonging to Cestode found (0.5%) in both reaction and non reaction leprosy patients. Overall result indicated that there is a positive association in development of reaction in leprosy patients to that of hookworm and S. stercoralis (helminths) and T. hominis (protozoa) infection. KAP survey among leprosy reaction and non reaction patients in relation to parasitic infection showed that, there was no significant difference (p<0.05) in the prevalence of intestinal parasites with respect to literacy, knowledge of mode of transmission of parasites, sanitary condition, occupation, food or water consumption by both groups of leprosy reaction and non reaction patients.