Time-to-Disability Determinants Among Leprosy Patients Enrolled for Treatment at ALERT Center, Addis Ababa, Ethiopia: A Survival Analysis

Abstract

Background

Mycobacterium leprae causes leprosy, which is a long-term or recurrent infection. The causative agent’s collusion with Schwann cells results in the irreversible loss of fringe nerve tissue; followed by incapacity, which includes not just actual impotence but also mental incapacity, creates a bad image of the transformed, resulting in segregation and societal humiliation of leprosy patients, as well as their families.

Methods

This study’s survival analysis includes a sample of 205 patients who were taking leprosy medication and had all essential data from January 2015 to December 2019 G.C. at the All African TB and Leprosy Rehabilitation and Training Centre. The Cox proportional hazard model was used to figure out what factors influence leprosy patients’ survival status during treatment.

Results

Among the 205 leprosy patients, 71 (34.63%) had at least one type of impairment grade during treatment. The Cox proportional model revealed that the most significant variables of impairment among leprosy patients were age, symptom duration, treatment category, living place, and sensory loss.

Conclusion

The study investigated and revealed characteristics associated with the survival status of leprosy patients in ALRT centers using survival analysis. Patients’ risk of worsening disability grade increased with age, was greater for patients with a long duration of symptom, was higher for defaulter patients, and was lower for patients who did not lose their sensibility throughout therapy. The existence of a difference in the survival curves between two or more groups of factors for the patient’s survival function was also discovered in this inquiry. Female patients, particularly those who were new to the medication, were shown to be more in their survival.

Keywords:

• disability
• survival analysis
• Cox proportional model

Abbreviations

ALERT, All Africa Leprosy, Tuberculosis and Rehabilitation Training Centre; DG, disability degree; ENAPAL, Ethiopian National Association of Peoples Affected by Leprosy; FMOH, Federal Ministry of Health; G0D, grade zero disability; G1D, grade one disability; G2D, grade two disability; GLRI, German leprosy and TB Relief Association; HR, hazard ratio; MDT, multidrug therapy; MB, multi-bacillary; PB, Pauci-bacillary; TB, tuberculosis; WHO, World Health Organization.

Data Sharing Statement

On request, the data can be obtained from the corresponding author.

Ethical Considerations

The data used in the current investigation were collected previously by the health staff for treatment purpose/for diagnosis leprosy and to start follow-up treatment. To use this previously collected data, an ethical approval certificate has been obtained from the ethical clearance review committee of College of Natural and Computational Science, University of Gondar, Ethiopia, with reference number: CNCS/10627/05/19/2020. In data collection, there was no written or verbal consent from participants. The reason was the investigators did NOT get participants rather, and secondary data were obtained in the patients chart. The study was conducted according to the guidelines of the Declaration of Helsinki and the data were de-identified by the investigators.

Acknowledgments

We would like to acknowledge ALRT center to make all data available.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no conflicts of interest for this work.

Additional information

Funding

This research received no specific grant from any funding agency in the public commercial, or not for profit sectors.