A study of behavioural changes and clinical evaluation of leprosy in school going children of leprosy parents

Introduction

Leprosy is a chronic infectious disease caused by Mycobacterium leprae which primarily affects the peripheral nervous system and skin.[1] Of all the diseases known, leprosy is most important for its potential to cause permanent and progressive physical disability. In addition, the disease and its visible disabilities in particular, contribute to intense social discrimination not only to patients but also to their children. As children are more susceptible to infection from affected family members i.e. upto 60% develop the disease. Now there are grounds for believing that transplacental transmission of M. leprae may occur as a rare event, thus accounting for a number of reports of clinical leprosy development in infants.[2]

Materials and Methods

A total of 77 school going children in age group 5-15 years, staying away from their parents in charitable ashram cum school for the last 6 months-6 years period were examined. The criteria for admission in these ashram cum school is either one or both parents should be having leprosy or has had leprosy.

A behavioural questionnaire prepared by child psychologist was used as criteria to look for any behavioural changes. This questionnaire included 26 points regarding psychological and behavioural attitude. In addition their parents′ status of disease and treatment and the state to which they belonged were taken into consideration. Also these children were thoroughly examined clinically for any signs and symptoms of the disease itself.

Results

All the 77 children in this study were boys, age ranging from 5-15 years. They were staying in the ashram cum school for the last 6 months to 6 years period. Out of the 77 children, 7 (9.09%) were having both parents affected with leprosy and 70 (90.91%) children were having single parent wither father or mother affected with leprosy. Only 19 (24.67%) children were having Punjabi parents while 58 (75.33%) children′s parents were Non Punjabis. [Table - 1]

Out of 77 children, 55 (71.43%) scored less than 3.22 (28.57%) scored less than 9 in the children′s behaviour questionnaire i.e. child score B. None of the child score B as more than 9 was taken as significant on. Neither any of these children required referral to child psychologist nor any one of these showed any clinical signs and symptoms of the disease.

Discussion

Leprosy is being considered a social stigma and God′s curse rather than a disease. No other disease is having this much public prejudice, hatred and social stigma than towards leprosy and its sufferers. Not only the leprosy patients but their children are also discriminated in all spheres of life. However, extensive efforts are being made to avoid segregation of leprosy patients and their family members and acceptance of leprosy patients and their family members in society.

In Brazil, where leprosy is endemic as in India, many separate homes for protection of children of leprosy parents were established in 50′s. These homes were named as Educandaria which were having a nursery, a K.G. section, a regular school, vocational school for training in agriculture and other arts and crafts. But now, it has been observed that these separate homes exclusively meant for children of leprosy parents interfere with the normal development of children.[3] To protect from infection, these children of leprosy parents should be separated soon after birth. However, soon after birth condition is very important and at the same time very difficult both for parents as well as for the child. So most appropriate time for separation of these children from their parents is school age.

In this study, neither of these school going children were found to have any significant behavioural changes nor any signs and symptoms of the disease, though they were staying away from their parents for a variable period of time. So these charitable institutes help these school going children to become responsible citizens without stigma of their parent′s disease.