Childhood leprosy in essimbiland of Cameroon: results of chart review and school survey.

Background: The WHO targeted to eliminate leprosy from the world as a public health problem by reducing the prevalence to less than 1 case per 10000 population based on the use of multi-drug therapy (MDT). Despite the success of MDT, endemic pools still exist in some countries that have attained the national elimination threshold. Objective: Assess the burden of childhood leprosy and control efforts in Essimbiland of Cameroon. Methods: The records of children patients were reviewed in two main primary health care institutions and 4 primary schools in Essimbiland having 459 pupils were surveyed for leprosy. A purposive sampling of all available registers and pupils was used. Results: A total of 1129 case files were reviewed covering the periods before MDT (1961-1967) implementation in 1982 and post MDT (1982-1999); no records were available from 1968-1991.From chart review, 42 (23.3%) new leprosy cases from 1961-1967 and 35 (12.2%) from 1982-1998 were from the Mbingo leprosarium. 31(39.7%) of 78 childhood leprosy cases from chart review [1961-1967 and 1982-1999] were from Essimbiland. Of the 35 incident childhood leprosy cases from 1982-1998, 24(68.6%) were from Essimbiland compared to other divisions. Poor record - keeping on leprosy was common in the study area. Among 459 pupils surveyed in 4 primary schools, 6(1.3%) new leprosy cases were identified giving a prevalence of 131 per 10,000 pupils. The common skin lesion was on the back but one pupil had both hands clawed. 16(3.5%) pupils were placed on observation. All the new leprosy cases from the school survey were indigenes of Essimbiland. Conclusion: Childhood leprosy is a public health problem in the Essimbiland requiring school surveys and a house-tohouse search for new cases. Keywords: Childhood leprosy, chart review, school survey, Essimbiland, Cameroon