{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:11:53Z","timestamp":1787015513489,"version":"build-2736575974"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,12,7]],"date-time":"2016-12-07T00:00:00Z","timestamp":1481068800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2017,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leprosy reactions are immunologically mediated conditions and a major cause of disability before, during and after multidrug therapy (MDT). Little data have been published on the epidemiology of leprosy reactions in Bangladesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the pattern and prevalence of leprosy reactions in the postelimination stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A descriptive retrospective cross\u2010sectional study was carried out in Chittagong Medical College Hospital using the registered records of patients in the period between 2004 and 2013.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 670 patients with leprosy, 488 (73.38%) were males and 182 (27.37%) were females. The prevalence of reaction was in 300 (44.78%) patients with a male:female ratio of 3.55 : 1. The age\u2010specific cumulative reaction cases at &gt;40 years were 115 (38.33%) among all age groups. The prevalence of reaction was found to be in 166 (55.33%) patients for the reversal reaction, 49 (16.57%) for the erythema nodosum leprosum (ENL) and 85 (28.33%) for the neuritis. Borderline tuberculoid was most common (106, 35.33%)in the reversal reaction group, while lepromatous leprosy was most common (37, 12.33%) in ENL group. More than half of the patients (169, 56.33%) had reactions at the time of presentations, while 85 (28.33%) and 46 (15.33%) patients developed reaction during and after MDT, respectively. The reversal reaction group presented with \u2265six skin lesions in 96 (57.83%) patients and \u2265two nerve function impairments (NFIs) in 107 (64.46%) patients. The ENL was present chiefly as papulo\u2010nodular lesions in 45 (91.84%) patients followed by pustule\u2010necrotic lesions in four (8.16%), neuritis in 33 (67.35%), fever in 24 (48.98%), lymphadenitis in six (12.24%), arthritis in five (10.20%) and iritis in two (4.08%). Bacterial index \u22653 had been demonstrated in 34 (60.71%) patients in ENL group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The incidence of leprosy reaction seemed to be more than three times common in borderline tuberculoid (52.33%) group than in lepromatous leprosy (14%) group. Reactions with NFI and disability still occur among multibacillary patients during and after MDT. Early detection and management of leprosy reaction are very important in preventing disability and deformity, and patients should be educated to undergo regular follow\u2010up examinations. Developing reinforced new therapies to curb leprosy reactions is crucial for improving leprosy healthcare services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.14049","type":"journal-article","created":{"date-parts":[[2016,11,16]],"date-time":"2016-11-16T13:23:54Z","timestamp":1479302634000},"page":"705-711","source":"Crossref","is-referenced-by-count":19,"title":["Leprosy reactions in postelimination stage: the Bangladesh experience"],"prefix":"10.1111","volume":"31","author":[{"given":"M.R.","family":"Mowla","sequence":"first","affiliation":[{"name":"Department of Dermatology &amp; Venereology Chittagong Medical College Chittagong Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Ara","sequence":"additional","affiliation":[{"name":"Chittagong Medical College Chittagong Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.F.M.","family":"Mizanur Rahman","sequence":"additional","affiliation":[{"name":"Chittagong Medical College Chittagong Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.P.","family":"Tripura","sequence":"additional","affiliation":[{"name":"Chittagong Leprosy Control Project Chittagong Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Medicine Chittagong Medical College Chittagong Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,12,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12975"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2004.tb00623.x"},{"key":"e_1_2_6_4_1","first-page":"559","article-title":"Epidemiologic characters of leprosy reaction","volume":"62","author":"Scollard DM","year":"1994","journal-title":"Int J Lepr"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.5935\/0305-7518.19910013"},{"key":"e_1_2_6_6_1","first-page":"173","article-title":"Occurrence of reactions their diagnosis and management in leprosy patients treated with multidrug therapy; experience in the leprosy control program of the all Africa Leprosy and Rehabilitation Training Centre (ALERT) in Ethiopia","volume":"60","author":"Becx\u2010Bleumink M","year":"1992","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"e_1_2_6_7_1","first-page":"204","article-title":"Nerve damage in leprosy: an epidemiological study of 396 patients in west Nepal\u2010part 1: definitions, methods and frequencies","volume":"65","author":"Van Brakel WH","year":"1994","journal-title":"Lepr Rev"},{"key":"e_1_2_6_8_1","first-page":"297","article-title":"Nerve function impairment in leprosy at diagnosis and at completion of MDT: a retrospective cohort study of 786 patients in Bangladesh","volume":"67","author":"Richardus JH","year":"1996","journal-title":"Lepr Rev"},{"key":"e_1_2_6_9_1","first-page":"170","article-title":"The occurrence of reactions and impairment in leprosy: experience in the leprosy control program of three provinces in northeastern Thailand, 1978\u20101995. 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Neural and other impairments [see comments]","volume":"66","author":"Schreuder PA","year":"1998","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"e_1_2_6_10_1","first-page":"18","article-title":"Incidence rates of acute nerve function impairment in leprosy: a prospective cohort analysis after 24 months (The Bangladesh Acute nerve Damage Study)","volume":"71","author":"Croft RP","year":"2000","journal-title":"Lepr Rev"},{"key":"e_1_2_6_11_1","first-page":"285","article-title":"The pattern of leprosy related neuropathy in the AMFES patients in Ethiopia: definitions, incidence, risk factors and outcome","volume":"71","author":"Saunderson P","year":"2000","journal-title":"Lepr Rev"},{"key":"e_1_2_6_12_1","first-page":"1","article-title":"Leprosy situation in South\u2010East Asia region","volume":"38","author":"Lobo D","year":"2006","journal-title":"J Commun Dis"},{"key":"e_1_2_6_13_1","first-page":"255","article-title":"Classification of leprosy according to immunity; a five group system","volume":"34","author":"Ridley DS","year":"1996","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"e_1_2_6_14_1","first-page":"185","article-title":"Lepra reactions\u2010 a clinical and histopathological study. 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