Publication:

Pattern and predictors of lepra reactions among patients treated for leprosy in southeast Nigeria: a mixed methods study

Background Lepra reactions occur among patients treated for leprosy. This study aimed to assess the pattern and predictors of lepra reactions in southeast Nigeria.

Methods This is a convergent parallel mixed-methods study that determined the pattern and explored the experiences of leprosy patients. Participants were recruited by cluster sampling technique. Chi-square test and binary logistic regression analysis were done. In addition, in-depth and key informant interviews were conducted.

Results There were 71 participants in total, comprising 35 males (49.3%) and 36 females (50.7%) with a mean age of 60.39±16.327. The prevalence of type 1 and type 2 lepra reactions were 59.2% (95% CI 47.14-70.17) and 35.2% (95% CI 27.30-50.07) respectively. Type 1 lepra reaction (LR) was significantly associated with gender (p<0.023) and farming (p<0.044). Furthermore, Paucibacillary leprosy (PB) was significantly associated with both types 1 (p<0.022) and 2 (p<0.011) lepra reactions. Type of diagnosis (PB) was a significant predictor of type 1 LR 5.89 (95% CI 1.58 - 21.99) and type 2 LR 8.76 (95% CI 1.67-46.15). Worsening and new lesions led to discrimination and stigmatization for leprosy survivors.

Conclusions Lepra reactions are common among leprosy patients in southeast Nigeria. Male gender, farming and PB leprosy were found to be predictors of leprosy reactions.