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

Abstract

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.