Clinical Features, Treatment Outcome, and Factors Associated with Defaulters among Leprosy Patients in Mae Sot General Hospital, Tak Province, 1993-2007-ลักษณะทางคลินิก ผลการรักษา และปัจจัยที่มี ผลต่อการขาดการรักษาของผู้ป่วยโรคเรื้อนในโรงพยาบาลแม่สอด จังหวัดตาก ปี 2536-2550

บทคัดย่อ

         This report presents clinical features, treatment outcome, and factors associated with defaulters among 186 leprosy patients treated inMaeSot GeneralHospital,TakProvince, during the fiscal year 1993-2007.  Medical records of these patients were reviewed.  Of the 186 cases, 53 (28.5%) were Thai and 133 (71.5%) wereMyanmar.  The number of registered Thai patients reduced to 1-2 cases per year during 2001-2005 and no cases from 2006 to 2007 whereas 5-17Myanmarcases per year were registered for treatment.  About 83.0 percent of Thai cases and 80.5 percent ofMyanmarswere male.  Of the Thai cases, 50.9 percent were 45 years old or older compared to 23.3 percent amongMyanmars.  About 5.7 percent of Thai cases and 6.8 percent ofMyanmarshad family history of leprosy.  The most common skin lesions in both Thais (34.0%) andMyanmars(34.6%) were red patches or plaques, followed by hypopigmented macules or patches.  Most of the cases in both groups had anesthetic or anhidrotic skin and abnormal skin color.  However, ulcers were significantly more common inMyanmarsthan Thais.  About one-third of the cases had leprosy reactions.  The ulnar nerve just above the elbow was the most common site of nerve involvement detected in both Thais (47.2%) andMyanmars(48.1%).  The proportions of grade 2 hand disability were 24.5 percent in Thai cases and 26.3% inMyanmars. Myanmarcases had a slightly higher proportion of lepromatous leprosy than Thais.  Only one of the Thai cases (1.9%) was defaulters compared to 41.4 percent ofMyanmars.  The study could not identify any significant factors associated withMyanmardefaulters.  The high prevalence of leprosy and high rate of defaulters amongMyanmarmigrants underscore the need for more efforts to fight against the disease in this border area.

Key words:  leprosy, disability, default, border area