a study of risk factors on contact case of leprosy -...

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STUDY OF ,RISK FACTORS ON CONTACT CASE OF

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Thesis Tit,le

Aut,hot"

Degiree

MeJor AdvlEon

PnoJect

Fecult,yDet,e of Gnaduet,ion

A SLudy of Risk Fact,ors on

cgse of Lepnosy

Miss Ninamon MuenSlsom

Cont,ect

Mest,en of' Sctence (Epidenlology)

Pnof. Dn. Somchal Supanvanich

Jo i nt, Gnaduate Pnognem in Ep I derni o-logy Feculty of Medlclne SirtreiHospitalrFecu lby of Pub I i c Hee lt,h t

Feculty of Medicine Renethibodee

Hosplt,el r

GneduaLe Studiesr Mehi'dol Unlvensit,yJune 29r 1987

ABSTRACT

The obJectives of Lhe study wene to compere t,he

ett,ack nat e of leprosy amongl fiousehold contecLs oflepnomatous and non-lepnomatous csaes of lepnosy end t,o

ident,if'y f act ons nelatlngf. Uo t he occunence of lepnosy

Bmongl household cont,acts. The associat,ingi veriebles tobe select,ed fon t he st udy inc luded Bge et, t,he f instdetec! r on and pegli st,net i on1 Lype of index cege ofleprosyr P€leLionehip of pat,ient,l size ot' fani ly end

dunet, I on of cont,ect.The st udy popu I et, i on wes 6B index caseB of

lepnosy end Chein 358 household contect,s only 1O5 ofwhich wene developed leprosy. 'fhe data were col Iect,ed

fnom pat,ient 's neconds1 int enviewing the secondery

casEF by adnrinlst,ened quest ionnaines t,oget,her wit,h

eddit lonel nhvstqel exeminat ion of household cont,ecLs

of lndex ce6es. Det,e col lect,ion wss conducted fon fournronths from October 1986 t,o Jenuery 1987. The fnequencyp

meen r stendErd dev i at, i on I specific eLteck net,el

pnoport, i on end neL I o ot' I epnoey emong each agi'e-girouP rCopyright by Mahidol University

)type, of lndex caBel 59x ot' bousghOld cont,ectE and

ElZe of fernl ly wene eppl ted for stet,iEtlcel enelyslE.

The nesulte ot' thB st$dy ane as follower-1. Thene wene no s{,at,istlcelly elginlflcent

differencee between t,he.at,Leck rEte ot' t,he chtldnen(agte leEs then 15 yeans) end the ett,ack rate of Edults( ege rDone lhen 15 yqanE ) . ( P=0 ,4449.',

2. There wene no st et t st,lcel ly ' slglntf lcantr

dlffenencee bEtween the atteck r.at,e of mele end the

at teck ret,e crf f eme le househo ld cont ect,s. ( P=O. 3936 )

3. ThEne wene st,etist ical lY'' Biglntf lcEnt

dlffenences bet,ween Lhe et,teck rBte of bhe household

contect,s of Non-lepnornat,oug cases and the atteck nete

Of the hOuEahold cont,scts of Lepnomet,ou6 Case6' '(P=0'O885)

4, Thene wene no sbet,ist'ical lY siginif icant

diffenencee between t,he ett,ack nste of lepnosy . emongi

household cont acts fnOn f'ani ly of si'ze 'less Lhan or

egu6l to 5 membens and one fnom feni ly of slze more

t hen 5 nernbens. ( P=O. 3594 )

5. wit,h reglErd to t.he neleLionship t,o t,he lndex

ceBea of leFnosy .in the faurilyr 60 peneent Ytere aOnB on

dauglht,erE.

The reEult,e of this st,udyr part,iculenly on Lhe:

rlsk feCtOns nelatingi t,o t,he occuFence of leprosy emongi

the household cont act s of lepnosy ceBes could be useful

not, only f'on' funt her EppI icet'ion t'o educet'e ihe

pBt,lentEl end thetn household contacts but, elso fon the

Lnelnlng of publ tc heelLh wopkens lnvolved in theTheIn bet t eninle$reted lepnoey sonUnol senvlces'

knowled$e Snd undenst,andllrgr theneforer cOuld nesult, In

ear.ly detectllon end tneet,nenL of nen cgges, of lepnosy

90 Lhet lt would be t'he $neat' impect t,o the neduculon

of infect,loue eBses who Bne t'he nsl'n sources of

t rensnl ss I on of lepnoey ir:r t,he conrnunity 'Copyright by Mahidol University

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lltu dsldalxlrniut r{solsilu#a{nnao{( In vit,no cult,tvebion)

o- r r fi ua iln::nd'r drg'l unrri duriun {r r fi ofinrur nni 6nr: nr lqill?n'l rfl

o. 61. 1960 (lrf. 6. 2503) SHEPARD alnrjxu tnnf,ilixorn?fl1d1x1tnt E lrn .t e 6 u rEr rtu'lc rflofiulei tudo rriruufrudn: t.'( Foot, Pad inocutet, i on> uavgio

11 fl n.6. 19?l Kircheirnen a,tnarfso[il?n1d1il1Tnt1{1vttf,ol:nE 5f v t I " a s - 'aTn fisfirfirarutToll lunfl? rnfl sanfl?fJllutlfiiloilnil no n?o'Iil'lo

(Nine Bended Anrnadel lo) uauuu"l{tu (Nude Mtcel ,i.r1rifigiaet

1nfrn 6oldfinfrd1rn1il !1{1u rdst'tai'irs rir'hintnrnflnu'rfioori'ir

r :to'ilf, inuiui,ri, dodofl rr,r?a'[ riunvyrqno { s'l r erfi rfrr ficrsi1 tr j l'lfiqnd

rir a1 s r dolrnriae r fr fl r'l o unvfi rJ: cle rri'l unr:flnuroir uins rdrfr rluuauilsrBinsl?ra.rT:a r {ouodr derln r {oT:nr, {our, flur,,iladardeod'lu

rtadur,,rtto (obl isiet,ory int,ne-cel lulen orgenism) Tprgr*'l,

adr td o, t^dta o r 6o r fi oortr rfi odel.rrJ r tiodl r'du:Jrc nrn ( s chwenn ce l l s )

rtavttndt"otonurlatufio{ (Reticulo-endot,hel iel sysLem,t,{u

l:nr{ou'ldrrar'lunr:udldruru Lz-zs r-u fi.su'rundr r:f,aT:ndu rrriu rdoiruT:n'ldrrar'lunr:urirdruru 20 d'lTarr uuafirf;snail

co t I f onm 'ldr rarrjrusJlll zo urfid+eaeaaa

I XA tTntTO$3Jn$dflUglglndn$fl:O ( Ac i d f'ast,ness )Adt \: [ lJl[Fltll

nrurifitosatti,,t rtndtot rdo rfiatiol.loirs Ac i d rest, sLa in ovfrorfluor

luddaruranfirl:vrrru g t orell rtnrfisn ldoTrnrSauq"fifiin"lfirj:vlrru

z drJor# unu r ttot:n, {nuitlortufiurtrlntotfiriesrusvfiooiadldldiu

nr:inur ovfifltood"toirj:vlrsl r-r iu rdoTrnr{oudornr:danfi rqu

'ltnrtrirr.rfiistoirflil€lrrurfitrt r$n{os (Mi cnoeenophi I i cl 'lunlrc

dfrdan?rquil?m$rrn e qufir'lfrdofurradga.r,dnrflnn$nilfifi'lunr:

I

I

t

rla rfiudmns r dannrirare'lddrflrr&q'A

uiln\luuT t {o,Uo{l tTn I TouItdq__ ^n t B.d d. + & er af^tylrJFl?1lnjnilTo $'u0 {flilgt1iln1u t n1ililn r ljlt ITFt t 50u nruretToll!tU-

drtf ,dOn'ln ( Lepnomet,ous Form/MulLibeci l lany lepnosy) U,tflCopyright by Mahidol University

10

ldleiirnrrint'rfiq, r fi uutd t nud, {ot4d.dq

naounnruord, (Portals of exit )

6o fliufr rnfi s ricrdrir r ?r uo rmn'arruri.rdliir Bnn I f, uuna uno'l tr dolqrn ' ' ' r doTta r {auilzourruiuav zo dufire cnnfruoanuon:r .t

nrsgiilrelsinrlttrou!{aunnrto{tfiruri,.rdluro{uu1 ttnauflna'tnq{fl ttac

fruil$ddr{ultn,{rurrurfiorsioqvfi ,'f,ofr" r'l? 1 18 t.riufi.uu 1'

&Aurfo ttoiloonmuondrsnrflqcfiflSnleiil:vilr$ r-7 iu wfiu,:ilaltet

r {aut sfr oddrl rt'l ufi o oddfr firiru:u n ufr nsiao naro"iarrianrot,du (Mode of' Tnensmi ssion)

+Jv,BlA-u---^atnflil? t1nlTtnfl tTnt1nun?1ilTlluT{'tt6O rf,O(Vinulence) llnu

6rrrlrtotn'r:frordo 1|,nu p"utog.r]icit,v (ctllxdltlltn'lunrrrir

'[#rfrnltar nrrllr'lunr:fro r{a:iluoqifilir.:nrstasseiacuno^ d{uxo

dOn [nuTvulltlfioirunrutotirnflltt ao,t.,rr," *""n"r,i "ilnrt uudfi crsioto tl:nt, {tu nur: nfiosi o1 sid silr {tsll .! rnunl t dal

uginrtuflifrogianrdnr{t (Dinect, cont,ecLl frdru'[iln1tf1rdol:n

lrnnr'rnrtuutficrgioillqdail'"' ( tndirecb confec!, dl,droaoo"

odnril r{asiT tot'ldto,,rfirirs o1lt1r fil aiuauaoo

riruriau lt$uttMa u5ofiufiufl o r{ouolriorad

uf;onrilu?,.*du

@'.'fioI . nrrdlfinnnnnfinr tfiruril tirfieuttfiTosflaon

d g r| 'vun 111 tll l5l

rJ16.r*n ,{o

z, nr:uuir{on.tailurs'lq o1flfl1tl,t1s'lq 1a q'trr lnsul'ir{

il'rstueufrngioriouinrrfrnul r:ilofiflin'lu, doqoryn uaustuu

'lttnluo tfialnro rfiuurs'lq

3. nr:uu:,,troanouatfin (art,hropod vect,orsl dtfinqdudt| tt u( tot

ilou llr t6l \


t1rJqdsnr soi'rulur+ti

IUAailn-.l

3+ dor ta l?n t$o le'l

nrrrdso.rT:n

r unfifi$ ' ' 'Fr?'lriunncir.r{ri'rnrudcr r ou'lud'lu{unvTonre r fiuTrn r {attrito

I

+ & + $vrrfr r roll rorgil? rilo1q r fio'toinnnaiarolfl ndrucilonldddilfrdfiil

urrr,fierltnlsirtaslrn'lurF,norsii'rndr 1 fl ' "'uuatrnotun{uaru to-?o fl

drol+atltldF1 fl{AInn"lfnltlflurill13itntil?i0d tTA uU Itllldn11Ejil1nn?1rtt

finsiauu'lu I untlrlr,tnn'ir r unufr r r d$fiu''' fr oito'lo r fio €qrn t ilRtref,d g rl r dr I s .I c qeof 9 e u r I

n1 r I rrfi oilfi r s "[ dnr ilfi sir s I il r nn'i rufl t fl rrir'hifi ] onT nda.r finfi u uu ti t uui

r {ofirT nn'i1 ' ' ' uau'lutiltxrl'l ruri soro, duc,,aqrndafrrvrr tdrnr uau

n 1 ? n? ? a? r o n r s'l #a v r 5 e rr'l u liufl s fi rlo a n'i r fr t r e

Tur? rra rTrau Au r " 4 JYgu a r

T utllt'Uo {tfl ilm1 ilYt'1 ltta { $fl nc ljnnn $au'i'1 ul u t'd o?1 [9lT Iil GJafl atl

lanradq" r fisrlzn ttasn?ltJTuttr \:flo,,rI:aa .)g

'l

an? r$cflslonrrr{finfinlrrrJdsuurjnotosoo{Tilur}rrr unu

a o{11 uqr n gi o ilu $l r n1 nr{r'l fi n fi sir rn r ua6'rstr n..r 6 r fi T o n r o, { u

lrn r r urf tt fi Erl-in unrndou"iriru r nn'j'r

l:nr{ou finultn'ort'lurl:u Inc1fl1fl'oil n?'urrfiuadroorjruttnrVlutilnflalaflttltu"

ri'',unfirlrv rnetunynfiornrn ut rrnrfitfiuu?oanrufidfro..o'tuXoo qrr .s + A t u e! & aaa vu t

rir -t

ri r T ol zn r 5 a ufi rJ v rl uu r rir {r rfl 'u o 't

eiri r s r fl a'.r u I35 n 1 dur uTu ( 01 a

od'ttilfrs 4E C.,,)''"' t' t

tvsvflndrtotTrn ( tncubsLion Peniod) dt$6irduiurda

ltnquilt'lnflalnlT roduudrulu 3-s fl ugit'n6rralrJ:lrfiaarqurufi,ra-ras 1l uTail1nnl1uil

" Jc Zf'17?l'ifl''ltJ I tlO t:Fl t TOU

I

t $aouflfldfrfrflonnrr'tllo ran ( uv- I i srht, I riresirfi.lolrJ rdolsiCopyright by Mahidol University

I

drufun::li 6nr ffi'Ifi r n r s r iilaT:n'l ult {tl,tEl'M a a nr ult nr r d 1 s 1 r016fl

dltnuoq rriu nrteil'lufirtfioo fl1rttf't {ou (Dnv Heat) 1l1tl 1

drllr nrroucirsurodu (Aut,oclave) tt'ttt l5-2o urfi nr:'ldAr:

rafimstfio Qo% uoanaaad uf,o s% d,ttaca'tsfluoa ufo s-10%

lnlta ) d1il1rCIrirnrs r {ol:a r {ollsi

d,$ urotdailnr teirud{nluns r nrugfie ( E '

sidlrinltnduriT u r fiunti1fr r ds .teionrz r frorttn , iou tnefirlil

ul'irnr: r fierl:n r foufierrrldlfiuCfiufl?'1ilqil rau I do'irnrtodriuarir t

uur uriudr ud t t ntll unrr uuin: v or st o d r tilolrn fr :r s t r ufi onr:Flntr

errrl'turiuCrou'ir {n?'let r fltaduulrdtfiunrt r firrT:nr, {nu ugifi1n

d1rr1?nqua6ursrdtrrfiurtede{ riasqrnfrrlqdndudoreqcfi6nGuasio

n1rtfiol:n,,{ou rJq{eruairrtt 6o nrrfia'uaurfitrdluuou^fi1tifi Bav

nrronlnril1fl'l? drfinrrldlfruCfiunr"rl r firrodatir suururiu 'luudta t

drnl errrldlfiuC'lndfio:ru'j'r tlnnrafiu {uatiriunn''r un1un1,s d rnn9.

rriu alq ,*rt tt{u (sociel clessr nrufilfruCluntoilRd?'"'(Feni ly relat ionship) ri,,r:ilulluiadnuuvtasdlnetorqqvfiflnoio

nrzuudn:uq1s'uoo rdoTzn tl

nr:dr utntfioto tltn t {ou

u$oo?o ilrutnRatilrg ,do e,.F1.1s53 (MADRID

(Classificat,ion of

lepnosy I utitt, fiu z ndl'ltqil' "' fio

1. dr$ilnnlilsrunttrlrctilnnrl:^,{ruu.urt'rfrn{td 6 d

CLASSIFICATION)

o5lru8susr tufu I n{tu

l. lndet,enminet,e LeProsY ( I )

2, Tuber.culoid LePnosY (T)

3. Borden I lne LePnosY ( B )

4. Lepromat,ous LeproeY ( L )

rumcdrufuld"lusrun'lunltto,{au uris r fiu o

, Copyright by Mahidol University

Iz. drutntiornlsltriltl?fl rritiunuT{rlrjfir(Ridley end Jopl insl

(R.J ) cleEsif lcaLion) r,fiil,tudlfifltruidflttaurrjiertfiguilrgtt-

Slnrfisrfiu'lurrunruarTto, {ou lasdruun, 6u

a

a

a

1

2

g

4, Sub Polar Lepromef,ous (LI on LLE)

Polar Lepnometous (LL or LLp)

c&roo1fl1T1A{ t_Tn r TOu|lmnutu6l

Indenterminete Leprosy

dorfiul:a,{ouuur"tjT':eiou leifrflu:t (Benisin Form)

dtur'lutrtrcrdilr$uT:nr{ou'luri r riourirrldnsd (unEbable) fin

n:rqhiurr{o uoflqlnruflc rdfifluuf,ut^uodu dnuuc Les i on inuu

r6urrairrfltrr uiafluat rdo riro'rnlrri'l r?r touhiderrou druru

1-s 1{r'nrufirororlnfiutou#or'$nfios n;rqldurrdo nlrnflf,orra-6rauSllto;Irjtfiu fn-tr{runauuSourndr c, o'tfl1rt1'tnilTcf,1n fiornr:tr finul

il1nil1uflar ru?orjnfi uauairumnuu'luairirsdfrarnrqod r f,ur ?n1u1il s,

a att l u al rv u In1flrJnliln1lt?to {tT1 $n1 gn {ilfl quu1 g I 1l t6t I o {T1'}TognE0tl

an 3 . u ,.,! d .a + r eBrJn1Un1U9l1 ?uguUA€ilnrilnglr[ljlltuora liltil1gldt

aorre{ uiaorqfio1fl1rn{ r firld r rjdfl uuiln sflaooldoucS6EtJnrrldrdrgro dT?n tSouttnil adfrnrtinuln?uqri r urryfirduuu

1tu I d , , .l ,tl d a +, u cl d

UnuTnHlUglllTnflquil"lu\t1tl n0$ilqu t lflgilt lliltlrfl lfl [ilTu1gld S{l t 111[

.a 6 ) a ,d d -o a (a t .i a a r rl,Vutilosrogtor?o r lla g u r u1[{ ufl n? MTn2 n o sfl 5 { o'l q8JFtl'l alfi nr :sioI ill ct

Polen Tuberculoid (TT)

ai'lurninrf,utiolelirsurt (Benisn) finstzrqhiurrdo

01n1TTusuuTfllrlr r fiur roir sfls'rr u?ouniuuiluo srfill1T:Jr s uuruusougiu

lndet,ermineLe ( I )

Tubenculoid (T)

Bordenl ine-Tubenculoid (BT) | Bondenl ine

(BB) Bondenline Lepnomat,ous (BL)

UAc

I

I60-80 usirir

os(aTTO11? [:JO?F|?


14

uur r 6r'd sorf,o r qtt t d$o nltnnao! r atrj:fr1'hdatnl'ln t nilo 'o,rufis

rse-uLgrU1i.: 41il?tlXfll,lll 1 -g 'l \: [4vilfl1.1il41fl'l7fi'lggl'llilFl? SnAl {? $n01l

( Cent ne I Hee t ingi) t fra'lqrnfinfisirunrutattr {fl'ltld€f 'lr{agac 60

u ril V ,, r,l tY ue u d a vl | 4 alt V Ifnurs [err o0fir tn lnSunrr{nu1rilasoln1T t$il1n n'1n8fl1iln1il lild0cot(ttJlf] a1n1Tn'l t 7uq1fl') $ol1n t llutlduxulte'l dfiu'] ( P I aque )

t

{rir el"r {?1 fl 01 quufi or nrtn"l .? ilr u d1?rod r s t fi sr lotlhifr orn'lt

nrrfirrflrras (pune Neunal rypel rtiu fiarrirtr ndur{afiu

r fludilurn uaufnur r fiu{r t t 6srto s:r snle

Bordenline Lepnosy

do r fi ul:n r {out'uo'dir s ut t fi fi ornr r'l der oi4tln r rjdsuurj n s t dlo+ oE - Y ra , ;t re ou rlr. -t-q- --d-

1 6tfl A14n1ufi 50 I n?A n l ljrAfl n tn.ljUAfl fl ilt'il911 lr,n1 1r.ll4 { 4111 fl '1 1 0il1 rr.llu

oLgvvurasrluTon1a { ??iln {fl'lT?flu1qnna $ilruY|?'111 tl.lfJ {l tT

q1fl RidIey Joplingl clesiflcetion ufil Bordenline

oaflrf,ru t gfiflilofl (sub-Gnoupa) fia

1. Bondenline Tubenculoid (BT)

2, Bonderline (BB)

3. Bondenline Lepronatous (BL)

Bonderl ine Tuberculoid (BT) Tvflut|TnfidnUfuvOlnlTnln

'rurufirrfiur.rsir{s1?nd1s TT usflq1n rr Tosriiurufilrnndr ttauiltt

Le6 i ons fl?u11flA6s.ilf olO r:f tn1fl ( Symmet,r'i ce I I Tog t ill.I'luglltl

tL,uult1 finul Lesi ons 'luai,ronoon'lil iliorfin'luritou i Lesions

rfrl rtgndr sat el I it e-leEions dnfiornr:yr1{tjrud1nil1nnd1 TTgvdrurlt4

n159lT?O I dOnl I !111$O1',ltJfl llllllj t XA dr r { uu aiutruuor \rfi ir1 01 qu!'t ril+,ousl!?nfl1 I n1?nflnouInt!T81{ tJntli.gJn 1-2 1l?n

Bondenl rne (BB) frarnrtlrintduriuau (unst,eble) rln1uuVlda-drq

n21iln1iln1il liln {n o1fl1?Yl1 001?u1r$Yl I 6lut6l

culva1ulillr1fl flTvq1flnO{'u"t{'UO{t71$n1fl OflUmv

odltlfltl! I lIllt|0,1ilUllllfl S1{U1

leslons fr 2 uttU

d t 6.r rl rV t r ellljlJnTfl I i]u$atltlrultu'tslr {n'n1 silri t 1l d oonil1 tarllltur1xa {l t il ttj l,6lu'll51

'lu Copyright by Mahidol University

uludoeo rfiuuaituuuur mr$nalt rf,u1T:ia'rlrt qrfiu1:hluurtdstan

ciru'luunrsauciuuonsnUutriufior 41fl'lTn1 tiltcn'lnfrrlosn'ir

nr?q r do*^n.ndrunar { fl1?nfl6ol r alrJtfit'lfialaauuialrnsir 3t

(BL) Snunllllulultll Ltl 1{o1n $lJultulill1 uaun}JHnilflllof.l

oq{ruav-airsnrg dnuuvetd'laflljt-uFl Lepromet,ous rJlfl

skin'lesions iln1fla

ilufl?ua1flaan?l'l {140fAuzldt

ltn0l21t1l{n I lJlt$alTuil

ulr1Snuo odtd., r fiufiu r.dailriofln"irt'lto Lepnomet, ous a1n11Yl1 d

ilrunrninil! t duil:uarnlnrir s t 6sr arnrttrfio rfrr 2 rir oarou:r1oi

Tu$uuds sL Snfir r ?l r fiurito Lepnomarous giolilldodr o:ro,4r

rl1fl fl1?nr?a r:f,0'lr, I es i ons l.tilil?nf, o usihilr n r rirtto

Lepnornagous nllYtodox r aTrj:fi uqr'lfEraau

Leprornet,ous LePnosY

d*tauetilu !:ntToutltot.ttJtt?{ }llltfialln (Mult,lbaci I lanvud.

Forrns ) qo r ttttriofincio tir'td'trifunr:rYnurfiq, t $uuutit utlt r {41:a

dsfrnrT ldrdrgnr{d1E'1r$dlt olnltrandoonil1 sfirufituluniuuuuurfl

un{ trhr fiufrutu6ol"1 srrer'llradr rl'llUfrnuiluo..t firlalinuruiafnrr

1 al qnoia t or nr r so o ltnq c rir, e un.,l, uU.u O o

" v $$1t ln n?, q r fl frrI il dtl

rqufrfiruolililultu1 (Plaquest unvsil'lu{ <HooJt"el losroillcsl'ltl

'luurir fievuu1Eu1 luufiruuuur rfiuurtrf slnf,o!Qll( Leonine facles )glltl

finrrrirnrsso0?cilililrunrnairu:Jnrsnavfrrufis r{'r'ltifiorn'lrtlsl1u

rJarsfio rjar$t?ir tudrtunlqvtdtir{qilililo o.tfl1fnl€sl1 rriu

rir[flrdntnu ( IriLis) $av l(ersLit,is quu!16iilafl airuarnr:nlt

rianr,r r fiuurs'lqdruuu t fiattqilnovtlul{llt dn t al rir'l#eioorynurs'lq

"trinvonnu^rt, nourutu"nnou*o"nnuu sioil#r ru6a lfinTor uilTvr'liltreutt

unudrmvdn r d! los r ilu1vrvsu r frnl:n r rio

fl1rflT?qr{urruanfir'lu skin tesions unutfiouqln n1Tnrl

aott r aTrltfi uqv'hinraau I dilo

1.6

BT


16AAUC&

fl1T2ilAOg tTFllTou

'lufirJrslto,{nurruur?n lnersil'luodrtdotio I r rr rnu

,, d o"olo1fl'lt r iur toir ottl d1 frr u#tu?ofiornrtnr oil:unrn r riu

t'l firu#s rudahiaon fio-rfireiourirfit fil "rn{ornrro1riuur{o

finnmou!1 t{rir trdl:nrir r ? lfr or nr zfr ru fi s uruo ru ur udr r riu'l u{ri'l u

tto sr tdfruoiuXuuu't o1ailil,,{uu.nofi'l't, {rlrutuuvflnsiodfi ,dun.n

( Mu lt, I bec I I I ery Leproey I lefUfitl^UO Lepnonat ous UAc

Bonderl tne < tfret sB, BL) oofiu nrziflodst:n'lu{ilrsrvuutlrfl

r dlfrornT : 6s:fruodfitnr:nrrodl {n1fln1 s'olruds uacYll stJ:ca1n

mnnr'rnrrflTlqil1 t do t "

)

fl1rnnnoil'irfiornr:mrfrenrtrdfin {ou rEu fufrn uar16r,

lirru skin lesi onE uaunlilu?til lt1 6l rf,udsdrdrgtrilfisnT :nr$r

rduil:varndrlnuf;oll.ist'rrrrttrrrudnrirleirios rrit f,u.t rrrudonan ria

fro rir r rir nT oil rauno olqndruu r duilrvnrnllsifiruri{roll I sk in

lesions

n.rrnr..r{" eon:ro'lufirire'lurin{outn4nrterrln:T urdocv

nr1!d1u! r {oua,od'lurvscfiosiouui r :fou6o1d rtibdazirdlnrudrdrgo - *Totr{ousioldd{ tilfl"lrn?ilqil tl

r dorirnr?n??oo1n1rn1tfirufit il:vnrn ttnuflf ?o r ffiaflrildroiu

d.rnd r r rir r rrudr rir d rhinr m : nqvfir nr ti f,q{nTrol d6,ir r fi tsio sdo

Bi opsy rdon:rotfiodfln1'susrfiiflersio1ilualaauf' A--.

udn lunt:rtoag ttnttou

fiufin'lunr:i'uqdtl 4 orirt q1nHa10{tfl1fslf?4i1tn1suaufl1?

flT,lan1srffaorlflrTfin1? 60 cand ina I 6 i sins' .'

l. n:fqgUfia1n11t1 (Loss oR- Impeirmen6 of sensat,ion)

2, nr{rrdudtunrmloTtgl (Thlckentng of nenvee)

B. nt?qurrdoT:nr{ouqrn'elrufitutooln (Denonst'net'ion of

M. lepnee)Copyright by Mahidol University

4, nrrqiflodslofln'r:fio{tr iiolrjntron1 0ils16iil$1

(Hi stopeLho logl'ical Di aginos i s )

n1?n?1eT1$fl1tJ tjtvnattoirfl fl11sI?'t401n'lrrl1tfirufit

( Derme+.o I ogti cE I Exen i nat, i on I llacq1nfl1T0T?qo1n11?l'l otj:cn1n

( Neuno I og I ce I Exarr i nat I on ) tf I rfrg.:r.radovAlt|llnnT?aa1fl1T'llo {l

ltn r{auloi:rr so%' E'

tfinrrerrlqrTtn t {au' "'I . fl1?ei1 t fltrnrtatfinnrotir.:qi sdt uncloilla'lutritu

z, nr:riuulrirjrs rdo'l#nr:fnu"r{riru drflaonrtfier r{o uac

fl1 ? uur r {a'l u: o u'i r t nu Tor fl il fl r fl r lriuu r'l fn'r:i todfl uau fnrr dri'l tl

'luroeru:n r dr

s. dr r nil'hfrfi:clunr: r flr:v{rfis r nnl:a 'lunii#f,lanrn, duI

+ | r u a 9v 9 r r ' aI:ndrfl rriu rinrisu {dlfraiuriru rfionrlnrdRlilnlrdnlr?ultloro&

1A\1 tTn tuxiltulrllq

4 . 6nnuwanr:dnsr ri,iorJo rfiufr'hfrT:nnfiurir r il'luri uiondu

r fiuT:n'luri duovria'l#r fiorTrgu''' , dndtu."luaurncl

as d .J ufln 01u2afrn I nglfla d

fl'lr r ficrT:n r {ot'ltdfufrn fierrrlfufruCfildnu,ilcarrl'[ndBota t

ddlfrnunvt'uotosfirhgT:nl'r$nu (Type of index c6se ) ' ro)

n1rdilfrdnannfi'lnd?qfirrfidaI finrudlriuCfirrtim$?ro0,'iludt

" u- - Y !'!' " io.ludufiuCnunlrrfiot:aeir$ ndri4rds{cionlr,nonil0'lf,Ou t0Tll n{iln?13Jnilu1l6'flllfl11l no tTna?g fl .Tznn rfio nderddrfinirlrirura r frriruTta r, #ou q'lnn'l?frntrtso {t

rtttl

Noondeen" " tiio n.n.19?e 'lunrn'ldloo6tr6g uu'ir Relebive

n i sk'lufrdlfrnsoofirirslr", Trur ir q rri'r taofrdld'hifrderfrnl:erttCopyright by Mahidol University

1B

gosddrg dr tnotdenc. 'lu{fufinlt.uas'ir Retatlve rlsk qu

onni. rriulrt'[tusiaunr:Flnrr n?1ilrnnei'r s{6uo{fiui6nrt rfiutoqn

r a$vr,, "rd'l

ffl $n1 :fi ngr* {fi r fior r ahi r rir fi* dr'f; sndn, nnrdd'l fft u

nrtltedslrneir sfiu 1d'ld,duoo.netrriluslneirdnl d?ulllettnsrtos

ltne3{t e1nfl1tfinrrtao Doul I uaunslv' '"' tdoo'61' 1942 'lu

Gebu uu,i'r Ar,t,eck ret ee 'lu{filfrnirilfiT u?,oo{rhe Lepromat'oue

r$u 6,2 sio t. ooo siafl u'nualflflltfinurtal Noordeen unc

Neelen'llnrn'lfitoldtvtnABtrfier,ll.'ir At't'eck net'ee r$rt ss' e

sia I, ooo siofl'lwiorddllro,{uulnqn n{#rdstsianrzrfioltnlsfio

n{l{fufiAlrnnolfirJrs1rn,{uu 1dfrn"rzfrnt1rrtlJ Pnoepect'ive'[t

ilrv rnet6urfrsnrrn,rer'tsi To$nrrfiasrrilnrlofrd$findrrfiT utar{riro

lrnr{o*r$*rinr s fl wanrrplnrruu'ir Att,ack net,e 'ln{fufiA|ter

rfu o.e siofiril?ut1n? unu o.e eiofrl'lun{ld1d'td{dlfinlta {do-

finlraocfilonrn rfiol:n I iuaao rrirfrrdlfrAfil{riru Lepnonat,oue''' n

$ncn1? r de osion'rt r fioTterc, , dn{u fuoqifiunrtdlfrnodr l'lnd?Eruav

rvgtv, ra.frdnfrOttet ( Dunat l on of oontEst' ) '


ilnd 3

t6rfr r'ntnrrids

:ilullnr:idfl cnoss-secLionel sbudy

nrri{sn{o{,f,un.tidsuuudrtrq ( sunvev I tfi su::str

( Deecn tpL tve srudy I rdafinnr r r1ts,, tfr$lnrz rficrTtn r{o*'lu{fi1fi^

irrJrit1|.t|os{rlfelrnr{oundil Non-Iepnone!ous,tlOU Lepnomet'ous

uac r doFinrr rJedeteir r e itfr n'l'd'fi uCfi 'n1

5 t fr olln r tf ou'l u{fiu dnd r'

firtlorfirJrel:a t{uu

rlrrsrntdf,nur 6o firireltn r{oudorfisadluiir r no

cEse )

I ndex

fiousif,

nila11dfl d,rd.r rnazaorir {ruicrnruflu{uard1 lnotfiol dtuioiosrStl

nrzFlntr Toafl{rlralrnr{au tndex caee (Pnirnerv

.lunrouoirdorfin* uarfrsidlfinltnudr rfrerrfitlto,{uu fio

cBee unvdrirsdlfiaf, rfitltn,{uu,$u{riradaonutflnufn*

't. Ft. zsoo Bn. zbze n'l? I fiudaryaet{o{'lduti.ui r n-or{

( Unit, of Ana lys I s > :veiln:ouetdr 'luntolni'ldq'finuroiotfi{riru

dr6u Index ceBe unuurisiltulflYllo$ lndex

I . firirgnair Non- l ePromatous

urinete tLnu Tubenculoid)

2, liilrflndil LePromaboustt

UAU Lepnornet ous )

ndudradroitl{'lun.rfinu"rn{t"u an {rlrolra r{oud tfir, Index

ce6e durr 68 r1g unufid,)elro,{uudfirltvifirf,ltt{dlfinTrntotfr

:Jrsdrfir rndex cBBe drurr 10s r1fl 'l{i6nr:ri'drotir{t$lmrQ1u

qrlosrfianflntrnrouerfrdfiXrirulrnr{au Primenv cB6e unu

secondarv cese t{diltiaT:etdrfiultntt,{ou' 6r1rufidilfia1:ntosfr

ca'e rf,t z ntil

< tirirstto tndeuen-tl

< siri?s$tfl Borderl ine


riredrf,t lndex ce6e(Pn{rnenv cesel fio$rurtt gse nu tfiltrtlr7r nu uauuft{ tB? nr Bsnrdu{fufrnTtnd,fiurdn 13s Frtt ftuoit.t

2Z.3 nll

r adq s fi qd'l dil tn r ri drl ,fiutlttnounrrrdrjrrnoffiirs'fiora z

drl drufr t il:unold'lu,iloXndr't:Jrdsrdildnr$cnrsiltuttnt rtrud

z r $ufia1a r dsrfiuil:u{frnrtdlfiaTtn 1, {utt uaunr:ilttr r dultn , {uuI

to.rfrdlfraTzn

d -^ .-q^-'- -'- roloiafl g i6 6an1r I nilTxll??ilto{a 1|Tef

1. ornrinttcrfiflT i.lJ. 1.ot.1o (tttttt 118.3) flos{riru Tora

n1? r fildoXatiouudt r f,udola r dnrfi:rnr:ilrs r fiuTtn , {nu

2, funrunidfufrol:nta'r{ilru lndex cBB€ Tofl'l{urlttna!

nur{dlfraTrn dolnitlci r $tdarra r dsrfildnu$un1 tdtvtrnr

rjrvifinrt r 6!rjrs'luofinriaud r dru'nornr:ro sl:n t {nu

B . firnr:n:roir tnr:{dlfrnl:nzrlrlrt rdodlur{rlrfl'lilti r dil

r fil u", r, do r fiunr:fiuduatanr:ntrofidlfiata {t t drnfirdTro ',

duudlti

rlfl rifi1 ufld sir urn rnu r 6ru firdTr or, {uuitio'arnt ou'[ lnr: fr onr l'lfinrt

fnn firJr fl '|, lfi o rdd r nrir r fi cr?ir n r rnt r o {dl fraruri'r tt o I drj r ad r 6u

lndex """" thft

u r a- {!, | --^-ti-.d^ d udrurj:6n:v leiun 019lno t?laonc t lsu?flD'l lv$v

, .^.ddu,ial:n ttcrta t drlrst:n , {uuddu-tu y v I d r !, -rf-t--+-- d---dd n?1ildllliuo t nglt|ornill,lu2tl t7n I ?o1l

U,uu16l'uodnTo!n??

v f, r i 4 + E-tdun fl1Til?el I !il lTn I f atl

ttau

t

cfrru'rjtnu


2t

nr:i r ntror{do{o

u d s o r n1 6idot al r rrdr tir{r n r : n f 1 o d o rta t r il nns1a o ua u

nr t lntt dr uT o s eir sl o r,fi s u lo'l uucia u r r s udr 6 o f r n r t a l : rin ( C o d I n sr )

uncfrlililrulSaalaoirflrniatnolfir,n.{ lcrs'l{lilrun1il sPss

(SLet,ist,ical Packagle fon Sociel Sciencel dqUdfrafffif fna{

lurinerdflilfina

I ano

1.

2,

Toflnrtuonua{n?1ild rir{asav rir rsdfl drur'nel

r tturt'tsl?5''l 1 rto { dnuru"tirl rJto oriona

dnuruu rfi I'rJtfltttfisttn?rildlri*Claleirurjtsirn "lcrnFirafifif, '[rlr'l d fi a

- Rete leilrrri Spec i f i c At t,eck' Rat'e

- Z-t est, ( Pnoport, i on) '

I


rnd o

a ttHAfl1T1 tAT,lutral|a

ilorn urisrfiu " aiT t fio

drtd r rfiunrtrnladnuuvttr e 1rltatn{lfidlfioTtnr{oud

I

rirs t fiuT:n r{otdr{rnrrfrnur loe r nloaranllrqnra on.rnfi r fitfoen'

..iruttnn1il rlrn o.ud,dn^onrrfrsuinr*r nrrflntr dn1tta1llnrrn

or'tuudn sil161t a $R, oooia

daXa r dn?fiunrt rir s r 6t1tn r, {nun" t fidl fialrrr kiuri tfloto t

Irn r {nufr , {n ( q1nfl1rn'qi'rodsro o urund uio r {rudrdarsll$at )

7 v sar r n r si s usi r d lrlr r n g o 1 n 1 : t o t T:ert, {t u" unt, d.r l r dln r t n: r efn -

rrulutrirl: (Dunat ion since onset') rjr u ifrnr: r 6:rrir scir sT:n

du'luafifl t'f utvgc 5 fl rioude, rdlfrornr:totTtn'{uu'

rlrcifinr:dldnltn t {tu 1eilrrd

tf,crto t{ritaltn t{uuddnfrnuaootiluato:.lerdr r fisrfit ( rvpe

of tndex ce6e) rcsut,.".f,dofiaTra,{uu atraldlriuCriisrfiosfiuff

rirelta,f;ou

rirud z fllrulatlldlriuCto'rfl'ndsgirt r filnr:rfinTrnrt{tu

'l lfifu fiArufir u lErsur 6irto$nv I a td, urj:d r'ntrl do .r ufi r rirl1nflda!

eirscir Z-Lest drul:drfl1il1n1n1lldrufiuC loirrri

ddauo'tttfi t -iln {ilv l lltlurflE'l

,ro

t'uerla s drir elrn, {nufr du fia un" od'l tnt olair r fr s r fi*U.t|il1fl.l|4{tnToilnT?


Idgrltl irYl

2g

uan d dnu{u, riarradrl ilta t fr dl fiaTt nfr ti r u r f, ul:er, iou

dluunnrfl' rila argfr r$r,ntnc tfisufnrr :vdlnr:

f,nur an1iln1ilail5d nltrudn til1tlllotntalafr

dnuuvnr trltutrn: oq-t1|?ltaTOflAv

t 1.161

t-)tla

TfU'1

f ?er

49

56

105

48.7

53. 3

loo.o

.)dsv01flil r 5iln {tls t iltluxflu1

'I'irnd'l r s fl

>, rs fl

r?il

J= z2.8oo fl,

39

66

105

S.D = t4,739

37 ,1

62.9

100. o

lJ

rudrnrtflnnr

il. s uavdrn'jr d. 4

nrn'ir il. s

f ?tl

74

31

105

-/o. 5

29,5

100. o

dn''rxn'1ilnilT6+tdoI

nJ

tlil91 $gn il'lB

iltJ

lg

52

1

66

19.7

78. I

1.5

100"o


24

n1i1od z tsiat

dnrruvnr lil:vdrnzIq11?X

af0flav

AUo'ltuilaflt fltsgl5flu TrUUtlJOl \t

ir:rtnrtoV

n1{11f111Uval.lj1llga1[nlT8U

'ir t tru??TJ

7g

5

I

2

?

?t

1

105

69. 5

4,81.O

1.9

1.9

2A,O

1.O

loo.o

drurram?n'lun:oundr ( tu'lglta{n:alnfr I

\<5nil6-8 n$

>8nilf ?tJ

i = 6.265

ZB

29

11

68

S.lJ. = 2.833

41,2

42,6

l6,Z100.o

alnet,rrl od , u:r.jrfifilfiaT:ad r fiulrn ,{ru drulurir fiu,rrt

ufis {asav s3. 3 olfr tiio ',dl"onc

tfisudnn'rairu'lurtrf,tfi'lud ( o,rsr

rrnn,ir rs fl:ilulrtr iosau 6l, ,s tuoiunr:frnur riru'luqiad'lutvdl

{'rlrrnrfld 4 unusirndrr1:vn'flf, a 6nrfiu{osac ?o'5 an1iln'lu

dtrn dtu'luqinlznudr 6o r {udosnv ?8 . B ortuufindru'luclr{rnr:

tn?nrfl?Til dogau G9. s drurtalr'tn'luertaunir (rttl1otannrort

erfr I dru'lurlturnntouerirfrdrurunl"r?n 6-8 nrr 6o i{udoflav

42, 6 ?ofnolr tfiw,tolnirfrfrriruruaatrfinriosn'i1 s uiarrirfil s

nrt dogau 41.2


ur1:1di4 s udertdruruuav{osavtotttn'uallrrrr{oudo:rou! ivtlv

r r nr d r usi r d lrlt r n g o 1 n 1 I fl a t 1: no tn: u rt t lr f ln 1 ? sl r ? Q

inrr :lt u i6n'r t r 6lrir tloir nTt nd u'[ uofi ndo ui{o, r dlf, o"r -

n1rflo rT:n, {uu

doln r dsrfiunrzrirs r fiulter, {ul a11'U?11

a,TAgNU

I

storo oTtn r {oudntroil!

I ndet enminet e

Tubenculoid

Borden I i ne

Lepnomat ous

T?'J

t4

54

.30

7

105

13.9

51.4

28. 6

6,7

100.o

3 r ^. f 4- -..--. 'l u u:ssv t rarsio usi t 5ililtrnla1nr:rto {Jtn t 5ouquntvYlsilt:!ntrn:to:nut

( Dunet, i on s i nce onset )

<lfll-3 fl

16

74

15

105

75.2

70, 5

14. 3

100. o

4 fl:ilu1rt

TX'J

f = 2.904 fl S.D. = 2.358 fl

+E1ro{ tTqlTail

VtatlrSJ

a3J

T1T

104

I

105

99.0

1.O

100. o


26

I

o1nn1r1{il!d1 ritototltodst:.orn d'lu1nrfr fiut'uo

Tuberculoid 6arfitdasao s1.4 ?a{ntlrrf,ttio Bonderrine 69t

rfiudasao zB. E ryvurrarfirusirdlrJ:rngalnltso$ltnr{ouountr-Juurflr,O--.rafrrnfunt?nr?qinu1 airt'luqi:Jr1flAo1n1r'lurctcI?41 1-3 fl hrr

r{tiosav 70. s ?ann$il'ldl1n0o1fl1r'u0tl:nr{trrnrafirn'ir r fl

fierrfiu{onnc 1s. z rjrv{fin'r:r6lrirtrdrsT:ndu'luo6n riouf,qo rdilfi

o1n1?tanttn r {au drt'lur[ld r 6urireoirsT:neir t ., lrriou

iogac 99.o

,l o u d d a !r- -al---9!r---u-gt1T1 dR 4 UdOsrlltl?1t5ofJnv1o0o18 t uO I Tila\:nu t lgtl?flu1 lTlJdill,fn

lrni4rjrn r $ulter r {oudT uuflo1eJ?vuv rla'rdtusir dlrJ:rng+&Jue

01n17.l|A { t?Fr t TAlrqll,fllcn $3J'lTiln1Tgll10TflU1

adFIO I lJ1

t

t,,A,ddaeTUflu I ',)A1gl { Ugl r TililT1nil o1A t ila t ?ila {nc t lultTfllt'l

JuO1 nllq XnT u n \t tJ1Tllfl 1 ?

nrloinr1 < 15 -lJ > 15 fl

5?tl

t

<lf,t-3 fl4-6 fl

5(12.8) 11(16.?) 16 (15.2)

33(84.8) 41(62.1) 74 (?0.5)

o (o.o) 7(lct.6, ? (6.?)

I (2.ti) 7(10.6) B (7.5)

39(37. 1 ) 66(62.9) 105( 100.O)

7 flrilu'trt

f ?eJ

I tt .tu u f d i tluu?1 ruatar|0,ta t5ano1rlsl1nl1 15 fl uacfidilfialradarqrl1n-||lt. I

ndr rs f,:ilulrJ urfunrzntrqfnurairu'lu{ riiorltrngolnl?to{Trn

rlilrfiurrnr 1-3 fl fior{uiasau 84.1 rav 62.1 nrriziroTtt

t Copyright by Mahidol University

27

Iost']?')dn b $nfl!d1x?il$aufaflnusod r l.tFlto sridufinlrnfrrirs r $11:n

, {uu drutnnrt lat)vr:nrfitugi r dlr.ltrnnornr:tall:agr

r iouqunr vvi tmdlnl :sl: r eintr

B r d7v1!a L?n1n{Ugl lTu

d:rnnarnrrotntrfro

rr{unr:nr2qfflB1

I l,lfl

??lf

t"tu u0o

t a<1lJ

1-s fl

a-s fl

9(18.4)

33(6?.3)

5(10.2)

'z (4.1)

49(46.7)

7(t2,5)

4tt73,Z'

? (9.6)

6(10.7)

56(53.3)

16 (15.2)

74 (70.5)

7 (6.7)

I (?.6)

lo5( 100.o)

7 flfiulrt

1?il

ut'jr tilhlt')flttnv tuOuf,t :lrfunl:sltrqinpr rfrorlrrngolfllT

tool:nuro,fiutt^. 1-3 fi fisrtfiu{aflao Erl,s uau 7s,2 cl'liliirfiu


n1r1dd 6 uda { d1 x? u$n u {os n u'lro { naiil'u o rtter, {u ud uldu fiaTrnr r fi or

trn drrunflril?urru ,.^.donri r *rril:rngJln.rno rtrerttlO9UU

t I ollqilfl tvn nil'l T ljfl 1 Tel? ? qTnB"l

:

U , dlvflvt?n1n{uglt?tJ

ilrrngarnr:qunrrrtsUU

3J1f Un','t?Sr1?q?nu1

nairura rT:nr , {tu

Non- I epnomeLous Lepnornat ous

T?11

n <rflr-3 fl

4-6 fl

10 ( 14,7 '

53 (77.9)

3 (4.4)

2 (2.9)

68 (64.8)

6 ( 16.2)

zt (56.8)

4 (10.8)

6 (16.2)

97 ( 35.2)

16( 15.2)

74(70.5)

7 (6.7)

B (7.8)

105( 100. o)

7 flfiulrt

1?tl

1.11111

Lepnonat ous

t?a1 1.3 fl

9) 5 A I trl I

Ettj'lu lT6tt Tounail Non- I epFomBLous unvil!?elnnuIttt|t

uee,q'dril15 lJnl1grr ?4Tfl U1 r ilAilr 1 nfl OlnlTtA € l?Flll1 il I lJU

6nr{udaga, 77,s ttav 56. B mr:l'drdu

I


29

n1r1df, ? rdn n d1 u? ura v {o E a u r a n d n''t iln 1 uatJrdto,: tfdl rind:ia fl r fi u

lrn, {au dr runflril lvuvr rar#l usi r dtrlrrnqaln'l?'tf o {

T:n r {uuounr r* I rn itnrtn: tqdnrr

Srd?ullv I ?A',l$l d ttgl t Ttf

ilrrngarn.tountrfio

$rfilnrtnarqdnur

dn1Utl1l.ldil?d

T?1,l

TasrI

FIo

I

r-s fl4-6 fl7 fl!fiulrt

?1lr

5 (38.4)

4 (30.8)

3 (29.1)

t ('1 ,7,

13 (20.0)

6 (11.5)

36 (69.2)

4 (7,7>

6 ( 11.5)

52 (BO.O)

11 (16.9)

40 (61.5)

7 (10.8)

1 (10.8)

65 (100.O)

urir darta ufr r ilr{ttn1:cf t'lqdnm r fi o:Jtrngalnl?fl o r Tu nur u

r fiur r"l t -s fl 6o r f,ufasa, Es . z ua"di4 r $uTaolrflnrtcltro{nrr

rdorJrrngalnl?ta{l:nsirn'jr r flfioiuuu" 38.4t


30

n1r1{fi B ud6r {rn1rn:v31nsa o fidlfiaTtnd , {u, frul:n , {aui4dnfin

giofiilrg I ndex case 1 llfi

.irtrufiderfrnl:nitrirn r fiuTto, {ru, ou,9ul,q1$?lrRTOlnT? TOSAU

I

z

3

4

5

71tl

4'B

I

7

2

z

6B

70. 6

13.2

1O. 3

2,9

2,9

100. o

, u! + ts -r d-q-q!tp^.Puil41fril?flI:ntTou lndex cEse 1 71tl qvll]l?lta lfic{nil!0a1ll

+ q -e- 4 v s Ylu--4.- - dlu]Jiaflau Z.glrn-lunzarnS? tnfl?nililn1TflTuq1fl ton{ns b Flu

I trs u c r d + & a Q r,r f-.dunuulJ'jlridtsialtnllsrillrlterrSau 1 Ftlr l|fl^rTflTvl1fj !udod?1rYl

t.lbr,-

nsn6fl6s5ognv 70.6rut

s u P 4 e I oo u u -+Itdn { d1 il? il$nY 5 0 fl a v 1a { 1l oiln t Rfl xn!!T u 2 slfl 15f, tJ Aln I ?A

tlJ

atToil

,uaveq.&rllulglfl1TnilHn tln r Tou

041il?11

JTOfldu

t'uora r{rirtrlrn r {ouddlfia

Tubencul o i d

Bonden I ine

Lepronetous

Tltl

4

l4

50

6B

5.9

20,6

73. 5

100. o


31er'r?'r od g < gio >

TUAUUFEil?u?nfl1?dilHn llntToil cq11l?U U

TOgAv

du .' .Tuflut?alnnrHnlro (fl)

\<4f,5-e fl

42

2B

35

105

S.D = 6.430 ii

40. o

26,7

33. 3

too.oIr o fi:ilulrj

??tl

f = 8.086 fl

r, u a d s v ut + An?1ilnilU$O t nfJ'tllO\:flU9Jil?fl lgn t TAU

a11911-1r',I?o"t

aau-51?791

1|gr7t,)uu-ila{t

arulsl

??il

4

15

63

18

5

ro5

3.8

14.3

60. o

17,t

4rB

100, o

IQ1nn1?1 {n e 1.r!'i1 airurrrnrfiusifirfrnTratosdrirsTtnr{ou

tfio Lepnometous 6orfiu{osno 23. s To{arlrrf,uddlfintor#riru

T:nr{outf,o Bordenl ine 6orr{ufatra" zo. 6 o^od'Sofial:adrulrn

fufiaTrer'lr?vsvr?a1e,1nn'i1 4 fl fifr.rdosav 60 :-vilarrnrfidrfra

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nT {nlldlJil9l{'lilnfl { t? t 11O {lO1flAldilt^ln tT6l?JO $ hllJ?$nAil Lepnomet,ousol|llt-

r fiunrild r dfl ssianrr r fioT:cr (Hish risk ginoup) $1fln'jrfifufrA!I

q. ut ItTn.l|0{tHll?flnail{t

Non- r epnometous ti s r t$aTrnrr {ouullrnlu dri?e

I

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bous udu Bonden 1 inE (u?fl BL, BB ) girjtflovuut rfroornqilnttauItc u .tt- v,rd u v A a . dSl?T1[0?lO{IBJU?gl,O{l tlJddStl?RAOil tl0uilflOuglT?O1.lllttOQ1flSf?Ulll]7lilll

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tl

dnruuriolai4 r dsrfilfirlrsi4 r6u I ndex cssett- r-


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?u u!n1 s r 6$fi 1 Er'rqro € ofl lnrtnfi T {1 ri n1T ttl,rinr va1 fl 10 tTtntcrsien, o

rriu Trer?fifrn uuos'lu nrdnrd!'ltnlrn$rfl !fifl fruTtnruavTtordou

dnrrnrt r finT:n r {aul udfu fraTrniufiaudotiluarailai?dfilrr1n

iu.u^n.Snrtasn'ir

uiorrirfil s nu unvridlfin:rlfirufiati'lunrolnfaf,fr'5rurualrfinfist,.

rusi o au:fiu1r.l hiuslnsirsfiuodrtfiriudrdrgvrl{dfifr (P=or 35e4l tit1d

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tuudrsddlfrnTrnrrlrirufirfrri, edr6r tndex ce6e ltnr{ouinrficr

'lunairntdo{ei'lnfiu Tos r orurr'lun: alnfr r fisrfiu' ' "'' 1oifinrtfinrrlu

tj:c tnndurfig loacochr6n* "o' uasrlEr.r'lu'irTanrn'lunr: rfioTtn

r :f au1 u{du fr n dlaqifiln r r nrnna-a'l n dtornfinn uarfiulr nn d rerr udlriuC

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il

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dntrnrr r fiotra r{aulufifilfiaiurrirl lunilfifufiad r fir,,6n

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t

I


r:.alto$lTat?ount uavtfiafl r.r,e1,2527 Pnevelence Rat,e >1t 1oo0ll

,!+AIJTu11flT t|nu3'n17Tu lJ101lO n ITFI t rO1[rllU1 1l

d,o( | 1l1lr ?n'l!7cil1$ t nail

so fl dlfitflrloqfiur ti,rusrnei'l{a1nurifi1uu?ollrudltnr{ou,fieruudr|i

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t|3

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arjrtfifisdrdqn'r{nfifi ( P=o. 3s36 )

i 1 nfl 1 ?Antr ilu ui r'l u'ir ur uoidl frnT t oi4 r dulter r {a u.ir ur u I o s

trfl fiddrfiaTtertot{rirun{ru t*pion,"t o,r" ri.rdufiafil rdol:n r{au& r a r d + & 5l ! - <r-9--,--. ?n{run$?fl tflortaulluulu ttntrott tutxnleiosJl fidrurt zt T'lfJ ho

dvI lJt[TOfJnu zo dru'luqirirflr6u 1:rrr{tur,fro"rq s-14 f, ioeav

s?, 1 uauurt'i1rfiorr{uTrnriau'luttrr6nfrt{osav 7 7' 4 uoo.r'irr6n

dfiu finfio drir trlrn r {a ut'uofr osi afi 1 on r n r fi ul: er rliaul eilr nn'i r fl uri

o61.rs1ei.jr r finfinrrllrsianr:frorr do ( S uscept, i b i I i t y ) n rn'jrflur[

uau t ofl 1 nail run r ndf, o t riunrt dltfi mnnd "r al'luqi.'l u'i'r ur ufrfilfrondl-urUt

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l:nr{otfinornlrjfi Low PBtrrogfeni cit y fio errrln.tr,l?n'l$flrzr{rltit

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I ?A1il1lAUnEuyt't t Eofif,v6tJ t?fi01ulu ltnuFr?''ltl,' uut {ltl1flldaYlqun1 tT

r fialrnld uiaddrfiaf, r fiultnduiudraarcfi Hasianisirunru i.rr{r'hf,l|$

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45

t

rir ur a r {rir a nu r r nri'r r"d'[ ntt tt'l d'l unr t'l finr rrriuri {rJr nTra, {nud

rfiu Index cB6e {dlfinirerrTruuaucg'tfru5o{ii1ndionu,ryl.u nrzl#

nrudfi onT :r,lfirifinudnncia,,ruri{:lruTtnr, {ou rdorlatfiunrtuudlrn

Tos r ourvarir..rd r firirsndu Lepnomatous ti u fiu{rile:rfl"fineiodflA I u - q' -4- ^51

g .l ^.-,.-.-.d^o-^^^^-,c^ . e.., I

r Botrntrn?Teuugflsir r o t d sto,o t erto o'ld'lutvsrd-a,arnrtfir t ?loti

r ii o r1a I fi uhi'[ riu,nnnd ud o tj'l uar o lnril fr s'l fi ufi oT: n To fl o r q u uu f r'l #

usnlia ououl{gi'l tu'rn'llrirudrntrr qun'ilqvnzrqlduu r {afiflin'lu

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lrnd4o fio qnttat{rlru t fla rern, e'un4ottfinru1ndflEra'unnuldlfiattr

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nrruutfindrnu oTzn uac'lrinrfiflu1 t t" olro r {ouuriunandoqi'llnrorr-

ndr rfitrfiufiu{rirtr'hifinru{n'lrt r dr'l-{ uauddndo Ifln41fl1?fiarJnfi

nr tfirudo Ters r ilu'lcolfllrruttuurn r $or,, sltnr, {uu ouriru'l#{dfi

o'lfl1td tds'j'lov r fiul:n t {aulrt'lnrtntrofflu'l | {.'ilu c

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irlriru rJods rdstloiuri tflerrrotfirirsT:nr,{tuddnfrn tufl orqr,du

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z, afae,rnfl.r?uldods r de tsionr: r ficrl:n r {au'llddlfrai'llfirl

nu r r nti'tl rl'l drtt u T fl s d'l rn r t t H u ufl r n r r l {urir, 6'l n fi . dn r o n r t uun d

ra u d l B'l ?ruqt r iio'hfler r ui t d s r fi rrn r : rf fi rlfin uii nnda..r uri dri ? sT: 4, {uu

uau dr uandnrlnrt r fi erTrn r #ou'l ufidl fiaTtnTnfl n1? r t I fa I I uqtfinrrCopyright by Mahidol University

f,firlrufln6nTu

B . r fiuuurnr t'lunr:finurrJodfl r iitr ssionr: r frol:a r fou'ludfil-

finlrnrur.iru'lurirudu "r rdlrfil rriu rlo{enrtoirudtnl-rFlru$fiq

'lun:alnfrto t {ri'lu

{o.irfioto tnrttdsn{t{'lunT tidsd drurudrati"r tddlfrnTtn'uosdrjrsn6irr Non-

$llt

lepnomat,ous udrrfiorfiul:n,{tu il!{os rirhinr:udrrun'lunr:no

noueirafifiursdrfiounlnolna?T lr$uott rriu n:lttdtfl!tfiflutuev

r rarddt,frnTrn'lufrdnrinl:ernao{riru I ndex cBEe noF Non-

lepnonatous o^, t"p.or"tJ,r" Hnfll:ngtdOlTog'ldn'ttilO6al

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fro t ououttv

I ) Fr?r r dr.irurud'lotir r d'fisrfial:"dti.u r firtta, {ouro sdrits

ndo Non-lepnomat,o.r"'lunrtfinur'ludflH$crfitpfil{ qcdrfl'l#Ha

n r t fi nrr ur: a r-srndru n o r{ ua o * nfr 1 uio u n 1 il 1 r n trirl rt'l {rt r "1

e t d'l u t r u

; rJatfiu rraun?uqett:ersiald

z,'lunr:tdger{tgio1il artfrnltfinuridsull case-cont,nol

st,udy'[utvn'ir tfidrdnTtnufir r fiotrer', {uu

hirfroTrn,{uu rfiofinyrfitrle{adudrfiurJqds,duo ltf,uri flqdsnrs

d.rm- rnTu5fiato{nrorni? nrufilliudnrs'lmraundt nr:finrtfit

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ornnrudrru{rnr\t Immunology'lurJooriuaurrnl{

spectftc Ant igen tosr{aT:nr{aufia Phospho ur""ol ipid-1

( PcL- I ) lr'lfflui6fl'l??1fl'dailtrxu Enzyme L inlced Immunosonbent

l

unvsidlfraTzaudrusidr

)

l=--*---


47

TcllflTnAfUnunfirilfiU ( Immuno-Epidemiolosiicel Study) 1dttlrardlrl

ofl 1 €au t o86t $au uiluoltg { ll1tfl ? 1 fl 't TFtTl.qT 1 n fl 1 ano1n17 |lnvfl 1 TntlqAAerua'lt,

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n?iln8J tt6t I TAU to0JnR0 {1lr tnU r.lnilT1nflnot tTnnoulj?1na01n1761tJ1?n

flnrtrTo sfinlafl r nfrrirrjn ( chenoprophy I ax i s ) il?o r niealf,ntrl{

r durTola r f, o s siurioudq cfifl uru u isrfi u ua u fr l r'l { r d oa r r am i o arn t r o

dr o Trn r {a u'l #u rodul rJ qr n tr t u't d'l uo u1 Frsr si o"l d .

t


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e - t p- t oon I1. 6tc r1ilf,n. eifronrtnrilnilTTnt?ou. frlriai.rfi 2, rl:uqr!fiTiiutit

Trrfruierudnrrnuttun, zs1s.

rlcguT nrtfigetttotTtr,r{au. ?11n1?ddnil6l1d1n{n1r-

l|,]fnd. 252U4r69-81..

World HealLh Ongenization. WHO Leprosy

Ttrei land' 1965.

--ltnr{aulurltctnn-a5lJilafl17n?!ail

Gnoup, Epideniolo$Y on

. lggslTechnicel RePort

z, 6tu ttudn.

AdviEony Tean.3.

4.

6.

7,

Repont on LePnosY sunvey in

no {T?n t {au rlriln?lnelT:nrfrsrsia .

1ng. 25z?, ( roflf,ltdodrttrl5. 6rv ?1lflst. l?SilAfifrnrtlrnt{ou.natl:err{ou nliln?rtnilTtnfinsio

flTun?l{n101T$td1. 2525,

World Healt h Ongienizat, ion

Lepnosy in nelet,ion to

Senles 7l6tg-2?.

Job r CK. The sounce ot-'

t,ransmi ss i on. Leprosy Rev i ew. 1981 t 52t 69-76 '

I . qTU flrflrrzrnrni. drf,d'rdrX'lrfl1rilru t fiusla $1rnlilolI:n r 5au.

?1r41?t?erfinsia 2s2412s s2- 103.

9, Hesf lngf r Rc. Lepnosy' churchi 1l LivinglstoDBr 1985'

lO. Noondeen, SK. The epldenrloloSy of leprosy. IntHest'lngrRC'

Lepnosy. Ghunchi I I Livingist,onet 1985t 15-28'

11. Noondeen; sK. Infectiviby of leprosy. lntcheLt,enJee BRr

ed. A window on leproey. Ghendi Memorlsl Lepnosy

Foundet, ionr New Delhi r 197S t 59-63

!2, Deslkenr KVr sreevet,sa. studies on viebi I ity of M. leprae

outs i de the humEn body. Lepnosy I nd i e. 1979 t 51 t 588-589'

ls.DoullrrlA.lELel.TheincidenoeoflepnosyinCondoveend

Tel lsey. Int ennet ionel Jounnel of Lepnosy 19421 lOt 1O7-181 '

Study

cont no I

inf ecL i on encl it,s mode of


14. Raol PSS. r et Bl. Trar:smi ssion of Leprosy wlUhin

Households. tnt,ennet ior:eI Journal of Lepnoey 1975143t45-54.

rb. rfir1er? isrrrfrnduri. r]odfli4finrrafufruCgion1ril1frn1rfnr1adT rndr

I 6lo,uo r oirlr eT:et r {au d ruiorouuriu. ivrar fruudrJ?rXrgrivru161f, nrilu 1

UAlJ$flgl

16. lulndqfl1a on:nilurtnsldfl tztz4 ,

'rAAI'6AUAUAd1?r1{?nnn !t[.ngr?nfl']nfl illJr1??rfl 1afl]J]lo.

tATdll7lf . TUUlO?nfJ1 . t^lljllFlT {Yl1 .t

l'l , Cochnene RG. A pract i ce I t,ext-book

Londont 0xfond Universit,y Pness r 194?.

18. Benensonr AS. Cont,rol of cGnmuniceble

l4 th ed. Wesh i ngt,on I l9B 5 .

ot' l epnosy.

d i sease in man.

1e. fT lu nrf,{a (lr osf'u"1. nfiFrnrsi{g. ttrdtyll,tars dr,,:dtaillr$rfiot{q

oltot Ioil n1Tfiild,zszo.

4o

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F a e I o v -.--It nililuqfl1a {n?nlilu11Ylg1nu , 2525 .

2529. ufit

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oluruud.rlnsf,,rfis'tri'titrorndaurt rdu nrt rrj€su tfiuuoiururlnr€uugrs (a)

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(l,tve births) tuurun€sdntroirsarourJau rflu3rhario sa :flia rloi rruf'Ifr

dnt'raies = f;

dtnaieu (Proportlon) rflunrt rrJEsu rii Elut:ndrsfrzfi.rds riluolueund,r

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rdu dfndeuaa.rnunrudesl:nrf,llo oiueununtsdrsltnfirlo x loo

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s. f,'lar;rs r?s roi

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