Leprosy in Costa Rica, Past, Present and Future

Abstract

Background and Aim: The aims of this review are to describe the clinical and epidemiological characteristics of leprosy from the first case documented and up to the year 2008 in Costa Rica and to advise health authorities on controlling disease strategies.
Materials and Methods: This is a descriptive and retrospective study concerning leprosy. The reference review allowed us to describe the disease from 1798 up to 1995. The National Institute of Census and Statistics provided the population data and the Ministry of Health the cases in order to calculate prevalence and percentages. The Mexico and Calderon Guardia Hospitals provided the patient files to classify leprosy cases by type and to compare them with the cases notified to the Ministry of Health.

Results: The first case was documented in 1798. In 1979 the Mercedes National Sanatorium was closed. Control strategies implemented by the Ministry of Health diminished the number of cases reported to a ratio of 1 x 10,000 inhabitants by the year 1995. From 2002 through 2008 there were 67 cases reported to the Ministry of Health but in 45 of these cases the type of leprosy diagnosed was not specified. From the 22 cases in which the type of leprosy was specified, only 3% were of the paucibacillary leprosy. 97% of the cases notified to the Ministry of Health were multibacillary leprosy. In the Calderon Guardia and Mexico Hospitals 35 patients were attended during the same period of time and 28 of them (80%) were found to have multibacillary leprosy.
Conclusion: Given the high percentage of multibacillary leprosy, it is a matter of urgency that the Caja Costarricense de Seguro Social implements the early detection and integral rehabilitation of patients and that it participate in an active and coordinated manner in the clinical and epidemiological control of the disease.