Leprosy among the Fulani nomadic pastoralist population of Adamawa State, Nigeria

Background: Leprosy remains a serious public health problem in Nigeria. This research highlights the burden of leprosy among an estimated 450,000 nomadic pastoralists in the remote regions of Adamawa State. Objective: To assess the prevalence of undiagnosed leprosy among Fulani nomadic pastoralists of Adamawa State. Methods: Active screening of the nomadic pastoralist population for leprosy was implemented over a 2-year period in Adamawa State. A total of 378 community screening days were organised with community leaders among Fulani nomadic pastoralists. Diagnosis of leprosy was done by trained leprosy supervisors, health workers and community volunteers, according to the national TB and leprosy control guidelines. Results: Sixty one (61) new cases were detected among the pastoralists, representing a prevalence of 1.35/10,000 population. The MB proportion was 85%, while the male: female ratio was 1:1.5, with a higher MB proportion seen among children (< 15 years) than the adult (> 15 years) age group. The prevalence of leprosy among children was 0.15/10,000. Adult females had a higher prevalence of undiagnosed leprosy than males (0.71 versus 0.48 per 10,000). Grade 2 disability was present in 13%, and three quarters of these had MB leprosy. Leprosy new case detection increased by over 26% in the final study period. Conclusion: Gender differences, a high MB proportion and on-going transmission of leprosy among nomadic pastoralists are a cause of concern. There is need for stringent public health measures to control leprosy among this group.