Table 3. Incidence of ENL in hospital populations (n>100).
| Study number | Country | Level of evidence | Study design | Follow up period | Study sample at risk | ||
| years | N | definition | ENL (%)* | ||||
| 12 | India [73] | 1b | Observational cohort (prospective) | 2 | 303 | MB† | 6 (2) |
| 13 | India [74] | 1b | Observational cohort (prospective) | <8 | 980 | MB† | 2 (0.2)‡ |
| 14 | Thailand [50] | 1b | Observational cohort (prospective) | 3 | 119 | BL+LL† | 44 (37) |
| 15 | Thailand, Philippines, Korea [75] | 2b | Controlled trial | 5 | 358 | BL+LL† | 36 (10) |
| 16 | India [55] | 2b | Controlled trial | 8 | 304 | BB+BL+LL† | 30 (10) |
| 17 | India [76] | 2b | Observational cohort (retrospective) | >2–10 | 578 | BB+BL+LL† | 164 (28.4) |
| 18 | India [66] | 2b | Observational cohort (prospective) | 6 | 100 | MB† | 6 (6.0) |
| 19 | India [60] | 2b | Observational cohort (retrospective) | >1 | 481 | BL+LL† | 117 (24.4) |
| 20 | Philippines [63] | 2b | Observational cohort (retrospective) | 4 | 296 | MB† | 36 (12.2) |
| 293 | MB† | 60 (20.5) | |||||
| 21 | Philippines [61] | 2b | Observational cohort (prospective) | 3 | 139 | MB† | 10 (7) |
| 295 | MB† | 27 (9) | |||||
| 22 | Zaire [59] | 2b | Controlled trial | 3 | 280 | MB† | 34 (12) |
| 23 | Nepal [62] | 2b | Observational cohort (retrospective) | 2 | 175 | BL+LL† | 10 (5.7) |
| 24 | Brazil [77] | 2b | Observational cohort (retrospective) | 2 | 169 | BB+BL+LL† | 43 (25.4) |
| 25 | Brazil [51] | 2b | Controlled trial | 2 | 140 | MB† | 48 (34.2) |
| 26 | Brazil [52] | 2b | Observational cohort (retrospective) | 2 | 162 | BB+BL+LL† | 51 (31) |
| 27 | Uganda [56] | 4 | Cross-sectional | 5 | 2,743 | MB | 18 (0.7)§ |
| 28 | India [64] | 4 | Observational cohort (retrospective) | >2 | 990 | BB+BL+LL† | 121 (12.2) |
| 29 | India [69] | 4 | Cross-sectional | 1 | 1141 | MB† | 187 (16.4) |
| 1 | 1,344 | MB† | 235 (17.5) | ||||
| 30 | India [58] | 4 | Observational cohort (retrospective) | 3–13 | 1,494 | MB† | 337 (22.5) |
| 31 | Nepal [57] | 4 | Cross-sectional | unknown | 563 | BL+LL† | 107 (19) |
| 32 | Brazil [67] | 4 | Cross-sectional | Unknown | 664 | MB† | 192 (28.9) |
| 33 | Netherlands [68] | 4 | Cross-sectional | Unknown | 231 | BB+BL+LL | 17 (7.4) |
| 34 | Morocco [53] | 4 | Cross-sectional | Unknown | 229 | MB | 76 (33) |
| 35 | Brazil [65] | 4 | Observational cohort (retrospective) | Unknown | 218 | MB | 28 (13) |
| 36 | India [54] | 4 | Cross-sectional | 2 | 187 | BB+BL+LL† | 25 (13.3) |
| 37 | Yemen [78] | 4 | Cross-sectional | unknown | 123 | BB+BL+LL† | 33 (26.8) |
| 38 | Brazil [79] | 4 | Cross-sectional | unknown | 120 | MB† | 13 (10.8) |
| 11 | India [17] | 5 | Collected data | - | 6,017 | Leprosy | 301 (5) |
| Average incidence (n>100) | 17,513 | 2,393 (13.7) | |||||
*
It should be noted here that cumulative incidence is presented as these have been published, although not all numbers could be traced and justified after conducting calculations while some inconsistencies were noticed. So therefore, these numbers should be treated with caution.
†
Studies that conducted slit skin smears. Studies not indicated with this footnote did not provide information on conducting slit skin smears.
‡
Assessed late leprosy reaction during surveillance that started after MB-MDT course until smear negativity. This study is excluded from the calculations.
§
Assessed admissions due to leprosy reactions. This study is excluded from the calculations because n is not well defined.