- Email: [email protected]
Impact of Lepromatous Leprosy on Fecundity
Vol. 24, No.4, April 1973 Printed in U.S.A.
FERTILITY AND STERILITY
Copyright © 1973 by The Williams & Wilkins Co.
IMPACT OF LEPROMATOUS LEPROSY ON FECUNDITY ARUN KUMAR, M.D., SUNDHIR CHANDRA BAGGHI, D.P.H., M.D., M.Sc.
AND
ABHAYA INDRAYAN,
Department of Social and Preventive Medicine, Moti Lal Nehru Medical College, Allahabad, India
The urogenital system has long been thought to be affected by leprosy, probably lowering fecundity. It has even been suggested that the extinction of leprosy in France in the 17th century was a consequence of the law obliging leprous persons and their descendants to marry only among themselves. 1 Reported investigations 2 • 3 tend to suggest that the impact on fecundity is manifested more severely in lepromatous males than in females. The present study was designed to explore further the relationship between lepromatous leprosy and fertility in males. MATERIALS AND METHODS
The investigation was carried out at Leprosy Mission Hospital and Home, Naini, Allahabad. The study unit was a lepromatous noncontracepting husband of age group 15-44 years. The size of the sample was 200. The investigation was started in October 1969 and concluded in September 1970. A parallel group of married noncontracepting males, not affected by any form of leprosy, and matched for age and duration of cohabitation, served as controls. The study and the control groups were derived almost entirely from the rural area around Allahabad, and were of low economic stratum and dependent mainly on agriculture for their livelihood.
since any adverse effect was likely to accumulate as length of illness increased. It was recognized that, as duration of the disease extended, age also advanced and the period of cohabitation increased, both possibly affecting the number of births. In order to consider these two factors in the evaluation of a correlation, a partial correlation coefficient was calculated, keeping age and duration of cohabitation constant. 4 This coefficient was: r = 0.15. This correlation was significant (t = 2.07, 0.04 > p > 0.03), indicating a decline in number of births with increase in duration of illness, when age and duration of cohabitation were fixed. The investigations revealed 24 births in 1 previous year to the wives of the 200 cases studied. All wives were in the reproductive age group. Thus, the fertility rate was 120/1000 women. The corresponding number of births in the control group was 47, or a rate of 235/1000 women. The fertility rate was significantly lower in the leprosy group than in the controls (Z = 3.25, 0.02 > p > 0.001). The total population comprising the families of the leprosy cases was 840. This number in the control group was 951. Therefore, the crude birth rates were 28.57/1000 and 49.42/1000, respectively. The difference in these birth rates was also significant (Z = 2.53,0.02> p> 0.01).
RESULTS DISCUSSION
The impact of lepromatous leprosy on fertility was evaluated by correlating the number of births with duration of illness,
Among Hawaiian lepers, with father a leper and mother not, a birth rate 83% of that of the total population has been reported. 2 In Cuba, the rate among leprous
Received January 11, 1972.
324
April 1973
LEPROMATQUS LEPROSY ON FECUNDITY
cases was decreased to 66% of that of the general population. 5 The crude birth rate of 28.57 observed for the lepromatous cases in the present study was 71 % of the general birth rate for the entire country, and only about 58% of that of the control group. These findings indicated high diminution in the fertility of the lepromatous males. SUMMARY
The number of births to a couple with lepromatous husband was found to be negatively correlated with his duration of lepromatous leprosy. Fecundity, in terms of both fertility and birth rates, was sub-
325
stantially diminished in comparison with the matched controls. REFERENCES 1. BARBIZIEUX, G. De la fecundite chez les leprux. Presse Med 21:721, 1943. 2. McCoy, W. G. Fecundity of the Hawaiian Lep· ers. Publ Health Bull (Washington) 61:23,1913. 3. BEIGUELMAN, B., HAMA, T., DE. GODOI, M. N. C., MARCHI, A., AMIN, C. C., AND BAPTISTA, T. A. Fecundidate E lepra. Rev Paul Med 66:213, 1965. 4. KENDALL, M. G., AND STUART, A. The Avanced Theory of Statistics (Vol. II, ed. 2). Charles Griffin, London, 1967, p. 317. 5. PEREZ, I. R., AND PRENDES, M. A. G. Orqutis epididimitis of otros factores que dimniuyen Fa fecundidad en los sujetros leprosons. Rev Sif Leprol Derm 1:120, 1944.
FERTILITY AND STERILITY
Copyright © 1973 by The Williams & Wilkins Co.
IMPACT OF LEPROMATOUS LEPROSY ON FECUNDITY ARUN KUMAR, M.D., SUNDHIR CHANDRA BAGGHI, D.P.H., M.D., M.Sc.
AND
ABHAYA INDRAYAN,
Department of Social and Preventive Medicine, Moti Lal Nehru Medical College, Allahabad, India
The urogenital system has long been thought to be affected by leprosy, probably lowering fecundity. It has even been suggested that the extinction of leprosy in France in the 17th century was a consequence of the law obliging leprous persons and their descendants to marry only among themselves. 1 Reported investigations 2 • 3 tend to suggest that the impact on fecundity is manifested more severely in lepromatous males than in females. The present study was designed to explore further the relationship between lepromatous leprosy and fertility in males. MATERIALS AND METHODS
The investigation was carried out at Leprosy Mission Hospital and Home, Naini, Allahabad. The study unit was a lepromatous noncontracepting husband of age group 15-44 years. The size of the sample was 200. The investigation was started in October 1969 and concluded in September 1970. A parallel group of married noncontracepting males, not affected by any form of leprosy, and matched for age and duration of cohabitation, served as controls. The study and the control groups were derived almost entirely from the rural area around Allahabad, and were of low economic stratum and dependent mainly on agriculture for their livelihood.
since any adverse effect was likely to accumulate as length of illness increased. It was recognized that, as duration of the disease extended, age also advanced and the period of cohabitation increased, both possibly affecting the number of births. In order to consider these two factors in the evaluation of a correlation, a partial correlation coefficient was calculated, keeping age and duration of cohabitation constant. 4 This coefficient was: r = 0.15. This correlation was significant (t = 2.07, 0.04 > p > 0.03), indicating a decline in number of births with increase in duration of illness, when age and duration of cohabitation were fixed. The investigations revealed 24 births in 1 previous year to the wives of the 200 cases studied. All wives were in the reproductive age group. Thus, the fertility rate was 120/1000 women. The corresponding number of births in the control group was 47, or a rate of 235/1000 women. The fertility rate was significantly lower in the leprosy group than in the controls (Z = 3.25, 0.02 > p > 0.001). The total population comprising the families of the leprosy cases was 840. This number in the control group was 951. Therefore, the crude birth rates were 28.57/1000 and 49.42/1000, respectively. The difference in these birth rates was also significant (Z = 2.53,0.02> p> 0.01).
RESULTS DISCUSSION
The impact of lepromatous leprosy on fertility was evaluated by correlating the number of births with duration of illness,
Among Hawaiian lepers, with father a leper and mother not, a birth rate 83% of that of the total population has been reported. 2 In Cuba, the rate among leprous
Received January 11, 1972.
324
April 1973
LEPROMATQUS LEPROSY ON FECUNDITY
cases was decreased to 66% of that of the general population. 5 The crude birth rate of 28.57 observed for the lepromatous cases in the present study was 71 % of the general birth rate for the entire country, and only about 58% of that of the control group. These findings indicated high diminution in the fertility of the lepromatous males. SUMMARY
The number of births to a couple with lepromatous husband was found to be negatively correlated with his duration of lepromatous leprosy. Fecundity, in terms of both fertility and birth rates, was sub-
325
stantially diminished in comparison with the matched controls. REFERENCES 1. BARBIZIEUX, G. De la fecundite chez les leprux. Presse Med 21:721, 1943. 2. McCoy, W. G. Fecundity of the Hawaiian Lep· ers. Publ Health Bull (Washington) 61:23,1913. 3. BEIGUELMAN, B., HAMA, T., DE. GODOI, M. N. C., MARCHI, A., AMIN, C. C., AND BAPTISTA, T. A. Fecundidate E lepra. Rev Paul Med 66:213, 1965. 4. KENDALL, M. G., AND STUART, A. The Avanced Theory of Statistics (Vol. II, ed. 2). Charles Griffin, London, 1967, p. 317. 5. PEREZ, I. R., AND PRENDES, M. A. G. Orqutis epididimitis of otros factores que dimniuyen Fa fecundidad en los sujetros leprosons. Rev Sif Leprol Derm 1:120, 1944.