Abstract: Objective: To explore the correlation of diagnostic delay, lepra reaction and grade 2 disability in leprosy patients. Methods: Clinical data of 49 leprosy patients admitted to Liangdang Sanatorium of Gansu Province from January 2016 to December 2023 were retrospectively analyzed. Demographic information, clinical classification, diagnostic delay, bacterial index, lepra reaction and disability grade were compared, and binary Logistic regression was adopted to screen independent risk factors for grade 2 disability. Results: Among 49 cases, 29 were males and 20 females, the average diagnostic delay was 5.8 years, and grade 2 disability rate was 32.65%. Univariate analysis showed diagnostic delay ＞5 years, LL type, BI≥3.0 and lepra reaction were significantly associated with grade 2 disability (all P＜0.05). Multivariate regression demonstrated that diagnostic delay ＞5 years (OR=5.114, 95%CI: 1.532-17.086), BI≥3.0 (OR=3.374, 95%CI: 1.062-10.712) and lepra reaction (OR=3.297, 95%CI: 1.071-10.157) were independent risk factors (all P＜0.05). Conclusion: Prolonged diagnostic delay, high bacterial load and lepra reaction are independent risk factors for grade 2 disability. Early identification, shortened diagnostic delay and timely treatment of lepra reaction may reduce severe disability.

Key words: leprosy, diagnostic delay, lepra reaction, grade 2 disability, risk factors