Residual Challenges in Leprosy: A Study of Post-RFT Phenomena at a Tertiary Care OPD in Eastern India

Background: Despite completion of multi-drug therapy (MDT), many leprosy patients in high-burden regions like Eastern India continue to suffer from lepra reactions, neuropathy, and Grade 2 disabilities (G2D). These complications are often under-recognized in post-treatment surveillance. Objective: To assess the spectrum of post-RFT phenomena in treated leprosy patients, including clinical presentation, disability profile, relapse evaluation, and therapeutic outcomes. Methods: A cross-sectional observational study was conducted over 12 months at a tertiary care dermatology outpatient department in Eastern India. Adults with prior MDT who presented with post-RFT complaints were evaluated for clinical and functional morbidity, smear results, and management outcomes. Results: Among 150 RFT patients, 118 (78.6%) were male. Persistent hypoesthesia or skin lesions were reported in 27.5% and lepra reactions in 24% with Type 2(16%) reactions being more frequent than Type 1(8%)lepra reaction. Grade 2 disabilities were seen in 20% of patients, most commonly plantar and hand ulcers, claw hand, joint resorptions. MDT was restarted in five patients (3.3%) with bacteriological index (BI) ?2. Psychological support was provided to 12% of the patients. Conclusion: This study highlights that post-RFT complications remain clinically significant. Structured surveillance and multidisciplinary rehabilitation services are essential, particularly in endemic zones.