World Leprosy Day raises awareness of a disease that many people believe to be extinct. Today it is not just the disease that is forgotten, but the people too. Everyday nearly 600 more people are diagnosed with and start treatment for leprosy. In 2014, 2,13,899 people were diagnosed and it is estimated that millions more go undiagnosed. Hansen’s disease (also known as leprosy) is an infection caused by slow-growing bacteria called Mycobacterium leprae.
SYMPTOMS
- Discolored patches of skin, usually flat, that may be numb and look faded (lighter than the skin around)
- Growths (nodules) on the skin
- Thick, stiff or dry skin
- Painless ulcers on the soles of feet
- Painless swelling or lumps on the face or earlobes
- Loss of eyebrows or eyelashes
- Muscle weakness or paralysis (especially in the hands and feet)
- Eye problems that may lead to blindness (when facial nerves are affected)
- Nosebleeds
- Paralysis and crippling of hands and feet
- Nose disfigurement
- Painful or tender nerves
- Burning sensation in the skin
Types
Leprosy has traditionally been classified into two major types, tuberculoid and lepromatous. Patients with tuberculoid leprosy have limited disease and relatively few bacteria in the skin and nerves, while lepromatous patients have widespread disease and large numbers of bacteria. Tuberculoid leprosy is characterized by a few flat or slightly raised skin lesions of various sizes that are typically pale or slightly red, dry, hairless, and numb to touch (anesthetic). Lepromatous leprosy is at the other end of the spectrum, with a much more generalized disease, diffuse involvement of the skin, thickening of many peripheral nerves, and at times involvement of other organs, such as eyes, nose, testicles, and bone.
Treatment
Antibiotics are used to treat the infection. Doctors recommend long-term treatment, usually for 6 months to a year. If you have severe leprosy, you may need to take antibiotics longer. Antibiotics can’t treat the nerve damage that comes with leprosy. Multidrug therapy (MDT) is a common treatment for leprosy that combines antibiotics.
- Paucibacillary leprosy: You’ll take two antibiotics, such as dapsone each day and rifampicin once a month.
- Multibacillary leprosy: You’ll take a daily dose of the antibiotic clofazimine in addition to the daily dapsone and monthly rifampicin. You’ll take multidrug therapy for 1-2 years, and then you’ll be cured.
You may also take anti-inflammatory drugs to control nerve pain and damage related to leprosy. This could include steroids, like prednisone. Doctors sometimes treat leprosy with thalidomide, a potent medication that suppresses your immune system. It helps treat leprosy skin nodules. Thalidomide is also known to cause severe, life-threatening birth defects. Never take it if you’re pregnant or plan to become pregnant.
CONTROL
The three main goals of control of leprosy are
- To detect the pathology early and treat the patient completely.
- To prevent the transmission to the others.
- To prevent the disabilities and other complications.
Thus the following modalities are adopted to control leprosy:
- Medical measures
- Social support
- Program management
- Evaluation