Leprosy also known as Hansen disease is a chronic infectious disease caused by Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, the eyes, and causes nerve damage, leading to muscle weakness and atrophy, and permanent disabilities. Leprosy has afflicted humanity since time immemorial.
It was well recognized in the oldest civilizations of China, Egypt, and India. It once affected every continent and it has left behind a terrifying image in history and human memory - of mutilation, rejection, and exclusion from society. There are mainly two types of leprosy–Multibacillary and Paucibaccilary.
Presence of infectious cases in environment, Humidity, infected nasal drops, overcrowding, poor ventilation are the environmental factors that favor the development of leprosy. It is predominantly found between 10 to 20 years of age. However, the prevalence is higher in male than female
Leprosy research scientists still do not completely understand how leprosy is spread but it may be due to contact with infected droplets. It also transmits through breast milk of lepromatous mother. However, it does not transmit by talking to a person with leprosy, shaking hand, hugging a patient, caring for a patient, eating together living together in a house.
Leprosy is easily diagnosed by examining skin, checking for patches and its numbers, testing for sensation, and looking for damage to nerves.
One is supposed to have leprosy if his/her skin patch that does not itch, have diffuse infiltration and/or nodules, tingling sensation of limbs, loss or thinning of eyebrow, weakness of muscles (hands/feet/eyes), and nerve pain.
Leprosy can be easily treated with a 6–12-month course of multi-drug therapy (MDT). The treatment is highly effective, and has few side effects and low relapse rates. There is also no known drug resistance.
Leprosy is curable and treatment provided in the early stages averts disability.
Health education should be focused on personal hygiene and general clean. There should be periodic screening of disease. Early diagnosis and treatment of the cases should be also prioritized. Multi-drug therapy surveillance, chemoprophylaxis, immune-prophylaxis are of paramount importance.
On Tuesday 19th January 2010, Minister of Health & Population, Government of Nepal, declared elimination of Leprosy as a public health problem. Elimination of Leprosy as a public health problem is defined as prevalence rate of below 1 per 10,000 population at the national level. Major collaborative partners of the leprosy program in the country have been the World Health Organization, Sasakawa Memorial Health Foundation, The Nippon Foundation, Netherlands Leprosy Relief, The Leprosy Mission, International Nepal Fellowship, Nepal Leprosy Trust, and many others.
Elimination of leprosy as a public health problem has been achieved in Nepal by implementation of community awareness programs aimed at early leprosy cases detection, expansion of the services to community level, reduction of stigma attached to the disease and provision of free Multi Drug Therapy (MDT) for treatment. Special interventions for case detection were undertaken in the high endemic districts.
Treatment of leprosy needs to be fully integrated into general health services. This is a key to successful continuation of elimination status of the disease. The most effective way of preventing disabilities in leprosy, as well as preventing further transmission of the disease, lies in early diagnosis and treatment with MDT. Surveillance, monitoring and ensuring accessible and uninterrupted MDT services available to all patients through flexible and patient-friendly drug delivery systems should be conducted.
The best way to eliminate leprosy is by developing community awareness programs aimed at removing the stigma attached to leprosy.
A new environment, in which patients will not hesitate to come forward for diagnosis and treatment at any health facility, must be created. Encouraging self-reporting and early treatment by promoting community awareness and changing the image of leprosy at the global, national and local levels. The country requires renewed commitment from all partners to sustain the achievement and progress towards prevention and control of other communicable diseases.