Breaking the stigma is just as important as treating the disease itself
Leprosy – What Do you Know About?
One of the Oldest Diseases – Neglected
Did you know that leprosy, one of the oldest diseases in history, is still affecting thousands of people today?
Although curable, leprosy challenges global health in some regions.
Leprosy is a neglected tropical disease (NTD) that still occurs in more than 120 countries, with around 200,000 new cases reported every year. Eliminating leprosy as a public health problem (defined as prevalence of less than 1 per 10 000 population as per World Health Assembly resolution 44.9) was achieved globally in the year 2000 and in most countries by 2010.
The Global Leprosy Strategy 2021–2030, a constituent of the Neglected Tropical Diseases (NTD) road map 2021–2030, calls for accelerating action to reach the goal of zero leprosy (zero disease, zero disability, and zero stigma and discrimination). This goal required a new paradigm for countries to move beyond the target of “elimination of leprosy as a public health problem” to “elimination of leprosy disease”.
What Is Leprosy?
Leprosy, also known as Hansen’s disease, is a chronic bacterial infection caused mainly by a type of bacteria called Mycobacterium The disease affects the skin, the peripheral nerves, the mucosa of the upper respiratory tract, and the eyes.
Apart from the physical deformity, persons affected by leprosy also face stigmatization and discrimination.
Leprosy is caused by the Mycobacterium leprae, which thrives in cooler areas of the body, like the skin and peripheral nerves.
Transmission of Leprosy
The disease is believed to be transmitted through droplets from the nose and mouth of an untreated leprosy case containing the causative agent, following prolonged, close contact. The disease does not spread through casual contact (like shaking hands, hugging, sharing meals, or sitting next to each other).
Important To Know, the patient stops transmitting the disease upon initiation of treatment.
“Leprosy is caused by the Mycobacterium leprae, which thrives in cooler areas of the body, like the skin and peripheral nerves.”
Who is at Risk to Get Infected by Leprosy?
- Living in endemic areas.
- Close contact with untreated cases.
- Genetic susceptibility.
- Poor access to healthcare.
Highlight Key Symptoms of Leprosy
Symptoms may occur within one year of being infected but can also take as long as 20 years or even more. The disease manifests commonly through skin lesions and peripheral nerve involvement.
Skin lesion usually has a different pigmentation than the surrounding normal skin (less pigmented or reddish) and may have various presentations (flat, raised or nodules). Skin lesions can be single or multiple with a definite loss of sensation.
Leprosy is a highly variable disease, affecting people in different ways, according to their immune response.
How to Diagnose Leprosy
The diagnosis of leprosy is done clinically. Laboratory-based services may be required in cases that are difficult to diagnose. The diagnosis of leprosy is based on at least one of the following cardinal signs:
- definite loss of sensation in a pale (hypopigmented) or reddish skin patch;
- thickened or enlarged peripheral nerve, with loss of sensation and/or weakness of the muscles supplied by that nerve;
- microscopic detection of bacilli in a slit-skin smear. Based on the above, cases of leprosy are classified into two types for treatment purposes.
Based on the above, cases of leprosy are classified into two types for treatment purposes:
- “paucibacillary” (translated as “few bacteria”, PB) case, a case of leprosy with 1–5 skin lesions, without demonstrated presence of bacilli in a skin smear.
- multibacillary (translated as “a lot of bacteria”, MB) case, a case of leprosy with more than five skin lesions; or with nerve involvement; or with the demonstrated presence of bacilli in a slit-skin smear, irrespective of the number of skin lesions.
Treatment of Leprosy
Leprosy is a curable disease!
The currently recommended treatment regimen consists of three medicines (dapsone, rifampicin and clofazimine) and is referred to as multidrug therapy (MDT). The same regimen with a duration of 6 months for PB (“few bacteria”) and 12 months for MB („a lot of bacteria”) cases has been recommended by WHO.
A multidrug therapy kills the pathogen and cures the patient. Early diagnosis and prompt treatment can help to prevent disabilities.
WHO has been providing multidrug therapy free of cost. Free multidrug therapy was initially funded by The Nippon Foundation (TNF) and has been donated by Novartis since 2000.
„Post-treatment care focuses on managing disabilities, nerve damage, and reducing stigma.”
Breaking the Stigma Around Leprosy
Leprosy is more than a medical condition it’s a challenge faced with strength and resilience. While physical deformities are often visible, the unseen burden of stigma and discrimination weighs just as heavily on those affected.
Did you know?
Patients undergoing treatment for leprosy cannot spread the disease.
Raising awareness can help combat stigma, promote understanding, and pave the way for social reintegration.
Call for Action
“Let’s advocate for kindness and build a world where everyone is treated with dignity and compassion”
Let’s break the silence around leprosy and support global efforts to eradicate it.
Share this post to spread knowledge and compassion.
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A contribution by Dr. Habab Basheir Elgamer,
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