Leprosy - Wikipedia. Leprosy, also known as Hansen's disease (HD), is a long- term infection caused by the bacilli. Mycobacterium leprae. This is believed to occur through a cough or contact with fluid from the nose of an infected person. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body's defenses being compromised by the primary disease. Contacts of people with leprosy are five to eight times more likely to develop leprosy than members of the general population. However, conditions that reduce immune function, such as malnutrition, other illnesses, or host genetic differences, may increase the risk of developing leprosy. People are no longer infectious after as little as two weeks of treatment. Lepromatous cases show large numbers of organisms deep in the dermis, but whether they reach the skin surface in sufficient numbers is doubtful. While older research dealt with the skin route, recent research has increasingly favored the respiratory route. Experimental transmission of leprosy through aerosols containing M. The Center referred to in paragraph (1) shall conduct training in the diagnosis and management of Hansen’s disease and related complications, and shall conduct and promote the coordination of research (including. Department of Health and Humans Services DHHS/HRSA 'Healthcare System Bureau Division oiNationaI Hansen's Disease Programs Louisiana State University School of Veterinary Medicine Skip Bel iman Drive Baton Rouge, La. Hansen’s disease (HD), also known as leprosy. Many people's immune systems are able to eliminate leprosy during the early infection stage before severe symptoms develop. The region of DNA responsible for this variability is also involved in Parkinson's disease, giving rise to current speculation that the two disorders may be linked in some way at the biochemical level. The lesions may be macules (flat), papules (raised), or nodular. Sensory loss at the skin lesion is important because this feature can help differentiate it from other causes of skin lesions such as tinea versicolor. Thickened nerves are associated with leprosy and can be accompanied by loss of sensation or muscle weakness. However, without the characteristic skin lesion and sensory loss, muscle weakness is not considered a reliable sign of leprosy. Positive skin smears: In some case, acid- fast leprosy bacilli are considered diagnostic; however, the diagnosis is clinical. Early diagnosis and treatment prevent nerve involvement, the hallmark of leprosy, and the disability it causes. Also, phonation and resonation of sound occurs during speech. Often, atrophy of the testes and impotency happen. Classification. It also adds an indeterminate (. Skin lesions resemble tuberculoid leprosy, but are more numerous and irregular; large patches may affect a whole limb, and peripheral nerve involvement with weakness and loss of sensation is common. This type is unstable and may become more like lepromatous leprosy or may undergo a reversal reaction, becoming more like the tuberculoid form. Multibacillaryborderline lepromatous (. Medications can decrease the risk of those living with people with leprosy from acquiring the disease and likely those with whom people with leprosy come into contact outside the home. National Hansen`s Disease Programs For Low IncomeTherefore, the WHO recommends that people who live in the same household be examined for leprosy and only be treated if symptoms are present. For paucibacillary (PB or tuberculoid) cases, treatment with daily dapsone and monthly rifampicin for six months is recommended. Instead, the registered prevalence is used. Registered prevalence is a useful proxy indicator of the disease burden, as it reflects the number of active leprosy cases diagnosed with the disease and receiving treatment with MDT at a given point in time. The prevalence rate is defined as the number of cases registered for MDT treatment among the population in which the cases have occurred, again at a given point in time. It includes cases diagnosed with onset of disease in the year in question (true incidence) and a large proportion of cases with onset in previous years (termed a backlog prevalence of undetected cases). Endemic countries also report the number of new cases with established disabilities at the time of detection, as an indicator of the backlog prevalence. Determination of the time of onset of the disease is, in general, unreliable, is very labor- intensive, and is seldom done in recording these statistics. History. They found four strains of M. Strain 1 occurs predominately in Asia, the Pacific region, and East Africa; strain 4, in West Africa and the Caribbean; strain 3 in Europe, North Africa, and the Americas; and strain 2 only in Ethiopia, Malawi, Nepal/north India, and New Caledonia. On the basis of this, they offer a map of the dissemination of leprosy in the world. This confirms the spread of the disease along the migration, colonisation, and slave trade routes taken from East Africa to India, West Africa to the New World, and from Africa into Europe and vice versa. In 1. 84. 6, Francis Adams produced The Seven Books of Paulus Aegineta which included a commentary on all medical and surgical knowledge and descriptions and remedies to do with leprosy from the Romans, Greeks, and Arabs. Located at Balathal, in Rajasthan, northwest India, the discoverers suggest that if the disease did migrate from Africa, to India, during the third millennium BC . Armauer Hansen in Norway in 1. The search for further effective antileprosy drugs led to the use of clofazimine and rifampicin in the 1. These three antileprosy drugs are still used in the standard MDT regimens. Leprosy was once believed to be highly contagious and was treated with mercury. Many early cases thought to be leprosy could actually have been syphilis. Until the introduction of MDT in the early 1. India enacted the Leprosy Act of 1. The Act was difficult to enforce, but was only repealed in 1. National Hansen's Disease Program. The National Hansen's Disease Program is the epicenter of Hansen's disease (leprosy) care. National Hansen's Disease Museum; Established: 1996: Location. Center to Baton Rouge, Louisiana, and as of 1999 the National Hansen's Disease Programs continues its clinical care and research for Hansen's disease in Baton. MDT therapy became widely available. In 1. 98. 3, the National Leprosy Elimination Programme, previously the National Leprosy Control Programme, changed its methods from surveillance to treatment of people with leprosy. India still accounts for over half of the global disease burden. This free provision was extended in 2. MDT manufacturer Novartis through the WHO. In the latest agreement signed between the company and the WHO in October 2. MDT by the WHO to all endemic countries has run until the end of 2. At the national level, nongovernment organizations affiliated with the national programme will continue to be provided with an appropriate free supply of this WHO- supplied MDT by the government. Historical texts. Various skin diseases translated as leprosy appear in the ancient Indian text, the Atharava Veda, as early as 2. BC. Another Indian text, the Laws of Manu (1. BC), prohibited contact with those infected with the disease and made marriage to a person infected with leprosy punishable. Ancient sources such as the Talmud (Sifra 6. It may sometimes be a symptom of the disease described in this article, but has many other causes, as well. The New Testament describes instances of Jesus healing people with leprosy (Luke 5: 1. Hansen's disease is not established. The biblical perception that people with leprosy were unclean may be connected to a passage from Leviticus 1. Judeo- Christian belief held that leprosy was a moral disease, and early Christians believed that those affected by leprosy were being punished by God for sinful behavior. Moral associations have persisted throughout history. Pope Gregory the Great (5. Isidor of Seville (5. Segregation from mainstream society was common. The third Lateran Council of 1. King Edward expelled lepers from city limits. Because of the moral stigma of the disease, methods of treatment were both physical and spiritual, and leprosariums were established under the purview of the church. JJ Hjort conducted the first leprosy survey, thus establishing a basis for epidemiological surveys. Subsequent surveys resulted in the establishment of a national leprosy registry to study the causes of leprosy and for tracking of rate of infection. Early leprosy research throughout Europe was conducted by Norwegian scientists, Daniel Cornelius Danielssen and C. W. Their work resulted in the establishment of the National Leprosy Research and Treatment Center. Danielssen and Boeck believed the cause of leprosy transmission was hereditary. This stance was influential in advocating for the isolation of those infected by gender to prevent reproduction. Isolation treatment methods were observed by Surgeon- Mayor Henry Vandyke Carter of the British Colony in India while visiting Norway, and these methods were applied in India with the financial and logistical assistance of religious missionaries. Colonial and religious influence and associated stigma continued to be a major factor in the treatment and public perception of leprosy in endemic developing countries until the mid- 2. Leprosy is most prevalent amongst impoverished or marginalized populations where social stigma is likely to be compounded by other social inequities. Fears of ostracism, loss of employment, or expulsion from family and society may contribute to a delayed diagnosis and treatment. Folk models of belief, lack of education, and religious connotations of the disease continue to influence social perceptions of those afflicted in many parts of the world. In Brazil, for example, folklore holds that leprosy is transmitted by dogs, it is a disease associated with sexual promiscuity, and is sometimes thought to be punishment for sins or moral transgressions. Lower- class domestic workers who are often employed by those in a higher socioeconomic class may find their employment in jeopardy as physical manifestations of the disease become apparent. Skin discoloration and darker pigmentation resulting from the disease also has social repercussions. In extreme cases in northern India, leprosy is equated with an . The organization emphasizes the importance of fully integrating leprosy treatment into public health services, effective diagnosis and treatment, and access to information. Often, the identity cultivated by a community environment is preferable to reintegration, and models of self- management and collective agency independent of NGOs and government support have been desirable and successful. World Health Organization.
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