Tag Archives: Leprosy

WHO updates fact sheet on Leprosy (14 March 2019)

The World Health Organization (WHO) has updated its fact sheet on Leprosy.

Background Information:

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. It mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes.

Throughout history, people afflicted with Leprosy have often been ostracized by their communities and families.

The first breakthrough in treatment occurred in the 1940s with the development of the medicine dapsone. The duration of treatment lasted many years, often a lifetime, making compliance difficult. In the 1960s, M. leprae started to develop resistance to dapsone, the only known anti-leprosy medicine at that time. In the early 1960s, rifampicin and clofazimine were discovered and subsequently added to the treatment regimen, which was later labelled as multidrug therapy (MDT).

In 1981, WHO recommended MDT. The currently recommended MDT regimen consists of medicines: dapsone, rifampicin and clofazimine. This treatment lasts for six months for pauci-bacillary and 12 months for multi-bacillary cases. MDT kills the pathogen and cures the patient.

classification of leprosy

multi drug therapy in leprosy

*RFT: Release From Treatment

Since 1995 WHO has provided MDT free of cost. Free MDT was initially funded by The Nippon Foundation, and since 2000 it is donated through an agreement with Novartis until at least 2020.

Elimination of leprosy as public health problem (defined as a registered prevalence of less than 1 case per 10 000 population) was achieved globally in 2000. More than 16 million leprosy patients have been treated with MDT over the past 20 years.

Key Messages:

Leprosy is a chronic disease caused by a bacillus, Mycobacterium leprae.

M. leprae multiplies slowly and has an average incubation period of 5 years.

Symptoms may occur within 1 year but can also take as long as 20 years or even more to occur.

The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and also the eyes.

Leprosy is curable with multidrug therapy (MDT).

Leprosy is likely transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.

Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs, and eyes.

grading of disability in leprosy

There were 211 009 new leprosy cases registered globally in 2017, according to official figures from 159 countries from the 6 WHO Regions.

Based on 193 118 cases at the end of 2017, prevalence rate corresponds to 0.3/10 000.

In 2016 WHO launched its “Global Leprosy Strategy 2016–2020: Accelerating towards a leprosy-free world” to reinvigorate efforts for leprosy control. The strategy focuses on children as well as on avoiding disabilities. It has three core pillars:

Pillar I: Strengthen government ownership, coordination and partnership

Key interventions

  • Ensuring political commitment and adequate resources for leprosy programmes.
  • Contributing to universal health coverage with a special focus on children, women and underserved populations including migrants and displaced people.
  • Promoting partnerships with state and non-state actors and promoting intersectoral collaboration and partnerships at the international and national levels.
  • Facilitating and conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities.
  • Strengthening surveillance and health information systems for programme monitoring and evaluation (including geographical information systems).

Pillar II: Stop leprosy and its complications

Key interventions

  • Strengthening patient and community awareness of leprosy.
  • Promoting early case detection through active case-finding (e.g. campaigns) in areas of higher endemicity and contact management.
  • Ensuring prompt start of, and adherence to treatment, including working towards improved treatment regimens.
  • Improving prevention and management of disabilities.
  • Strengthening surveillance for antimicrobial resistance including laboratory network.
  • Promoting innovative approaches for training, referrals, and sustaining expertise in leprosy, such as e-health.
  • Promoting interventions for the prevention of infection and disease.

Pillar III: Stop discrimination and promote inclusion

Key interventions

  • Promoting societal inclusion by addressing all forms of discrimination and stigma.
  • Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services.
  • Involving communities in actions for improvement of leprosy services.
  • Promoting coalition-building among persons affected by leprosy and encourage the integration of these coalitions and/or their members with other community-based organizations.
  • Promoting access to social and financial support services, for example to facilitate income generation, for persons affected by leprosy and their families.
  • Supporting community-based rehabilitation for people with leprosy-related disabilities.
  • Working towards abolishing discriminatory laws and promote policies facilitating inclusion of persons affected by leprosy.

Targets of the Global Leprosy Strategy

  • Zero disabilities among new paediatric patients.
  • A grade-2 disability rate of less than 1 case per 1 million people.
  • Zero countries with legislation allowing discrimination on basis of leprosy.

Useful Links:

Link to the updated fact sheet:

https://www.who.int/news-room/fact-sheets/detail/leprosy

Link to Operational Manual- Global Leprosy Strategy 2016-2020 (English) [PDF]:

https://www.who.int/lep/resources/9789290225256/en/

Link to Global Leprosy Strategy 2016-2020 (English) [PDF]:

https://www.who.int/lep/resources/9789290225096/en/

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