Leprosy has afflicted humanity since time immemorial.

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.
Since ancient times, leprosy has been regarded by the community as a contagious, mutilating and incurable disease.

07/29/16

When M.leprae was discovered by G.A. Hansen in 1873, it was the first bacterium to be identified as causing disease
in man. However, treatment for leprosy only appeared in the late 1940s with the introduction of dapsone, and its
derivatives. Leprosy bacilli resistant to dapsone gradually appeared and became widespread.
Multidrug therapy (MDT) treatment has been made available by WHO free of charge to all patients worldwide since
1995, and provides a simple yet highly effective cure for all types of leprosy.

It should be pointed out that the male preponderance in leprosy is not universal and there are several areas,
particularly in Africa, where there is either equal occurrence of leprosy in the two sexes, or occasionally even a higher
prevalence among females. Such situations have been observed in Uganda, Nigeria, Malawi, Gambia, Burkina Faso,
Zambia, Thailand and Japan.

The frequency of the polar forms of leprosy in different countries varies widely and may in part be genetically
determined; certain HLA associations are known for both polar forms of leprosy

The bacillus multiplies very slowly (every 14 30 days), which explains why the incubation period is so long - on
average 5 to 8 years. The bacillus causes inflammatory reactions damaging the skin and peripheral nerves, which
constitute some of the coolest places in the body. The nerve damage affects the 3 modalities of the nerve function i.e.
sensory, motor and autonomic functions. The resulting symptomatology is represented by loss of sensation,
weakness and/or paralysis in innervated muscles and skin dryness due to lack of sweating and hypo-pigmentation of
the innervated skin.
07/29/16

However, in practice, most programmes use clinical criteria for classifying and deciding the appropriate treatment
regimen for individual patients, particularly in view of the non-availability or non-dependability of the skin-smear
services. The clinical system of classification for the purpose of treatment includes the use of number of skin lesions
and nerves involved as the basis for grouping leprosy patients into Lepromatous (multibacillary) and Tuberculoid
(paucibacillary) leprosy.
07/29/16