PRESENTATION ON LEPROSY;

ITS PREVENTION AND

TREATMENT
BY
PHARM. HALIMA ABDULAZEEZ
UMAR
 OUTLINE
 Introduction

 Classification

 Epidemiology

 Clinical features

 Complication

 Prevention

 Goals of therapy

 management

 references
 INTRODUCTION
 Leprosy is a chronic infectious disease, curable and not highly contagious
disease caused by Mycobacterium leprae

 It affects mainly the skin, nerves, mucosa of the upper respiratory tract and the
eyes

 The disease is transmitted via droplets from nose and mouth during close and
frequent contacts with untreated person

 Untreated leprosy can cause progressive and permanent damage to skin,

nerves, limbs and eyes

 Leprosy is known to occur at all ages ranging from infancy to very old age.
 CLASSIFICATION
 There are 2 classification schemas: ( WHO Standard)

1. The 5- category Ridley- Jopling system

 tuberculoid leprosy

 Lepromatous leprosy

 Borderline lepromatous

 Bordeline tuberculoid

 Mid borderline leprosy

2. Based on skin lesion

 Paucibacilliary leprosy

 Multibaciliary leprosy
 EPIDEMIOLOGY
 Globally, approximately 208,000 people have leprosy around with most cases
found in Asia and Africa

 India accounts for one-third of all registered leprosy cases globally

 Leprosy is endemic in tropical countries, especially in underdeveloped

countries.

 Its prevalence has decreased markedly since the introduction of MDT in the
beginning of 1980s

 In Nigeria, leprosy is still prevalent with over 3500 new cases being diagnosed
annually, according to Nigeria Centre for Disease Control, with 25% causing
irreversible deformities
 CLINICAL MANIFESTATION
Early symptoms
 Disfiguring skin sores
 Lumps
 Stiff, thick and dry skin
 Growth on the skin
 Nerve damage
 Stiffness and nose bleeding
Advanced leprosy symptoms
 Loss of eyebrow and eyelashes
 Sores on the sole
 Loss of sensation
 Blindness
 Shorter toes and finger

 COMPLICATIONS

 Leonine face
 Glaucoma
 Blindness
 Skin on the legs thicken and forms ulcer when nodules break down
 Internal organ infection
 voice becomes hoarse
 PREVENTION
 These are measures that inhibit the development of the disease before it
occurrence or interrupt it progression after occurrence.

 Stages of prevention

1. Primary prevention; focuses on health promotion and protection

2. Secondary prevention; focuses on early identification of health problems and

prompt intervention to alleviate health problem

3. Tertiary prevention; focuses on restoration and rehabilitation

 Prevention cont'd

als to
 Goal of primary prevention : to reduce risk of exposure of individu
disease which can be achieved through 1.
hygiene
 general health promotion such as good housing improved personal
and poverty reduction
compliance
 Health Education on risk reduction strategies and importance of

 Specific protectiotn via vaccination

single dose.
 Chemoprophylaxis given to close contact used of Rifampicin as a
 Prevention cont'd

 Goal of secondary prevention: To identify individual in early stage through

early diagnosis and treatment. Cases can be detected via:

 Contact survey which involves examination of all household contact with

lepromatous case

 Group survey in areas or community with high prevalence of leprosy

 Mass survey; examination of individual by house to house visit in

hyperendemic areas
 Prevention cont'd

 Goal of tertiary prevention: it aim in returning individual to an optimal level

of function through limitation of disability and rehabilitation which can be
done through medical, surgical, social, educational and vocational
restoration
 GOALS OF TREATMENT

 To improve quality of life of patient

 To prevent transmission to others

 To prevent disabilities and other complications

 To prevent drug resistance, relapse and reaction

 TREATMENT Cond…
 Management of leprosy depends on the type of leprosy presented by the
patient based on skin lesions

 Leprosy is curable with a combination of drugs known as multidrug therapy

(MDT)

 The duration of therapy is 6 or 12months

 The drugs used are dapsone, rifampicine and clofazimine

 The treatment depends on the age of the patient

 Treatment cont'd

 After completion of treatment, clinical surveillance is important to ensure

complete cure.
 For paucibacillary leprosy, follow up is required for atleast once a year for
2yrs

 For multi bacillary leprosy, follow up is required atleast once a year for 5yrs
 REFERENCES
 World Health Organization. Global leprosy burden. Weekly Epidemiological
Record. 2005;13:118-124
 Guide to eliminate leprosy as a Public Health Problem. Leprosy Elimination
Group World Health Organisation CH-1211 Geneva 27 Switzerland. 2000.
Available from: www.who.int/lep, WHO/CDS/CPE/CEE/2000.14
 Guidelines for the diagnosis, treatment and prevention of leprosy. New Delhi:
World Health Organization, Regional Office for South-East Asia; 2017.
Licence: CC BY-NC-SA 3.0 IGO
 REFERENCES Cond….

 Bharadwaj R. Textbook of Public Health and Community Medicine. 1st ed.

Pune: Department of Community Medicine, Armed Forces Medical College;
2009. pp. 1173-1176
 Suryakantha AH. Community Medicine with Recent Advances. 3rd ed. New
Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2014. pp. 325-341
 Steven GR, Malcolm SD. The International Textbook of Leprosy, Part II,
Section 6, Chapter 6.4. Vaccines for Prevention of Leprosy, Infectious Disease
Research Institute; 2016