Leprosy Disease

Introduction

Leprosy, also called Hansen's disease, is one of the first microbiology diseases that cropped up in the 1940's. People living in poverty had and still have a high probability of suffering from leprosy. During the 1940's, leprosy was an incurable disease. Leprosy is caused by an infective agent known as Mycobacterium leprae. The causative agent, Mycobacterium leprae, causes a long-term infection in people suffering from leprosy. The infective agent can be transmitted from one host to another through contact with fluid from the nostrils of an infected patient or through a cough. However, leprosy is not very communicable (1). The signs and symptoms of leprosy include granulomas of the skin, nerves, eyes, and the respiratory tract and poor eyesight. These signs and symptoms make an infected person to be numb to pain. Infected people may sometimes not be aware of wounds on their skin due to their numbness. Treatment for leprosy is done through the multidrug therapy. Lymphocyte transformation, radioimmunoassay, immunogel diffusion, fluorescent antibody absorption tests are used to detect the Mycobacterium leprae during treatment. Leprosy control programs are being used to prevent the spread of leprosy (1).

Leprosy

Leprosy, also referred to as Hansen's disease, is a mycobacterial infection that affects the skin, eyes, testes, peripheral nerves, bones, and mucous membranes. Leprosy affects about 1.15 million people, of both sexes and all ages, in areas that are poverty stricken. Poverty stricken regions that have been hit hard with leprosy include Nigeria, India, Indonesia, Brazil, and Myanmar (4). These regions have the highest number of leprosy cases. Also, the probability of being infected with leprosy is higher in these particular regions. In today's modern world, the name leprosy has been replaced with the Hansen's disease. This is because leprosy is connected with the Biblical leprosy, thereby making the leprosy patients to be discriminated. To avoid discrimination or harsh treatment, the Western hemisphere refers to leprosy as the Hansen's disease (1). The Hansen's disease is caused by an infective or causative agent known as Mycobacterium leprae (3). Mycobacterium leprae is an intercellular bacillus that gradually grows and enters the peripheral never, eyes, bones, mucous membranes, and testes. This causative agent for leprosy is related to the causative agent of Tuberculosis. The incubation of Mycobacterium leprae is between two to ten years or twenty years sometimes. This means that the period between infection and emergence of leprosy is two to ten or twenty years (4). Human beings infected with leprosy, primary reservoirs of Mycobacterium leprae, may transmit the infection to other hosts through various routs of transmission like skin to skin and airborne routes of transmission. Skin to skin transmission is the main route of transmission in leprosy. Since the bacilli cannot be located on unbroken skin, the transmission may take place through surgical processes and tattooing. Airborne transmission is only possible through an infected person's nasal secretions with Mycobacterium leprae to an uninfected person's nasal mucosa. The Hansen's disease is, however, considered to be less communicable because of human beings' natural immunity, which destabilizes the infection. The host of the Hansen's disease is mainly human beings but armadillos have been found to be naturally infected with leprosy in Louisiana (1).

Symptoms of Leprosy

People who have been infected with the Mycobacterium leprae exhibit signs and symptoms like skin lesions, nose bleeding, nose congestion, peripheral nerve trunk damage, and hair loss on eyelashes, eyebrows, and on the body (5). The peripheral nerve trunk damage results into numbness and paralysis of body parts that later causes deformities and trophic changes. The numbness affects the peripheral nerve trunks and the small dermal nerves. The damage of the nerves may happen in untreated individuals infected with leprosy or those undergoing chemotherapy and instances when treatment is stopped because of the association of neuritis with erythema nodosum leprosum reactions. These signs and symptoms may later on make an infected person suffer from blindness or visual impairment (6). Blindness or visual impairment is as a result of mycobacterial infection and the inflammation of parts of the anterior segment of the eyes. The diagnosis of leprosy is founded on the clinical symptoms. For a person to be diagnosed with leprosy, immunogel diffusion, fluorescent antibody absorption, radioimmunoassay, and lymphocyte transformation tests have to be performed. Positive results from the tests often indicate the type of leprosy a person has. The number of skin smears further suggests whether a patient has the indeterminate, tuberculoid, lepromatous, borderline or dimorphous, or the paucibacillary-multibacillary types (1).

Treatment of Leprosy

The recommended treatment for leprosy is the multidrug therapy (3) (2). Patients with leprosy are expected to visit the leprosy clinics near them every month for clinical check-ups. The multidrug therapy should strictly not be utilized as monotherpay for leprosy. The first drug that was used for the treatment of leprosy is Dapsone. Dapsone is bacteriostatic against the Myobacterium leprae. It is combined with Rifampicin to treat paucibillary leprosy. The treatment of multicibillary leprosy is a combination of Rifampicin and Clofazimine. One dose of the combination therapy can be administered to treat single lesion paucibillary leprosy. The dosage form is Rifampiin (600mg), Minocycline (100mg), and Ofloxacin (400mg). An adult takes twice a child's dose (4). In cases where a patient's results are not certain, the patient should be prescribed the multidrug therapy for multibacillary leprosy. Any individual infected with leprosy and has tested positive for skin smear should be treated with the multidrug therapy dosage for multibacillary leprosy. It is important to note that the dosage for paucibillary leprosy should not be administered to patients suffering from multibacillary leprae (4).

Control of Leprosy

A leprosy control program could be built to stop the transmission of leprosy. The main aims of such a program disrupt the transmission of the infection from a primary host to a second host, discover new subjects that are symptomatic, making follow ups on all leprosy patients under medication, and create awareness to the public, medical personnel, patients, and their families on leprosy (1).

Conclusion

In conclusion, leprosy, also referred to as the Hansen's disease, is a mycobacterial disease that is caused by Mycobacterium leprae. This causative agent infiltrates the bones, eyes, mucous membranes, testes, and the peripheral nerves. The Myobacterium leprae is an intracellular bacillus that grows slowly and infiltrates these areas. The incubation period between infection and emergence of the disease is two to ten or twenty years. The main routs of transmission of leprosy are skin to skin and airborne transmission. However, leprosy is not highly communicable. For a person to be diagnosed with leprosy, immunogel diffusion, fluorescent antibody absorption, radioimmunoassay, and lymphocyte transformation tests have to be performed. The main treatment for leprosy is the multidrug therapy. The transmission of leprosy could be regulated through the leprosy control program.

References

Health Report Manual Department of Health and Hospitals. (2010). Hansen's disease (Leprosy), Infectious Diseases Epidemiology Section, 1-12. Medical Research Resource ICMR BULLETIN. (2002). Short Course Treatment of Leprosy Present Status, vol.32, No.1. Leprosy Elimination Group. (2000). Guide to Eliminate Leprosy as a Public Health Problem, 1- 22. Health Report World Health Organization. (1998). Drugs Used in Leprosy, WHO Model Prescribing Information, 2-30. Fact Sheet Maryland Department of Health & Mental Hygiene. (2002). Leprosy (Hansen's Disease), Fact Sheet. Electronic Journal Centers for Disease Control and Prevention. (2017). Hansen's Disease (Leprosy): Signs and Symptoms. Website via the Internet (https://www.cdc.gov/leprosy/symptoms/index.html)

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