Leprosy, a chronic infectious disease caused by Mycobacterium leprae is transmitted via droplets from the nose and mouth and has an incubation period of 1–20 years. Also known as Hansen’s disease, it may affect the skin, the peripheral nerves and the eyes.

Despite the significant advancements made in medical science, elimination of the disease continues to be a challenge. The disease primarily affects the skin, peripheral nerves, mucosa of the upper respiratory tract, and eyes, leading to disfigurement and nerve damage.

More than 2,00, 000 new cases are reported in the world every year, which is spread across 120 countries, according to latest data with the World Health Organisation. Unfortunately, India accounts for more than 50 percent of the global burden of the new leprosy patients.

The World Leprosy Day is observed globally on the last Sunday of January, but in India, it is observed on January 30, the death anniversary of Mahatma Gandhi.

Challenging task

The bacteria responsible for the disease has a long incubation period and most of the patients do not develop clinical symptoms for several years. By this time, an infected person could have transmitted it to some others including family members. So early detection is the key to treatment. Contact tracing like that in Covid can play a vital role in tracking those who have been in contact with an infected person to start an early treatment.

It is not easy to accurately establish the burden of the problem of leprosy. This is partly due to the difficulty of measuring the various parameters like the impairment, stigma, social participation and quality of life. There is a need to reverse the delay in diagnosis and for this awareness of the disease has to be built at all levels. The diagnostic skills have to be increased and there should be more commitment to tackle the disease among the healthy personnel. Sustained efforts have to be made to build awareness about the disease and there should be more funding for the various leprosy programmes.

Towards zero leprosy

In order to understand the actual leprosy burden in India, it is essential to have suitable indicators and measurement tools for tracking the disability in all its aspects, including physical impairments and activity limitation. Knowledge of these factors will help in developing effective preventive and supporting programmes at various levels.

Transmission of the bacterium is yet to be understood well. There have been studies that have stablished that the transmission can also be due to the environment. A 2016 study in the Indian Journal of Dermatology, Venereology and Leprology has established that environment can play a role in transmission. Understanding the exact way the bacterium transmits can go a long way in defeating the disease. There is also an underlying need to make the people conscious about hygiene and cleanliness.

Resistance to the drugs has posed a major challenge. The multi drug therapy has proved to be successful but in a large number of cases because of economic challenges, the drugs are not taken in the dosage that is required. Some leave the treatment midway. There is a need to develop a system for tracking to ascertain that the treatment is not left in between.

Early detection is another roadblock and despite efforts there is a shortage of tools that can detect the disease at a stage where they can be treated. Like all diseases, an early detection, can have a better chance for cure. There is a need for a diagnostic kit that can detect the disease at a very early stage even when the patient does not have any clinical signs.

All these efforts will prove futile if measures are not taken to address the stigma and discrimination that are associated with the disease. For this the health workers need to be sensitised. The elimination of the disease needs a serious effort by the government and various stakeholders should partner in the efforts for addressing the issues of stigma.

Like the other health programmes, the COVID-19 pandemic has also affected the the existing leprosy programmes. Fewer people received timely diagnosis, and has led to subsequently increased the leprosy-related disabilities. And it is time to review of the damages done.

The government and the stakeholders must act to bring the leprosy programmes back on track. The Leprosy Day that is observed worldwide should be a reminder for all to act and work together to defeat the disease.

—The author, Dr Vanita Srivastava, is an independent science and health writer. The views expressed are personal.

Read her previous articles here

(Edited by : C H Unnikrishnan)

First Published:Jan 30, 2023 5:15 PM IST