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Leprosy is a disease of our time - a disease of poverty caused by a bacillus called Mycobacterium Leprae (a distant relative of the TB bacillus). Most people are naturally immune but over 90% of people affected by leprosy live in developing countries where resources are scarce. Life expectancy can be reduced by up to 50%, mainly due to economic hardship.
What is leprosy?
It is the least contagious communicable disease. Leprosy is not highly infectious, but is probably spread by airborne droplet infection. Symptoms can take up to 20 years to show.
Leprosy starts by damaging the smaller nerves that control feeling on the skin's surface. The first outward sign of leprosy is usually loss of feeling in patches on the skin. If treated during these early stages there will be no further damage. If left untreated, leprosy then affects the trunk nerves in the elbow, wrist, neck, knee and ankle. The resulting damage can lead to loss of sensation in the hands and feet, shortened digits, clawed fingers and drop foot. Ulcers can also develop. Loss of sensation in hands, feet and eyes means that everyday activities are fraught with danger - burns go unrecognised, wounds untended, stones in shoes and grit in the eyes go unnoticed.
Leprosy can damage the eye nerves so that the eyelid muscles stop working. If this happens the person will not be able to close their eyes, even if they try. Our eyelids normally make the eyes blink regularly to keep them moist and clean. Without this natural cleaning and protection a person can eventually become blind.
Leprosy can also damage the bones of the nose. In time this causes the nose to collapse and flatten.
Medical and lifestyle interventions are essential to prevent disability and blindness. Millions of people have visible deformities and approximately 30% of people affected by leprosy have irreversible disabilities. Work is still being carried out to develop a preventative vaccine for leprosy.
How we help
The good news is that leprosy is curable with multidrug therapy (MDT), a combination of dapsone, clofazimine and rifampicin. It kills the leprosy bacteria, meaning that early diagnosis can prevent irreversible disability and associated stigma. Leprosy is a very complex disease so specialist care is required to cure reactions and ulcers, provide physiotherapy, perform eye and reconstructive surgery and ensure full rehabilitation.
Although official detection rates for leprosy are declining (around a quarter of a million new patients are diagnosed and registered for treatment every year1), many people do not seek treatment for fear of social exclusion. This means that the actual number of new cases is probably much higher. The Leprosy Mission therefore considers it vital to focus on leprosy; the ultimate goal is to eradicate the causes and consequences of this disease. We are committed to helping implement health education programmes, prevent disability and train patients to look after themselves.
We are also increasingly investing in community-based approaches to leprosy and physical disability. We support families and communities affected by leprosy through facilitating self-help groups and providing education (such as Catch Them Young, aimed at keeping children in school) and vocational training. Microfinance and low-cost housing also help families and communities make a way out of poverty.
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