Leprosy still exists! It’s not a disease of the past; it is still an ongoing issue

It’s probably time to use technology like it was used in COVID in all our health programs to fight Leprosy

IADVL is the representative association of dermatology in India and it’s the second largest such organisation in the world. Since inception, Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) and its members have been at the forefront of Leprosy research, community management and awareness campaigns.

Every year World Leprosy Day is observed in India on January 30 with an aim to increase public awareness of Leprosy to assist people to seek treatment and live a life of dignity. This year, the theme for World Leprosy Day is “Act Now, End Leprosy”.

Leprosy is one of the oldest diseases known to mankind and is one of the most stigmatised diseases. Every year, over 200,000 such cases are detected globally and India accounts for more than half of these, according to the World Health Organization (WHO).

Dr Rohit Batra, President, IADVL Delhi said, “Leprosy can impact people of all ages. It is a disease that targets the most vulnerable people in our societies.  If not diagnosed and treated on time, it can result in debilitating disabilities. Although leprosy is curable and early treatment can help prevent any disability. Still, the disease is surrounded by stigma and people living with it undergo immense mental trauma, and anxiety which also leads to depression. People are not willing to come in front for treatment because they have fear that their family and community will reject them if they come to know that he/she is diagnosed with leprosy. The cases of Leprosy are more common in remote places which are difficult to find”.

Leprosy is caused by a bacterium called Mycobacterium leprae and is a chronic infectious disease. It affects the skin, peripheral nerves, eyes, and mucosa of the upper respiratory tract.

Dr Sumit Gupta, Secretary, IADVL Delhi said, “As per National Leprosy Eradication Programme (NLEP) data India was declared “leprosy-free” in 2005, today India accounts for almost 60 per cent of the world’s new leprosy cases. Declaring Epidemiological Elimination of Leprosy in 2005 has not only been misleading but also has probably taken the public mindspace away from Leprosy which continues to maim thousands every year. Additionally, COVID-19 pandemic impacted Leprosy control screening and awareness programmes, which has further increased the burden”.

As per Dr Gupta, “It’s probably time to use technology like it was used in COVID in all our health programs. We can have Leprosy centric App for diagnosed patients and their close contacts ensuring compliance and better access to treatment and rehabilitative measures. Similar apps for Leprosy centres and treating physicians can help tracking data better”.

According to Dr Batra, “Leprosy is not highly contagious but repeated contact with an untreated person for a longer period leads to the spreading of the disease. It has aerosol transmission. The bacterium dividing time is slow; therefore, the disease has an average incubation period of 5 years. Symptoms can appear from within one year to as long as 20 years. It manifests as muscle weakness, numbness in the extremities, and skin lesions resulting in decreased sensation to touch, temperature, or pain. Multidrug therapy (MDT) has been developed by WHO which uses a combination of antibiotics for the treatment of the disease. Additionally, Imparting proper knowledge about the disease to the sufferer and others is very much required to improve the quality of life of the patient. Tragically, after receiving complete treatment for leprosy, patients continue to face discrimination because the general public is unaware of their condition. This obliterates their social life, opportunity to find a school/ college or get employment. Infact, finding a partner becomes a distant dream for them. The social stigma and discrimination push the patients towards mental disorders and negative emotional states. To combat mental health issues, coping mechanisms should be strengthened for those affected and the negative community attitude should be changed by spreading awareness”.

Dr Gupta added, “Timely detection of leprosy and its early treatment can cure the disease by 6-12 months. The focus should be done to improve active case detection, on regular surveillance, and on providing multi-drug treatment to all the patients promptly. By early identification and treatment of every leprosy patient, it has been proven that spread of Leprosy can be effectively stopped. National Leprosy Eradication Program also recommends surveillance and adequate chemoprophylaxis (single dose Rifampicin to prevent growth and spread of Leprosy Bacteria) of close contacts of diagnosed patients.

Dr Batra further added, “Unlike popular belief, leprosy doesn’t spread by physical touch and if the infected person has received Multi-drug therapy (MDT) for 72 hours, they are no longer contagious. MDT is also available free of cost to all leprosy patients at government approved centres. To registered patients, MDT  can also be obtained at Primary Health Centres”.

Dermatologists are the qualified specialists to diagnose and treat Leprosy as their degree is DVL (Dermatology, Venereology and Leprology). Often because of multi-systemic involvement like nerves, limbs, eyes etc., an inter-disciplinary approach involving Neurologists, Ophthalmologists, Surgeons, Orthopaedics to effectively treat patients is sometimes required.