Another World Leprosy Day has come and gone and the disease is still spreading with 3,000 new cases been reported annually in Nigeria, especially with the involvement of child-related cases. KUNI TYESSI in this report highlights the causes, symptoms, treatment as well as preventive measures as many still live in ignorance of it.
Known as Hansen’s Disease, leprosy is caused by a type of bacteria otherwise known as mycobacterium leprae and is known to multiply very slowly. Its incubation period is said to be between 5 years while symptoms can take 20 years to appear and it mainly affects the skin and peripheral nerves.
Throughout its history, leprosy has been feared and misunderstood with several mythical and cultural undertone attached to it. For a long time, it was thought to be a hereditary disease, a curse, or a punishment from God as there are stories in the Bible that suggests this.
Before and even after the discovery of its biological cause, leprosy patients were stigmatized and shunned. For example, in Europe, historical fact records that during the Middle Ages, its sufferers had to wear special clothing and ring bells to warn others that they were close, and even walk on a particular side of the road, depending on the direction of the wind. Even in modern times, its treatment has often occured in seperate hospitals and live-in colonies called leprosariums because of the stigma of the disease.
Contrary to the social stigma, it is not highly contagious, and does not cause body parts to fall off. It is not also caused by witchcraft, neither are the suffers witches or wizards. In fact, 95% of the world’s population is naturally immune to the disease and once diagnosed, a person is easily cured.
It is not highly infectious and transmission from human to human is through respiratory droplets from the nose and mouth, during close and frequent contacts with untreated cases. It’s also possible to get the bacteria from armadillo and other non-human primates.
Leprosy, if left untreated is capable of causing damage to the nerves, limbs, skin and eyes as seen in most patients. The deformities in the fingers and toes occure due to cartilage being absorbed back into the body and they are not leprosy but the aftermath of late diagnosis and treatment and this can happen in the case of other diseases.
This damage gives the patient decreased feeling in the areas affected. The decreased feeling can leave the patient unaware that they have injured themselves and they can get secondary infections. These infections result in the loss of body tissues.
The symptoms are wide and can start out mild and progress into presentations that are the subject of misconceptions and cultural beliefs. The hallmark signs of leprosy are hypesthesia, which is an abnormally weak sense of pain, cold, heat, or touch, skin lesions, and peripheral neuropathy.
The first visible indication that someone has leprosy usually has to do with the skin. Things like painless skin patches (lesions) that are not itchy begin popping up. They tend to be circular with a dry scaly centre. These usually first present themselves on the buttocks, face, and the surfaces of limbs. This is because the bacteria prefer cooler zones of the body. In fact, the organisms involved grow best at 80-86 degrees Fahrenheit.
As the disease progresses, the skin’s features like sweat glands and hair follicles are destroyed. Further, the nerves become enlarged and can become quite painful. The patient loses their ability to “feel” and they can injure themselves easily. These injuries lead to muscle atrophy, weakness, and infections. This can cause “foot drop” or clawed hands. Ulcers can also form on the hands and feet.
As the face becomes involved, a person can begin to sound hoarse, loose their eyebrows, and eyelashes. Their nasal cavities may collapse because of the breakdown in the septum. When the eyes become involved in the process, the person can get glaucoma or keratitis. The facial skin can also become thickened and corrugated. When it remains untreated, the progressive impairment becomes permanent damage to the skin, nerves, limbs and eyes. Early diagnosis and treatment with multidrug therapy (MDT) still remains the key elements in eliminating the disease as a public health concern.
In 1991, WHO passed a resolution that would eliminate leprosy as a problem by the year 2000 (the definition of a problem meaning less than 1 case per 10,000 people). Due to the advances in drug treatments and the use of multi-drug therapies, WHO did accomplish their goal. In 1995, they began offering free therapies to any patient in the world who contracted the disease. Nigeria still records about 3000 cases annually and more disturbing are cases of children who have been affected by the disease, thereby leaving experts in the field of medicine and other stakeholders to declare that on no account must children be allowed to suffer such.
A person is also not contagious after a few weeks of the treatment. This, combined with many surgical options that decrease a person’s deterioration and increase their nerve function, give leper colonies everywhere something to party over.
The national director of The Leprosy Mission, Nigeria, Dr Moses Onoh, further creates awareness about the disease so that people can understand it’s signs, symptoms, prevention as well as treatment, based on the standard of the World Health Organisation, WHO.
He said referring to victims of the disease as lepers is derogatory and as such, the proper way to define them is “ persons affected by leprosy” as it is a disease that can affect anyone and therefore called for good general hygiene as the disease is caused by germs that reside and breed in dirty environments.
“They are not lepers but persons affected by leprosy. The reason why the ailment still persists is because most people do not know the signs and symptoms and so do not come out early enough for treatment. “
“The deformities you see on persons affected by leprosy is a result of late treatment but is not leprosy in itself. Most of them do not come for treatment until they are faced with the deformities. It’s just a deformity which can also occur in other ailments.
It is not contagious and can be treated and the treatment is free.”
“We always advise that once a patch is discovered on the skin, such persons should go for test because it can be a sign of leprosy. The patches do not often itch and are not painful. However, that a patch has been seen on the skin doesn’t mean it is leprosy until a test has been done and proven otherwise.”
He said there are wonder drugs that care cure the disease and called on medical doctors to always refer pregnant women for test whenever a patch has been noticed on their bodies during check-up as loss of fingers is not a parameter to diagnosing the disease.
He revealed that there are four organisations in Nigeria which oversee leprosy- related diseases and are committed to its total eradication. They are based in Enugu, Enugu state, Jos, in Plateau state, Ibadan in Oyo state and Abuja the federal capital territory which are situated in the south-east, south-west, north-central and the nation’s capital respectively.
Published: Feb 1, 2016 By Kuni Tyessi
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