World leprosy day 2021: Beat Leprosy; Leprosy is curable

What is the need?

Despite all efforts taken by GOI, out of 36 states/ UTs, 34 states and UTs achieved elimination. One State (Chhattisgarh) and one U.T. (Dadra & Nagar Haveli) are yet to achieve elimination. Five more states/UTs wherein elimination was achieved earlier, namely Odisha, Bihar, Chandigarh, Goa, and Lakshadweep have reported with PR>1/10,000 population, as of 31st March 2017. Therefore, early diagnosis and treatment of leprosy are essential for reducing the burden of this disease in our country.

When is it celebrated?

World Leprosy Day is observed on the last Sunday of January every year. This year, it takes place on 31 January 2021. *In India, World Leprosy Day is celebrated on 30 January, the anniversary of Mahatma Gandhi’s death.

We unite around one goal: #BeatLeprosy. This World Leprosy Day, we are going to help spread the word that #LeprosyIsCurable, joining hands in the fight to #EndStigma, and advocate for the #MentalWellbeing of persons who have experienced leprosy and other neglected tropical diseases.

It is a celebration of the leprosy community and an opportunity for enhanced efforts and commitment for the elimination/ eradication of this debilitating disease at the earliest. 

It focuses on the target of zero cases of leprosy-related disabilities in children. 

Early detection is the prime focus to achieve this target, along with strengthening interventions to prevent leprosy transmission. 

World Leprosy Day was established in 1954 by French journalist and activist, Raoul Follereau. 

He created World Leprosy Day with two goals: to advocate for the equal treatment of persons affected by leprosy and to reeducate the public about leprosy by correcting historical misconceptions surrounding the disease.

Problem statement:

According to WHO, 216108 new leprosy cases were reported globally in 2016. 
India has the  & highest burden of the disease, has reported a decreasing number of new cases.
135,485 cases in 2016 to 120,334 cases in 2017–2018 and a reduction in new pediatric cases, to less than 10,000 (9227 in 2018) from more than 10,000 (10,287 in 2017) previously.

Leprosy/ Hansen's disease:

It is a chronic infectious disease caused by a bacterium, Mycobacterium leprae (M. laprae). The symptoms occur generally after a long period of getting an infection on average 5 years, as M. leprae multiplies very slowly. It mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes.

Classification:

Paucibacillary (PB)- few (up to 5) skin lesions (pale or reddish)

Multibacillary (MB)- multiple (>5) skin lesions, nodules, plaques, thickened dermis, or skin infiltration

The spread of the disease:

The only known source for transmission of the bacteria is an untreated leprosy-affected person.

• From the respiratory tract of the infected person into the environment (in the form of droplets from the nose/mouth).
• The organism enters the healthy body through the respiratory system.
• Organism migrates to nerves and skin (may cause permanent disability, if not treated).

Signs and symptoms:

Leprosy should be suspected if a person shows the following

• Pale-skinned people have darker or reddish patches while dark-skinned people might have light patches on the skin.
• Loss or decrease of sensation in the skin patches
• Numbness or tingling in hand or feet
• A weakness of hands, feet, or eyelids
• Painful nerves
• Swelling or lumps in the face or earlobes
• Painless wounds or burns on hands or feet.

What to do in case of suspicion?

In case of the presence of signs and symptoms of leprosy, contact ASHA or ANM of your area or visit the nearest dispensary/ PHC. Treatment of leprosy is available free of cost at all government dispensaries/ PHCs in India.

MDT (multidrug therapy):

MDT is a combination of different drugs  

• One should complete the full course of MDT as prescribed by a trained health worker according to the type of leprosy. 
• MDT is available free of charge at most health facilities including in remote areas.

National Leprosy Eradication Programme (NLEP):

The National Leprosy Control Programme was launched by the Government of India in 1955. 

• After the introduction of Multi-Drug Therapy in 1982, the program was converted into National Leprosy Eradication Programme (NLEP) in the year 1983. 
• Till 31st March 2018, 29 States/ UTs had attained the level of leprosy elimination i.e., the prevalence rate of less than 1 case of leprosy per 10000 population, and 572 districts (81.13%) out of total 705 districts also achieved elimination level.
• ASHAs are helping in case detection and to assure complete treatment at the community level; for that they are being paid an incentive.
• Post Exposure Prophylaxis has been started for all contacts of leprosy cases from 2nd October 2018 under NLEP.

Sparsh Leprosy Awareness Campaign, 2018: 

It was conducted as an annual activity during the fortnight from 30th January to 13th February to create awareness about leprosy.

Sparsh Leprosy Elimination Campaign (SLEC): 

In order to pay homage to our Father of the Nation, Mahatma Gandhi, on his 150th Birth Anniversary, Central leprosy Division, MoHFW, GOI had committed to achieve the new cases with Grade II disability < 1 case/ million population by introducing SLEC from 2nd October 2018 to till 2nd Oct 2019.

Important points:

• Leprosy is curable with MDT (multidrug therapy).
• It is taken regularly to ensure complete cure of leprosy which prevents deformities and stops transmission to other individuals.
• Early diagnosis, appropriate treatment, and completion of a full course will prevent disability due to leprosy.
• Leprosy is not hereditary; it does not transmit from parents to children.
• Leprosy does not spread through casual touch like shaking hands or playing together, or working in the same office. Close and frequent contacts with untreated cases favor the spread.
• Leprosy is not the result of past sins or immoral behavior. It is caused by a bacterium called Mycobacterium leprae.
• People affected by leprosy have the right to livelihood and the right to live with dignity.

Prevention:

Through chemoprophylaxis:

• Use of single-dose rifampicin (SDR) is recommended as a preventive treatment for contacts of leprosy patients (adults and children 2 years of age and above), after excluding leprosy and TB disease, and in the absence of other contraindications. 
• Post-exposure prophylaxis with SDR for all contacts of leprosy cases has been provided under NLEP.

Through immunoprophylaxis (vaccines):

• BCG vaccination at birth is effective at reducing the risk of leprosy.

Reference:

1. https://zeroleprosy.org/world-leprosy-day/
2. https://www.who.int/news-room/events/world-leprosy-day
3. https://www.awarenessdays.com/awareness-days-calendar/world-leprosy-day-2021/
4. https://www.nhp.gov.in/world-leprosy-day-2020_pg
5. https://leprosymission.org.nz/world-leprosy-day
6. https://www.leprosy-information.org/leprosy/world-leprosy-day-2021
7. https://www.nhp.gov.in/disease/skin/leprosy
8. http://nlep.nic.in/
9. https://es.123rf.com/photo_94219992_stock-vector-world-leprosy-day-.html photo credit
10. https://microbewiki.kenyon.edu/index.php/Mycobacterium_leprae_in_India photo credit