World Leprosy Day
29 January 2023
World Leprosy Day is a celebration of the leprosy community and an opportunity to raise public awareness of leprosy, also known as Hansen's disease. Global Partnership for Zero Leprosy
UpToDate
Articles
Diagnosis
General
Leprosy in Australia
Journals
E-books
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Articles
Diagnosis
Leprosy: A review of epidemiology, clinical diagnosis, and management
Leprosy is a neglected infectious disease caused by acid-fast bacillus Mycobacterium leprae. It primarily affects the skin and then progresses to a secondary stage, causing peripheral neuropathy with potential long-term disability along with stigma. Leprosy patients account for a significant proportion of the global disease burden. Previous efforts to improve diagnostic and therapeutic techniques have focused on leprosy in adults, whereas childhood leprosy has been relatively neglected. This review aims to update the diagnostic and therapeutic recommendations for adult and childhood leprosy. This review summarizes the clinical, bacteriological, and immunological approaches used in the diagnosis of leprosy. As strategies for the diagnosis and management of leprosy continue to develop better and more advanced knowledge, control and prevention of leprosy are crucial. Journal of tropical medicine 4 July 2022
Study of correlation of high-resolution ultrasonography and ultrasonography guided fine needle aspiration cytology in diagnosis of pure Neuritic Leprosy in a tertiary care hospital
This study assesses the features of high-resolution ultrasonographic and ultrasound-guided FNAC of peripheral nerves and correlates the findings in clinically suspected cases of pure neuritic leprosy (PNL). As per the study protocol, clinically screened pure neuritic leprosy cases from January 2017 to June 2018 were subjected to high resonance ultrasonography and ultrasonography-guided FNAC. The aspirated material was stained with modified ZN stain for AFB. Nerves showed hypoechogenicity, loss or distorted echogenic rim, and fibrillary echotextures in ultrasonography. Epithelioid cells, epithelioid cell granuloma was found in the histopathology sections of FNAC specimens with the presence of AFB in some cases. From these findings it may be concluded that HRUS and ultrasound-guided FNAC could be incorporated as rapid and reliable diagnostic tools for PNL. It may enlighten the future path as an early indicator of neural damage and be critical and useful to prevent the disabilities. Indian journal of Leprosy 30 December 2022
Improving early case detection in leprosy: Reports from recent workshops
This Editorial reflects on two recent conferences, one organized by the Global Partnership for Zero Leprosy (GPZL) on the research needs related to early case detection, and the second run by ILEP on the practical aspects of promoting early case detection in the field. With recent developments in mapping and in post-exposure prophylaxis (PEP), we have the tools to greatly improve case-finding and work towards zero leprosy. Leprosy review 28 November 2022
Evaluation of altered patterns of tactile sensation in the diagnosis and monitoring of leprosy using the Semmes-Weinstein monofilaments
The patterns of hands and feet tactile sensation at diagnosis and their consequent modifications with the anti-leprosy drugs define the bacterial etiology of neuropathy, an important tool for the clinical diagnosis and follow up of the disease, highlighting the tibial nerve findings, the most affected nerve among leprosy patients by SWM-test, with significant asymmetry and focality impairments. Plos one 10 August 2022
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General
A literature review: The history of psychological impact of illness amongst people with Leprosy (PwL) in countries across the globe
From year to year, the PwL’s knowledge about leprosy has been getting better; nevertheless, their attitude towards the disease is still poor. The emotional response, social participation, and quality of life of PwL are persistently poor due to the persistent stigma. Dermatology research and practice 9 November 2021
Active case detection methods for crusted scabies and leprosy: A systematic review
Crusted scabies is a severely debilitating skin disease with potentially fatal consequences that is endemic in some remote Aboriginal communities in the Northern Territory (NT) of Australia. Early detection is essential to maximise the chance of recovery and help prevent transmission of scabies to others. There is little knowledge about how to actively detect crusted scabies, so we sought relevant knowledge about a disease with many similarities: leprosy. The review demonstrates the importance of ACD campaigns in communities facing the highest barriers to healthcare access and within neighbourhoods of index cases. Lessons for crusted scabies in the NT include the importance of skilled screening personnel and appropriate community engagement strategies to maximise screening uptake. More research is needed to assess ACD cost effectiveness, impact on disease control, and to explore ACD methods capable of capturing the homeless and highly mobile who may be missed in household centric models. Plos one -Neglected tropical diseases 23 July 2021
Multibacillary leprosy with an incubation period exceeding 50 years
Leprosy is a chronic granulomatous infection predominantly involving the skin and peripheral nervous system. The condition is caused by infection with the obligate intracellular bacillus Mycobacterium leprae and the clinical phenotype is largely dependent on the host immune response to the organism. Transmission is suspected to occur via respiratory secretions with infection usually requiring prolonged periods of contact. The incubation period is highly variable with disease manifestations appearing up to several decades after the initial exposure. The disease can be broadly divided into ‘paucibacillary’ and ‘multibacillary’, and treatment with multidrug therapy including dapsone, clofazimine and rifampicin offers high rates of cure. Here, we report of a case of leprosy with a suspected incubation period in excess of 50 years following occupational exposure in rural Australia. To our knowledge, this incubation period is the longest reported to date. BMJ case reports 5 July 2022
Experiences of living with leprosy: A systematic review and qualitative evidence synthesis
The objective of the review was to identify, appraise, and synthesise qualitative studies on the lived experience of individuals diagnosed with leprosy, the impact of the disease, and how they coped with the disease burden. Plos one -Neglected tropical diseases 5 October 2022
Delayed detection of leprosy cases: A systematic review of healthcare-related factors
Delays in leprosy case detection are due mainly to misdiagnosis. It is crucial to improve the training and capacity of healthcare staff. To avoid misdiagnosis and reduce detection delays, national leprosy control programs should ensure the sustainability of leprosy control within integrated health services. Plos one -Neglected tropical diseases 6 September 2022 _____________________________________________________________________________________________________________
Leprosy in Australia
Neglected tropical diseases in Australia: a narrative review
MJA 6 June 2022
Medical history: Leprosy is a terror of the past. Right?
Not so. Leprosy, one of history’s most dreaded diseases, is still with us. Western Australia has had 20 new cases of leprosy in the past five years. The disease disproportionately affects Aboriginal and Torres Strait Islander communities. So what is leprosy? And why isn’t it a thing of the past? RACGP 17 September 2018
Leprosy in Far North Queensland: almost gone, but not to be forgotten
The low numbers of cases of locally acquired leprosy in FNQ reflect improved access to treatment and less household overcrowding, factors that reduce M. leprae transmission. However, while there has been no case of locally acquired leprosy since 2009, two PNG‐born Torres Strait Islanders were diagnosed with the disease in the past decade. The continuous flow of people between Australia and PNG makes ongoing vigilance essential. MJA 5 August 2019
Stigma, separation, sorrow: leprosy in Australia
Leprosy (Hansen’s disease) was introduced to Australia in the mid-1800s and its story reflects the attitudes of the 19th and 20th centuries, with treatment including segregation, paternalism, and racism. The approaches taken within the Australian states were similar and based on isolating people affected by leprosy, as both a measure to assist the patient but, more importantly, to protect the European society. The most devastating effects of this introduced disease and these approaches were on Indigenous Australians. With the advent of effective antimicrobials, isolation practices were slowly replaced with community-based treatment. However, the term ‘leper’ still evokes negative images in Australian society today. Microbiology Australia 22 October 2020
A polymorphic rash from across the seas
A 21-year-old man who migrated to Australia from Nepal 4 years previously was referred to a dermatologist. He had a 12-month history of a polymorphic eruption consisting of widespread macules, plaques, papules, and nodules. As these were asymptomatic, he had not previously sought medical attention. A left wrist biopsy showed a granulomatous response with perineural histiocytic infiltrates, consistent with paucibacillary leprosy. In 2020, the World Health Organization reported 127 558 new cases of leprosy worldwide.1 In Australia, leprosy is a notifiable disease, with 9 cases reported in the past year, and an average of 9.6 notifications annually over the past 5 years. MJA 22 August 2022 ________________________________________________________________________________________________________________
E-books
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