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Leprosy

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Neglected Tropical Diseases - Sub-Saharan Africa

Part of the book series: Neglected Tropical Diseases ((NTD))

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Abstract

From its East Africa origin, leprosy has afflicted humans since ancient times. The tide turned against the disease from the 1980s when effective multidrug therapy was introduced worldwide. By 2005, all countries in sub-Saharan Africa had attained the WHO elimination target of prevalence less than 1 per 10,000 population. Africa accounts for 9 % of global leprosy prevalence and new case detection with a worrying number of new cases having significant disability at diagnosis. Public stigma has also contributed to the persistence of segregated settlements for leprosy sufferers, long after cure. No case in sub-Saharan Africa has been linked to the recently discovered Mycobacterium lepromatosis. Leprosy spread is believed to be by droplet and skin transmission with growing evidence for zoonotic spread from infected armadillos, a species not found outside the Americas. The presentation of leprosy in sub-Saharan Africa is as elsewhere, varying between two polar states of tuberculoid and lepromatous leprosy and modified by complications including acute reactions.

Clinical diagnosis and classification of leprosy at present are most amenable for treatment purposes, with the continuous supply of effective MDT being the backbone of leprosy control activities. There is a greater push towards reducing the disability burden with improvement of the generally weak African health care systems within which leprosy services are provided and increased involvement of sufferers and the community being key strategies. A fixed-duration course of rifampicin and dapsone, with addition of clofazimine in multibacillary disease, remains the mainstay of treatment.

Leprosy control activities are now suffering from reduced attention on both global and subregional scales, and the knowledge of front-line health care workers regarding leprosy is dwindling. With leprosy likely to remain with us for the foreseeable future, more research and political will are required to sustain the gains and possibly accelerate us to true elimination.

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References

  • Barua S (2013) Global leprosy situation and new challenges and priorities with reference to Bangkok Summit [Presentation to WHO-Afro Leprosy and HAT Managers and partners]. Annual Leprosy and Human African Trypanosomiasis Programme Review Meeting, Yaoundé, 11 Nov

    Google Scholar 

  • Bhushan P, Sardana K, Koranne RV, Choudhary M, Manjul P (2008) Diagnosing multibacillary leprosy: a comparative evaluation of diagnostic accuracy of slit-skin smear, bacterial index of granuloma and WHO operational classification. Indian J Dermatol Venereol Leprol 74(4):322–326

    Article  PubMed  Google Scholar 

  • Brandasma JW, Van Brakel WH (2003) WHO disability grading: operational definitions. Lepr Rev 74(4):366–373

    Google Scholar 

  • Brennan PJ, Barrow WW (1980) Evidence for species-specific lipid antigens in Mycobacterium leprae. Int J Lepr Other Mycobact Dis 48(4):382–387

    PubMed  CAS  Google Scholar 

  • Chehl S, Job CK, Hastings RC (1985) Transmission of leprosy in nude mice. Am J Trop Med Hyg 34(6):1161–1166

    PubMed  CAS  Google Scholar 

  • Croft RP, Smith WC, Nicholls P, Richardus JH (1998) Sensitivity and specificity of methods of classification of leprosy without use of skin-smear examination. Int J Leprol 66(4):445–450

    CAS  Google Scholar 

  • De Messias-Reason I, Kremsner PG, Kun JF (2009) Functional haplotypes that produce normal ficolin-2 levels protect against clinical leprosy. J Infect Dis 199(6):801–804

    Article  PubMed  Google Scholar 

  • Desikan KV, Sreevista (1995) Extended studies on the viability of Mycobacterium Leprae outside the human body. Lepr Rev 66(4):287–295

    PubMed  CAS  Google Scholar 

  • Dharmendra, Loew J (2012) The immunological skin tests in leprosy. Part II. The isolated protein antigen in relation to the classical Matsuda reaction and the early reaction to lepromin. 1942. Indian J Med Res 136(3), 9p following 502

    Google Scholar 

  • Groenen G, Saunderson P (2001) How to diagnose and treat leprosy (ILEP Learning Guide 1). The International Federation of Anti-Leprosy Associations, London

    Google Scholar 

  • Han XY, Silva FJ (2014) On the age of leprosy. PLoS Negl Trop Dis 8(2), e2544. doi:10.1371/journal.pntd.0002544

    Article  PubMed  PubMed Central  Google Scholar 

  • Han XY, Seo Y-H, Sizer KC, Schoberle T, May GS, Spencer JS, Li W, Nair RG (2008) A new Mycobacterium species causing diffuse lepromatous leprosy. Am J Clin Pathol 130(6):856–864

    Article  PubMed  CAS  Google Scholar 

  • Han XY, Sizer KC, Velarde-Felix JS, Frias-Castro LO, Vargas-Ocampo F (2012) The leprosy agents Mycobacterium lepromatosis and Mycobacterium leprae in Mexico. Int J Dermatol 51(8):952–959

    Article  PubMed  PubMed Central  Google Scholar 

  • ILA Technical Forum (2002) The diagnosis and classification of leprosy. Int J Leprol 70(1 [Suppl]):S23–S31

    Google Scholar 

  • Job CK, Jayakumar J, Kearney M, Gillis TP (2008) Transmission of leprosy: a study of skin and nasal secretions of household contacts of leprosy patients using PCR. Am J Trop Med Hyg 78(3):518–521

    PubMed  Google Scholar 

  • Lastoria JC, Abreu MA (2014) Leprosy: review of the epidemiological, clinical, and etiopathogenic aspects – part 1. An Bras Dermatol 89(2):205–218

    Article  PubMed  PubMed Central  Google Scholar 

  • Malaviya GN (2003) Review: sensory perception in leprosy – neurophysiological correlates. Int J Lepr Other Mycobact Dis 71(2):119–124

    Article  PubMed  Google Scholar 

  • McDermott-Lancaster RD, McDougall AC (1990) Mode of transmission and histology of M. Leprae infection in nude mice. Int J Exp Pathol 71(5):689–700

    PubMed  CAS  PubMed Central  Google Scholar 

  • Miller RA, Gorder D, Harnisch JP (1987) Antibodies to phenolic glycolipid-I during long-term therapy: serial measurements in individual patients. Int J Lepr Other Mycobact Dis 55(4):633–636

    PubMed  CAS  Google Scholar 

  • Monot M, Honoré N, Garnier T, Araoz R, Coppee JY et al (2005) On the origin of leprosy. Science 308:1040–1042

    Article  PubMed  CAS  Google Scholar 

  • Norman G, Joseph G, Richard J (2004) Validity of the WHO operational classification and value of other clinical signs in the classification of leprosy. Int J Lepr Other Mycobact Dis 72(3):278–283

    Article  PubMed  Google Scholar 

  • Onyeze A (2013) Elimination of neglected tropical diseases in the African Region – an overview. [Presentation to WHO-Afro Leprosy and HAT Managers and partners]. Annual Leprosy and Human African Trypanosomiasis Programme Review Meeting, Yaoundé, 11 Nov

    Google Scholar 

  • Ridley DS, Jopling WH (1966) Classification of leprosy according to immunity a five-group system. Int J Leprol 34(3):255–273

    CAS  Google Scholar 

  • Saunderson P (2002) How to recognize and manage leprosy reactions (ILEP Learning Guide 2). The International Federation of Anti-Leprosy Associations, London

    Google Scholar 

  • Spencer JS, Dockrell HM, Kim HJ, Marques MAM, Williams DL, Martins MVSB, Martins MLF, Lima MCBS, Sarno EN, Pereira GMB, Matos H, Fonseca LS, Sampaio EP, Ottenhoff THM, Geluk A, Cho S-N, Stoker NG, Cole ST, Brennan PJ, Pessolani MCV (2005) Identification of specific proteins and peptides in Mycobacterium leprae suitable for the selective diagnosis of leprosy. J Immunol 175(12):7930–7938

    Article  PubMed  CAS  Google Scholar 

  • Truman R, Fine PEM (2010) “Environmental” sources of Mycobacterium Leprae: issues and evidence. Lepr Rev 81(2):89–95

    PubMed  Google Scholar 

  • Truman RW, Singh P, Sharma R, Busso P, Rougemont, Panis-Mondolfi A, Kapopoulou A, Brisse S, Scollard D, Gillis TP, Cole ST (2011) Probable zoonotic leprosy in the southern United States. N Engl J Med 364(17):1626–1633

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Ulrich M, Smith PG, Sampson C, Zuniga M, Centeno M, Garcia V, Manrique X, Salgado A, Convit J (1991) IgM antibodies to native phenolic glycolipid-I in contacts of leprosy patients in Venezuela: epidemiological observations and a prospective study of the risk of leprosy. Int J Lepr Other Mycobact Dis 59(3):405–415

    PubMed  CAS  Google Scholar 

  • WHO Expert Committee on Leprosy (1988) WHO Expert Committee on Leprosy: sixth report. (WHO Technical Report Series, No. 768). World Health Organization, Geneva

    Google Scholar 

  • WHO Expert Committee on Leprosy (1998) WHO Expert Committee on Leprosy: seventh report (WHO Technical Report Series, No. 874). World Health Organization, Geneva

    Google Scholar 

  • WHO Expert Committee on Leprosy (2012) WHO Expert Committee on Leprosy: eight report. (WHO Technical Report Series, No. 968). World Health Organization, Geneva

    Google Scholar 

  • WHO Study Group on Chemotherapy of Leprosy (1994) Chemotherapy of Leprosy: report of a WHO Study Group (WHO Technical Report Series, No. 847). World Health Organization, Geneva

    Google Scholar 

  • World Bank Group (2011) Poverty data – world development indicators. Available at: data.worldbank.org/topic/poverty. Accessed on 2nd Jul 2014

  • World Health Organization (1982) Chemotherapy of Leprosy for control programmes: report of a WHO Study Group (WHO Technical Report Series, No. 675). World Health Organization, Geneva

    Google Scholar 

  • World Health Organization (2013) Global Leprosy: update on the 2012 situation. Wkly Epidemiol Rec 88(35):365–379

    Google Scholar 

  • World Health Organization, Division of Drug Management and Policies (1998) WHO model prescribing information: drugs used in leprosy. World Health Organization, Geneva

    Google Scholar 

  • World Health Organization, Department of Control of Neglected Tropical Diseases (2012) Leprosy prevalence rates, data reported to WHO as of January 2012. Available at: http://www.who.int/lep/situation/Leprosy_PR_2011.pdf. Accessed 25th June 2014

  • World Health Organization, Regional Office for Africa (2012) Progress towards the reduction of the burden of leprosy: leprosy is curable. World Health Organization, Regional Office for Africa, Brazzaville

    Google Scholar 

  • World Health Organization, Regional Office for Africa (2013) Leprosy: facing the remaining challenges – The WHO African Region strategic plan for further reducing the burden of leprosy 2013–2013. World Health Organization, Regional Office for Africa, Brazzaville

    Google Scholar 

  • World Health Organization, Regional Office for South-East Asia (2009a) Enhanced global strategy for further reducing the disease burden due to leprosy -plan period: 2011–2015. World Health Organization, Regional Office for South-East Asia, New Delhi

    Google Scholar 

  • World Health Organization, Regional Office for South-East Asia (2009b) Report of the tenth meeting of the WHO Technical Advisory Group on Leprosy Control. World Health Organization, Regional Office for South-East Asia, New Delhi

    Google Scholar 

  • World Health Organization, Regional Office for South-East Asia (2011) Report of the eleventh meeting of the WHO Technical Advisory Group on Leprosy Control. World Health Organization, Regional Office for South-East Asia, New Delhi

    Google Scholar 

  • World Health Organization, Regional Office for South-East Asia (2012) Monitoring enhanced global strategy. World Health Organization, Regional Office for South-East Asia, New Delhi

    Google Scholar 

  • Yawalkar SJ (2002) Leprosy for medical practitioners and paramedical workers, 7th edn. Novartis Foundation for Sustainable Development, Basle

    Google Scholar 

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Authors and Affiliations

  1. Ghana Leprosy Service Headquarters, Ankaful Leprosy General Hospital, Ankaful, Cape-Coast, Ghana

    Benedict Okoe Quao & Ekow Amankrah-Otabir

Authors
  1. Benedict Okoe Quao
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  2. Ekow Amankrah-Otabir
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Correspondence to Benedict Okoe Quao .

Editor information

Editors and Affiliations

  1. Ofc of Research, Innovation & Dev, University of Ghana, Accra, Ghana

    John Gyapong

  2. Lymphatic Filariasis Support Centre, University of Ghana, Accra, Ghana

    Boakye Boatin

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Quao, B.O., Amankrah-Otabir, E. (2016). Leprosy. In: Gyapong, J., Boatin, B. (eds) Neglected Tropical Diseases - Sub-Saharan Africa. Neglected Tropical Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-25471-5_6

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