Leprosy

Leprosy is a chronic infectious disease caused by the bacterium Mycobacterium leprae. It is also known as Hansen’s disease and mainly affects the skin, peripheral nerves, upper respiratory tract, and mucous membranes. It can be identified by skin lesions, nerve damage, and muscle weakness and can cause disability and deformities if not treated correctly or early.

1.0Types and Causes of Leprosy

Types of Leprosy

Leprosy is divided into several types based on the seriousness and immune response of the body: some of them are as follows: 

1. Tuberculoid Leprosy (Paucibacillary Leprosy): Presence of a few well-defined skin lesions and high immune response. Few bacteria cause little nerve damage and are unlikely to be transmitted.

2. Lepromatous Leprosy (Multibacillary Leprosy): Severe disease with widespread skin lesions and many nerve injuries. The low immune response causes the proliferation of bacteria and results in deformities and worsening symptoms if left untreated.

3. Borderline Leprosy: Intermediate between tuberculoid and lepromatous leprosy. It has fluctuating severity with a moderate immune response and thus needs careful observation since it may progress into more severe types.

4. Borderline Tuberculoid Leprosy: in this, the skin concedes a few lesions and mild nerve involvement. The immune response is weaker than tuberculoid but stronger than lepromatous, and it has the risk of progression to more severe forms.

5. Borderline Lepromatous Leprosy: This is a transitional form between lepromatous and borderline forms characterised by multiple lesions and nerve damage. It calls for long-term treatment to avoid the progression of full lepromatous leprosy.

Causes of Leprosy

There are many direct and indirect causes of leprosy. Some of the main causes are mentioned below: 

1. Causative Agent: The main cause of this disease is the bacteria known as Mycobacterium Leprae, which is a rod-shaped, slow-growing Microbium with an incubation period of up to 5 years. This bacteria has the ability to invade nerve tissues, which is central to causing this disease. 
2. Transmission of Leprosy: Leprosy is a contagious but not highly contagious disease. It can be transmitted by close contact with an untreated infected person by coughing or sneezing. 
3. Environmental Factors: It is not clear, but it is noticed that people from tropical regions are more susceptible to this disease than people from sub-tropical regions. The main reason is the favourable conditions for growth and transmission in this region. 
4. Genetic Susceptibility: It is noted that people with genetically weakened immune systems are more susceptible to this disease than to its counterpart. 

2.0Symptoms of Leprosy

The most common symptoms of leprosy include: 

• Skin Lesions: Pale or reddish patches of skin that do not feel (numbness).
• Nerve Damage: A loss of sensation, especially in the hands, feet, and limbs, that makes it more challenging to realise injury or infection.
• Muscle Weakness: Nerve damage causes weakness, especially in the hands, feet, and facial muscles.
• Facial Deformities: Extreme cases may lead to disfigurement, including thickened skin, loss of eyebrows, and a flattened nose.
• Peripheral Neuropathy: There is a loss of sensation in the hands and feet, leading to an increased risk of unnoticed ulcers, burns, and injuries.
• Eye Problems: Leprosy may cause blindness at its advanced stages as it can affect the eyes.
• Respiratory Issues: Leprosy may lead to chronic respiratory problems, such as nasal congestion and facial deformities, if not treated.

3.0Prevention and Treatment of Leprosy

Prevention of Leprosy

1. Vaccination for Leprosy: Currently, there is no vaccine that is specifically designed for leprosy, but the BCG (Bacillus Calmette-Guerin) vaccine, which is primarily used for the prevention of tuberculosis, has been shown to provide some protection against leprosy. 
2. Avoid Close Contact for long hours: Do not spend too much time with untreated individuals to prevent the spread of leprosy. 
3. Regular Screening: Regular screening of individuals living in endemic areas is important for early detection and prevention of this disease. 
4. Public Education and Awareness: although treatable, leprosy has been taboo for a long time due to its visible symptoms (especially disability and deformities). Spreading awareness among people can significantly help in vanishing this stigma and encouraging people to seek treatment. 

Leprosy Treatment

The mainstream treatment of leprosy is multi-drug therapy (MDT), which includes a combination of several antibiotics to kill the bacteria: 

• Rifampicin: Rifampicin is a bactericidal antibiotic, and the drug kills Mycobacterium leprae bacteria. It exerts its mechanism of action by inhibiting bacterial RNA synthesis, hence preventing the reproduction of the bacteria.
• Dapsone: Dapsone is an antimicrobial that inhibits the synthesis of folic acid in bacteria and prevents bacterial growth and multiplication.
• Clofazimine: Clofazimine is an anti-inflammatory and antimicrobial that reduces the inflammation caused by the disease leprosy and kills Mycobacterium leprae.

Early-stage diagnosis and consistent treatment help not only in curing leprosy but also in preventing post-care complications and permanent disability. 

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