Leprosy today

Leprosy is a disease common to developing countries. It is relatively rare in Europe. There are an estimated 5.5 million patients in the world, of which two-thirds are found in South East Asia. Currently, 3.1 million are registered for treatment. Mycobacterium leprae, the causative organism of leprosy, is an intracellular acid-fast organism not cultivable in vitro. The disease is transmitted from man to man mainly through inhalation. The disease occurs in several types depending upon the immunological status of the individual. They are generally grouped into two main categories, multibacillary and paucibacillary. The diagnosis of leprosy, which is generally not difficult, is based on characteristic skin lesions, sensory loss, thickening of the nerve trunks and the presence of acid fast organisms in the skin smears. Complications in leprosy include reversal reaction and erythema nodosum leprosum. Currently, the treatment of leprosy is based on the administration of a combination of drugs, referred to as multidrug therapy, which for multibacillary leprosy is treatment with rifampicin, clofazimine and dapsone and for paucibacillary treatment with rifampicin and dapsone. The treatment of complications such as reversal reaction and erythema nodosum leprosum essentially involves the use of prednisolone. Multidrug therapy has been found to be highly effective in curing leprosy and in preventing relapse, although the duration of treatment is still considered long. The optimistic situation in leprosy treatment has led to WHO establishing a target of eliminating leprosy as a public health problem by the year 2000, defining elimination as attaining a level of prevalence below one case per 10,000 population.(ABSTRACT TRUNCATED AT 250 WORDS)