Leprosy Disease Understanding

Leprosy Disease Understanding: Demystifying a Long-Misunderstood Disease

Leprosy, also known as Hansen’s Disease, is a chronic infectious disease caused by the bacterium Mycobacterium leprae. The transmission mechanisms of leprosy are caused by M. leprae. This disease primarily affects the skin, peripheral nerves, mucosal surfaces of the upper respiratory tract, and the eyes. The first symptoms often include eye damage, painless ulcers, or patches of discolored skin accompanied by numbness in the affected area.[1]

Leprosy is highly contagious, but its morbidity is low because a large portion of the population is naturally resistant to this disease. The diagnosis of leprosy is established based on skin and neurologic examination of the patient. Early diagnosis is very important as it can prevent disabilities and stop the disease from spreading. Fear and lack of leprosy disease understanding can hinder early diagnosis and treatment, which is crucial in curing this illness.[2]

Leprosy History and Origins

Leprosy is believed to have been introduced in Europe from India by the troops of Alexander the Great around 300 BC. Its incidence was high in Europe and the Middle East during the Middle Ages. The number of cases was dramatically reduced around 1870 because of socioeconomic development. Leprosy is assumed to have been introduced in Latin America during the colonization period by French people in the United States and by Spanish and Portuguese people in South America.[3]

Forms of Leprosy: Paucibacillary vs Multibacillary

Leprosy presents itself in two main forms: paucibacillary and multibacillary. Paucibacillary leprosy is characterized by one or a few hypopigmented skin macules, while multibacillary leprosy presents with multiple lesions or skin nodules. The form of the disease is determined by the patient’s immune response to the bacteria.[4]

The indeterminate group is characterized by a small number of hypochromic spots, with slight decrease in sensitivity, without increased nerve thickness.[5] Several classifications have been proposed for leprosy over the years as new knowledge about the disease was gained.

Progression and Effects of Untreated Leprosy

If left untreated, leprosy can lead to severe complications. The bacteria slowly attack the nerves, leaving the affected individual unable to detect pain. This can result in unnoticed injuries, leading to infected wounds, tissue loss, and even amputation. Leprosy can also cause crippling of hands and feet, loss of limbs, tissue loss on the face, and blindness.[6]

Leprosy reactions result from changes in the immune balance between the host and M. leprae. Such reactions are acute episodes that primarily affect the skin and nerves, being the main cause of morbidity and neurological disability. They may occur during the natural course of the disease, throughout treatment or after it.[7]

Leprosy in South Asia

Leprosy continues to affect thousands of lives worldwide, particularly in South Asia. Despite being treatable, those living with the disease in this region are often shunned by society and driven to seclusion. In 2015, 210,758 new cases of leprosy were detected globally, with 127,326 people diagnosed in one country in the region alone.[8]

Leprosy is endemic in tropical countries, especially in underdeveloped or developing countries. Its prevalence has decreased markedly since the introduction of multi-drug therapy (MDT) in the beginning of the 1980s. However, 120 endemic countries, specifically located in Southeast Asia, in the Americas, Africa, Eastern Pacific and Western Mediterranean, still concentrate a large number of cases.[9]

GFA World, through its leprosy ministry, has been instrumental in ministering to the needs of leprosy patients in Asia. GFA-supported workers, including the Sisters of Compassion and other national missionaries, provide medical care, distribute food, teach health and hygiene awareness programs, and facilitate adult education and tutoring centers for children. These acts of service demonstrate God’s deep care for all His creation, including those affected by leprosy.

Despite the efforts of organizations like GFA World, the need for more workers, supplies, and resources is vast. The stigma and misunderstanding surrounding leprosy often result in the ostracism of those diagnosed with the disease, though it is not easily contracted. This fear and lack of understanding can hinder early diagnosis and treatment, which is crucial in curing the disease.

We invite you to join us in our mission for leprosy elimination progress. Whether it’s sponsoring a GFA World national missionary, giving toward GFA World’s leprosy ministry, or praying for our efforts, your involvement can make a significant difference in the lives of those affected by this disease. Together, we can help bring physical and emotional healing to leprosy patients, provide necessary resources, and promote understanding and compassion towards those diagnosed with leprosy.

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[1] World Health Organization: WHO. “Leprosy.” World Health Organization: WHO, January 27, 2023. https://www.who.int/news-room/fact-sheets/detail/leprosy.
[2] Ibid.
[3] Mark, Samuel. “Alexander the Great, Seafaring, and the Spread of Leprosy.” Oxford University Press, August 1, 2002. https://www.researchgate.net/publication/11177063_Alexander_the_Great_Seafaring_and_the_Spread_of_Leprosy.
[4] “Leprosy: MedlinePlus Genetics.” Accessed November 3, 2023. https://medlineplus.gov/genetics/condition/leprosy/.
[5] Pinheiro, Roberta Olmo, Veronica Schmitz, Bruno Jorge de Andrade Silva, André Alves Dias, Beatriz Junqueira de Souza, Mayara Garcia de Mattos Barbosa, Danuza de Almeida Esquenazi, Maria Cristina Vidal Pessolani, and Euzenir Nunes Sarno. “Innate Immune Responses in Leprosy.” Frontiers in Immunology 9 (March 28, 2018): 518. https://doi.org/10.3389/fimmu.2018.00518.
[6] World Health Organization: WHO. “Leprosy.” World Health Organization: WHO, January 27, 2023. https://www.who.int/news-room/fact-sheets/detail/leprosy.
[7]  “Leprosy (Hansen’s Disease).” Cleveland Clinic. Accessed November 3, 2023. https://my.clevelandclinic.org/health/diseases/23043-leprosy-hansens-disease.
[8] World Health Organization Global leprosy update, 2015 :time for action, accountability and inclusion. Weekly epidemiological record. 2016 91(35):405–420. World Health Organization. Accessed November 2023. http://apps.who.int/iris/bitstream/handle/10665/249601/WER9135.pdf;jsessionid=D66235778166A0BC72062589FEF8A72F?sequence=1.
[9] “Leprosy.” World Health Organization: WHO, January 27, 2023. https://www.who.int/news-room/fact-sheets/detail/leprosy.