BASIC FACTS OF LEPROSY Presented by DR. Md. Asadozzaman Asstt. Registrar of Dermatology & Venereology, MMCH Chief Guide : Dr. Shahab Uddin Ahmed Chowdhury Asso. Prof. of Dermatology & Venereology, MMCH Date : 20.10.2003

Origin of the Name Lepros – Greek Word means scaly Kustha from ‘Kusthani’ means eaten away Leper – means person suffering from leprosy

Definition Most chronic, communicable, grannulomatous, infectious disease, primarily of skin & peripheral nerves but may involve all organs of the body except CNS, GIT & Lungs, caused by Mycobacterium Leprae.

Historical Background Oldest scourge of man kind Probably originated in India The Vedas written about instruction for prevention of Leprosy in 1400 B.C.

Contd………… First authentic description and treatment with chaulmoogra oil is given in Sushruta Samita in 600 B.C. The Hindo’s Lord Krishno’s son Samba had developed kustha

Contd…… Mycobacterium Leprae Bacilli first discovered by Norway Scientist Hansen in 1873. He had made unsuccessful attempt to infect himself as well as his chief and Father-in-Law Dr. Danielssen with material from leprosy patient.

Epidemiology Population at risk in the world – 1.6 Billions Total No of Leprosy cases in the world 1.5 Millions Endemic areas – 83% of Leprosy cases concentrated in only 5 countries – India, Brazil, Nigeria, Myanmar & Indonesia. Nearly 75% of world’s Leprosy patients are in South East Asia. Highest No of Leprosy – In India (Bihar, Uttar Pradesh)

Contd…………. Highly prevalent in Central Africa Incubation Period : 2 – 5 years Source of Infection : Infected Human considered as the only Source of Leprosy Mode of Transmission: Close & prolonged contact is necessary, the nose is the prime portal of exit of the Bacilli. High Natural Immunity – 95% Affects all ages & Sexes

Present Status of Leprosy in Bangladesh Reg. prevalence – 31/12/2002 Total Cases – 8943 SLPB – 421 PB – 4300 MB – 4222 Prevalence Rate : 0.63/10000 Detection – 9844 SLPB – 851 PB – 5489 MB – 3504 SSS : positive – 772 Child : 1101 Detection Rate – 0.762/10000

Bacteriology Common Name : Bacillus of Hansen Morphology : Pleomorphic straight or slightly curved rod like, gram positive bacteria Staining Properties by the Zeil Neelsen Method. Bacilli appears as solid staining (viable), fragmented and granular (dead bacilli) Life Span – 6 months Cannot grown in artificial media or tissue culture Generation Time : 10 – 14 days

Technique of Bacteriological Examination Slit Skin Smear Nose Blow Smear Nasal Scraping

Reading of Smears BI – Density of Leprosy Bacilli in smears MI – Percentage of living Bacilli among total SFG – Percentage of solid, fragmented & granular Bacilli

TREATMENT MDT – Multi Drug Therapy FDT – Fixed Duration Treatment RFT – Release From Treatment