Leprosy is a bacterial infection largely associated with poverty. It causes nerve damage and, left untreated, leads to a loss of feeling or mobility in the hands, feet or around the eyes. Everyday tasks become fraught with danger – burns, blisters and other minor injuries go unnoticed leading to more serious injuries. These injuries can lead to permanent disfigurement and disability. Injuries to the eyes can often lead to blindness.

Arshad was diagnosed with leprosy. How did it affect him?

Leprosy starts by damaging the small nerves in the skin’s surface. The first outward sign is usually discoloured patches where there is no feeling. These can be easily missed, ignored, or mistaken for another disease. If correctly diagnosed and treated at this stage, it is likely that permanent damage or disability can be prevented.

early-stages

If it is not treated, leprosy goes on to damage the large nerves that lead to the hands and feet. This damage can lead to loss of sensation or feeling in the hands and feet and muscle paralysis, which causes clawed fingers and foot drop.

disability

Without feeling, when the person treads on something sharp or holds something hot, they do not feel pain and so they ignore their injuries. These wounds can be difficult to heal and become infected, often leading to increasing deformities, shortening of fingers and toes or ultimately, amputation of limbs.

If the nerves leading to the eye or face are damaged, the person may not feel the irritation when something gets in their eye and their eyelids may not be able to blink properly. This can easily lead to infection or injury to the eye and even blindness. The bones of the nose can also be damaged resulting in a common facial feature or people affected by leprosy, a sunken or flattened nose.

Since 1982, there has been a very effective cure for leprosy available, Multi-Drug Therapy (MDT) This is a combination of three drugs which is taken for between six and twelve months.

diagnosis-and-treatment

Within just a few days of starting the treatment there is no risk of spreading the disease to anyone else. While MDT will cure the leprosy itself, it cannot undo any disability which has already been caused.

Surgery can sometimes give back movement to paralysed hands, feet or eyelids but lost sensation can never be restored and the person will need to take special care to protect their hands and feet for the rest of their life.

There is currently no vaccine against leprosy. The best way to prevent it spreading is through community health education to ensure that anyone with any of the early symptoms is diagnosed and treated as quickly as possible to prevent any serious damage to themselves and stop them from spreading it to anyone else.

prevention

People already affected by leprosy can be taught how best to avoid any future injuries which could lead to deformity or disability.

In many countries, stigma against people affected by leprosy is still widespread. A combination of superstitions, religious beliefs, attitudes to physical deformity and discriminatory laws can lead to prejudice and mistreatment against anyone affected by it.

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Because of fear and stigma people affected by leprosy can be forced to leave their home or job or to get divorced. Their children might be prevented from going to school or from getting a job themselves.

Families excluded from their community because of leprosy will find it very hard to lift themselves out of poverty and can become trapped in a spiral of poverty, disease, isolation and despair.

Fear of this kind of stigma can prevent people seeking treatment for leprosy making their situation much worse than it could have been if treated early.

The World Health Organisation reported that 213,899 people were diagnosed with leprosy in 2014. More than half of them were in India. The next largest numbers were in Brazil and Indonesia.

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Fewer than 20 countries report more than 1000 people being newly diagnosed with leprosy each year but leprosy still exists at some level in most countries in South and Central America, Africa and Asia. Because of the reluctance of leprosy patients to seek treatment for fear of the stigma surrounding the disease, The Leprosy Mission Scotland believes these figures under-represent the true number of people affected by leprosy.