Why has leprosy, a curable disease, still not been eradicated?

Why has leprosy, a curable disease, still not been eradicated?

Leprosy, a disease that was once known as leprosy, is curable and has already been the target of goals and measures by the World Health Assembly — a decision-making body of the World Health Organization, WHO —, ​​which sought to eliminate it by the year 2000, starting in the early 1990s. Why, then, does the condition continue to afflict hundreds of thousands of people each year?

  • Leprosy bacteria may help regenerate organs
  • Leprosy drug has potential to prevent severe COVID-19, says study

The fight against the pathology involved the creation of the Multidrug Treatment, or multidrug treatment, in free translation, a combination of medicines that managed to greatly reduce the number of cases. Even so, approximately 200,000 people end up having a diagnosis of leprosy annually. The country with the most cases, currently, is India, with half of them, followed by Brazil and Indonesia. The last Sunday in January is World Leprosy Day, used to raise awareness of the disease.

What we know about leprosy

Well known, leprosy is one of the oldest pathologies in the world. Stories that depict the condition date back to hundreds of years before Christ, but medicine only discovered its cause in 1873 — the bacterium Mycobacterium leprae —, with the Norwegian scientist Gerhard Armauer Hansen, whose name ended up baptizing the disease.

Spreading around the world through global trade routes, it affects people with weaker immune systems, especially those who are malnourished, appearing mainly in fragile social strata in the countries it affects. Transmission is via infected droplets, but contact must be prolonged and close. In 95% of cases, a healthy adult immune system can fight the bacteria and mitigate the infection, according to the US Centers for Disease Control and Prevention (CDC).

There is also a long incubation period before symptoms begin. This can take an average of 2 to 4 years, but in some cases it can take up to 20 years. This makes control and eradication more difficult, as the number infected cannot be fully estimated.

A disease is officially under control when it affects less than 1 in every 10 thousand people, reducing the control programs and sanitary measures in force. When many infected people leave the incubation period and show symptoms, then readiness for treatment may not be effective, infecting even more people. The current caseload, for example, is less than the actual burden present in communities.

Diagnosis, symptoms and treatment

An aggravating factor in the mitigation of the pathology is its diagnosis, often late. M. leprae bacteria can be detected in a patient’s lymph fluid and skin tissue, but the detection method is not always reliable and infections can remain hidden until symptoms appear. To make matters worse, microbes cannot be easily grown in laboratory or animal models, making it almost impossible to find out more about the disease with laboratory experiments.

The symptoms are represented by visible changes in the skin and damage to the nerves, causing the loss of pain sensation in specific parts of the body. This insensitivity can lead to more serious injuries and chronic inflammation, and when this goes undiagnosed for too long, the limb in question may end up having to be amputated.

More extreme cases can lead to physical disabilities, which is combined with prejudice and inhumane treatment of patients with the condition. Historically, people with leprosy have been stigmatized and made outcasts, and in some places the social problems they face remain the same. One of the measures to combat stigma was the abolition of the term “leprosy” in official Brazilian documents in 1995.

Leprosy is treated and cured via multidrug therapy, which uses 3 drugs: rifampicin, dapsone and clofazimine. The duration of its use will depend on the severity of the infection, ranging from 6 to 12 months until the eradication of the bacteria. Due to the difficulty in the laboratory study, there is currently no way to create new drugs or vaccines against the disease, but, from its detection, the cure is relatively simple, and the treatment is available free of charge through the SUS.

Source: With information: Deutsche Welle