Leprosy still maiming Africans

Lazarus Sauti

Leprosy is maiming Africans and hampering the development of the continent.

According to a World Health Organisation fact sheet, leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus.

The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and also the eyes.

Leprosy is not highly infectious.

It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.

Untreated, the disease can cause progressive and permanent damage to the skin, nerves, limbs and eyes.

Although the disease is still haunting most Africans, the good news is that it is curable.

“Leprosy is curable and treatment provided in the early stages averts disability. Multidrug therapy treatment has been made available by WHO free of charge to all patients worldwide since 1995, and provides a simple yet highly effective cure for all types of leprosy,” notes the WHO fact sheet.

WHO official figures show that almost 182 000 people, mainly in Asia and Africa, were affected at the beginning of 2012, with approximately 219 000 new cases reported during 2011.

Despite these figures, WHO said leprosy control has improved significantly due to national and subnational campaigns in most endemic countries.

But in Africa, this condition which is easy to combat continues to cripple and exclude millions.

Pauline Froissart of the Agence France-Presse says fear and ignorance fuel spread of leprosy in most – if not all - African countries.

“Leprosy, transmitted most effectively in overcrowded conditions with poor sanitation, “afflicts the poorest, the most vulnerable”, further explains Dr Charles Kinkpe, chief medical officer at Hospital of the Order of Malta in Dakar, Senegal, which provides free care for the destitute.

The orthopaedic surgeon goes on to say: “They (leprosy victims) often wait until the last minute to be seen. Yet the bacterial illness can be easily cured before it causes serious damage.”

This means early diagnosis and treatment with multidrug therapy (MDT) remain the key elements in eliminating the disease as a public health concern.

Multi-drug therapy, available free of charge through the World Health Organisation since the 1980s, consists of three antibiotics which together can cure patients in a few months.

Instead of taking advantage of multi-drug therapy, Dr. Kinkpe says those afflicted with leprosy do not know how to spot the signs early on and the disease takes an insidious hold, attacking nerve endings, destroying the ability to feel pain and injury.

He adds that they burn themselves holding a hot pan or injure their feet walking on glass, for example.

“Unable to sense these injuries, patients are susceptible to sores and infections which can eventually lead to the loss of fingers, hands, toes and feet, blindness and facial disfigurement,” Dr. Kinkpe says.

Due to folklore, people with leprosy are isolated and/or kept remote because people do not touch them.

Sometimes – if not all of the times, people say they are cursed.

Therefore, organisations dealing with leprosy in Africa need to combat prejudice through education, hammering home the message that leprosy is not hereditary, nor a sign of a divine curse.

In other countries, integration of primary leprosy services into existing general health services has made diagnosis and treatment of leprosy easy.

Consequently, for Africa to reach all patients, leprosy treatment needs to be fully integrated into general health services.

Reaching all corners of the continent requires funding and political will.

Stakeholders in leprosy elimination need to continue to ensure that human and financial resources are available and political commitment needs to be sustained in countries where leprosy remains a public health problem.

Countries within and across Africa can also adopt the WHO Strategy for leprosy elimination.

The WHO Strategy for leprosy elimination takes in ensuring accessible and uninterrupted multi-drug therapy services available to all patients through flexible and patient-friendly drug delivery systems; and ensuring the sustainability of multi-drug therapy services by integrating leprosy services into the general health services and building the ability of general health workers to treat leprosy.

It also contains encouraging self-reporting and early treatment by promoting community awareness and changing the image of leprosy; and monitoring the performance of multi-drug therapy services, the quality of patients’ care and the progress being made towards elimination through national disease surveillance systems.

American politician Barbara Jordan (May her soul rest in peace) once said, “Education remains the key to both economic and political empowerment.” Therefore, iincreased empowerment of people affected by the disease, together with their greater involvement in services and community, will bring us closer to a world without leprosy.