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Leprosy


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Leprosy a chronic infectious disease, known from ancient times in the subtropical and tropical areas, characterized by disfiguring cutaneous lesions, peripheral neurological damage, and progressive debilitation; caused by the organism Mycobacteria leprae. The pathogen has a long incubation period, which makes it difficult to determine where or when the disease was contracted. Children are more susceptible than adults.

Leprosy has two common forms, tuberculoid and lepromatous, although these have been further subdivided. Both forms produce lesions on the skin but the lepromatous form is most severe, producing large disfiguring nodules. All forms of the disease eventually cause peripheral neurological damage (nerve damage in the extremities) manifested by sensory loss in the skin and weakness of the muscles. People with long-term leprosy often lose the use of their hands or feet.

Leprosy is a public health problem in Bangladesh. The resultant disabilities, social stigmas and economic implications add to the gravity of the problem. The disease is not evenly distributed all over the country. Over 120 upazilas are known to be endemic for leprosy. The most endemic areas of leprosy are Rangpur and Dinajpur. Bogra, Rajshahi, Tangail, Sythet, Dhaka, Chittagong, and Chittagong Hill Tracts areas are less endemic with less incidence rate. Leprosy control programme in Bangladesh started in 1965 with dapsone monotherapy in a few upazilas and extended to about 195 upazilas till 1998. However dapsone monotherapy is being replaced by MDT since 1985 in a phased manner to cover the upazilas under leprosy control.

Prevention consists of avoiding close physical contact with untreated people. People on long-term medication become noninfectious (they do not transmit the organism that cause the disease).

Symptoms include one or more hypopigmented skin lesions that have decreased sensation to touch, heat, or pain; skin lesions that do not heal after several weeks to months; numbness or absence of sensation in the hands and arms or feet and legs; and muscle weakness resulting in signs such as foot drop (the toe drags when the foot is lifted to take a step). Leprosy hospitals are available to treat specifically leprosy affected persons. [Md Shahidullah]