No abstract available.
Leprosy*

No abstract available.
Leprosy*

No abstract available.
Leprosy*

No abstract available.
Leprosy*

No abstract available.
Leprosy*

Background: Ophthalmologic evaluation is often neglected in routine screening of Hansen’s disease patients. In line with the global aim of reducing grade 2 disability, eye examination should be an essential part of routine examination of Hansen’s disease patients. Objective: To describe the ophthalmologic profile of patients with Hansen’s disease seen in a tertiary hospital. Methods: A point-prevalence survey was conducted. Sixty-six Hansen’s disease patients, aged 18 and above, underwent complete ophthalmologic examination including visual acuity, refraction, external eye examination, intraocular pressure determination, dilated pupil examination, palpebral aperture measurement, corneal sensation testing, and tear breakup time determination. Statistical analysis was done. Results: All patients had ocular findings with lepromatous leprosy (62%) being the highest. Fifty-three percent had Type 2 lepra reaction. Most were males, disease duration in majority was < 5 years and bacillary morphologic index was 4.0 – 4.99. Patients with Grade 1 and Grade 2 disability of the eyes were 62% and 17% respectively. The most common ocular complications were: abnormal tear breakup time (79%), cataracts (53%),blepharitis (47%), madarosis (39%) and corneal opacities (24%). Conclusion There is a significant number of ocular findings among leprosy patients in this study. The highest number of ocular complications is among patients in the lepromatous pole. There is a preference of M. leprae for cooler areas; hence, the anterior chamber was greatly affected.
Leprosy

The author involved in the National Leprosy Elimination Program (NLEP) in Papua New Guinea (PNG) as a WHO consultant has studied the epidemiological status of the disease from 1980 -2000. The result are shown as follow: - Before implementing multi-drug therapy (MDT), the prevalence rate (PR) of the disease was very high (28.1 per 10,000 population). - After 5 years of MDT introduction, the registered cases reduced dramatically and PR declined to 50%. - Distribution of leprosy was even in the different areas. This related possibly to environment, hygiene, living condition and health net work. - After 10 years of implementing the NLEP, PNG has reached already the goal of leprosy elimination with PR less than 1 per 10,000. - MTD has proved to be very effective in treatment of leprosy. It has important role in changing epidemiological status of leprosy in PNG
leprosy ; Leprosy, Lepromatous

By investigating the trends of leprosy in Khanh Hoa through epidemiological indicators during the period of 16 years (1985 - 2000), we estimate its prevalence to be reduced below the rate of 0,5/10.000 and its incidence to be under 5/100.000 in 2003. Proportions of 2 nd degree disability and of multibaciallary type among newly detected cases remaining unchanged in the past 16 years account for a delay in case -finding and a high level of transmission in population. The risk factors for leprosy- related disabilities include delay of diagnosis and erythema nodosum leprosum. It is likely that improvement of information on leprosy at peripheral level and intergration of leprosy control services into general health care system are necessary for us to reach the goal of leprosy elimination
leprosy ; Leprosy, Lepromatous

Introduction: Hansen’s disease (HD) is a chronic granulomatous disease principally affecting the skin and peripheral nervous system caused by Mycobacterium leprae. The incubation period varies from months to more than 30 years. The tuberculoid form of HD usually presents with a single hypoesthetic patch and skin biopsy shows epithelioid granulomas with absence of bacilli on Fite-Faraco stain. In contradistinction, lepromatous leprosy usually presents with numerous papules, plaques and nodules with induration of the ears and nose. Biopsy shows foamy granulomas with presence of acid-fast bacilli on Fite-Faraco stain. Case summary: We present a case of a 13-year old female who presented with a 3-year history of a single hypoesthetic patch on the left knee. The initial clinical diagnosis was tuberculoid leprosy. However, histopathology revealed a Grenz zone, and a nodular granulomatous infiltrate consisting of epitheloid and foamy histiocytes with scattered lymphocytes. Fite-Faraco stain showed a bacillary index (BI) of 3+. Slit-skin smear revealed a BI of 4+. She was then started on multidrug therapy. Conclusion This case highlights the importance of slit-skin smear and biopsy as routine procedures in all new cases of suspected HD. These procedures will help differentiate multibacillary from paucibacillary forms of the disease which will influence decisions for treatment and prognostication. This case emphasizes that lepromatous leprosy may present with single lesions and may be misdiagnosed as paucibacillary leprosy if skin-slit smear and biopsy have not been done. This case further suggests that there are factors yet undetermined which play significant roles in determining the host response to M. leprae which are believed to influence morphology, configuration, number and distribution of skin lesions.
Leprosy ; Leprosy, Multibacillary

Author observed histopathologically and immunologically the old lepers of 360 cases, having the duration of infection with average 11 years and 5months. Here summarize as follows : 1. Microscopically in L-type, lepra cells, or Virchow cells (foamy cells) were relatively large, and the infiltration showed the tendency to concentrate particularly around the periglandular regions. Free zones were mostly obscure and disappeared. 2. Tuberculoid structure tends to be obscured in T-type of leprosy. 3. The healings showed few granulomatous infiltration, rather the almost normal findings. But periglandular and perivascular infiltrates were present. 4. Lepromin test was considerably positive in T-type of leprosy (about 57.8%)
Lepromin ; Leprosy