World Leprosy Day — challenges and advancements in Leprosy eradication

Leprosy (also called as Hansen's disease) is one of the most dreadful diseases prevalent all over the world. It has tortured the human race all through history and has had a huge impact on various aspects of human life.

It's been over three decades since multiple drug therapy (MDT) was first used to treat leprosy, yet millions of victims still live a crippled, poor quality of life due to leprosy infection. As per the 2011 statistics, India rank's number one by contributing about 58.1 per cent of new leprosy cases detected worldwide. Read what the Indian health minister has to say about eradication of leprosy in India.

Today, on 26 January—recognised as the World Leprosy Day, we discuss why the world is still not free from the disease and what are the recent advancements in leprosy treatment so far. Read more about the stigma associated with leprosy.

Challenges to be met:

Leprosy, till date, remains an ignored problem that gets detected at later stages because of lack of awareness of its early symptoms. Hence, there is a need for speedy and accurate diagnostic tests which can detect the disease in early stages, especially in remote areas.
Multiple drug therapy (MDT) has been the mainstay of leprosy treatment right since it was first used in 1980s. In fact, the significant decrease in incidence of leprosy was possible only because the drugs clofazimine, rifampicin and dapsone, used for treating leprosy, were made freely available to everyone by the World Health Organization (WHO). But, with prolonged use of drugs, resistance is a huge concern and threat to control leprosy. Finding newer drugs is therefore critical.
The mode of transmission of the disease is still unknown. For complete eradication of the disease, interrupting its transmission is also very important.

Advances in treatment of leprosy

Focusing mainly on the three aspects mentioned above, remarkable advances in management of leprosy have emerged from research point of view. Read about the efforts of India to fight leprosy.

Last year in Brazil, the lab OrangeLife introduced a new test for diagnosing leprosy. The test is rapid and similar to a pregnancy test. A drop of blood from the patient is taken on a reactive strip to detect the presence of antibodies against leprosy causing bacteria. The test provides 90% accurate results and looks promising as a diagnostic tool in remote areas, where a large number of people are silent carriers of the disease.
Leprosy is a disease that affects the nerves causing loss of sensation. Because initial symptoms of the disease are often misleading, detection of thickened and enlarged nerves can help in its early diagnosis. Earlier, confirmation of nerve damage was extremely difficult. But, recent advances in imaging techniques including the use of ultrasonography (USG) have made assessment of structural changes in nerves possible.
Extensive research is carried out in various parts of the world to develop newer drugs for effectively treating leprosy, especially in people who become drug resistant over a period of time. Of all the drugs in the initial stages of testing, the drug moxifloxacin has been found to be the most active agent against leprosy causing bacteria. Other drugs including rifapentin, clarithromycin and minocycline are also proposed to be included in the new drug therapy for treatment of leprosy.
The best approach to eliminate the disease is vaccination, and a lot of research in vaccine development is also going on. As a part of their strategy to fight leprosy, American Leprosy Missions initiated vaccine research in 2011. After completion of their toxicology studies this year, they will begin with safety trials in 2015.

With concerted efforts of WHO, all health care providers, local governments and researchers, the barriers to eradication of leprosy will surely be eliminated and the world will see an unprecedented improvement in leprosy eradication, just as it witnessed in case of polio. Read more about the views of WHO at international leprosy summit in 2013.

References:

P Narasimha Rao, Suman Jain. Newer management options in leprosy.
Sunil Dogra, Tarun Narang & Bhushan Kumar. Leprosy – evolution of the path to eradication
World health Organisation: Enhanced Global Strategy for Further Reducing the Disease Burden due to Leprosy. (2011-2015)
Rapid diagnostic test promises end to leprosy torment (http://www.bbc.co.uk/)
American leprosy Missions (http://www.leprosy.org/)
Leprosy 2013 – The Problem and the Solutions

source: health.india.com