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Leprosy introduction copy

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    Leprosy introduction   copy Leprosy introduction copy Presentation Transcript

    • LEPROSY INTRODUCTION  By MD ZAFAR EQEUBAL 2009 Batch JNMC,AMU  Moderators Dr M. Haroon Khan Dr Malik Shehnawaz Dr Srikant Kanoogo Dr Khushboo
    •  A CHRONIC INFECTIOUS DISEASE CAUSED BY MYCOBACTERIUM LEPRAE. IT MAINLY AFFECTS PERIPHERAL NERVES. IT ALSO AFFECTS THE SKIN,MUSCLES, EYES, BONE & INTERNAL ORGANS.  DISEASE IS CLINICALLY CHARACTERISED BY ONE OR MORE OF THE FOLLOWING:: o HYPOPIGMENTED PATCHES o PARTIAL OR TOTAL LOSS OF CUTANEOUS SENSATION o PRESENCE OF THICKENED NERVES o PRESENCE OF ACID FAST BACILI IN THE SKIN OR NASAL SMEAR [PARK’S 21ST]
    • HISTORY  FOR A LONG TIME LEPROSY WAS THOUGHT TO BE HEREDITARY DISEASE , A CURSE OR A PUNISHMENT FROM GOD.  DUE TO DR HANSEN’S EVOLUTIONARY WORK IT IS ALSO KNOWN AS HANSEN’S DISEASE.  LEPROSY IS KNOWN TO BE “KUSHTHA ROG” SINCE VEDIC ERA.  HOLY BIBLE ALSO DESCRIBE LEPROSY CURE AS A MIRACLE OF HZ. ISA A.S.
    • WORLWIDE  IN 1991 WHO MEMBER STATES RESOLVED TO DECREASE GLOBAL LEPROSY BURDEN BY 90%.  TILL TODAY HIGH ENDEMIC COUNTRIES ARE::BRAZIL, INDONESIA, PHILIPINES, INDIA, NEPAL, CONGO, TANZANIA. INDIA  LEPROSY IS WIDELY PREVALENT IN INDIA  INDIA HAS ACHIEVED GOAL OF LEPROSY ELIMINATION AT NATIONAL LEVEL BUT STILL 3 STATE/UT VIZ. BIHAR, CHATTISGARH AND D&N HAVELI WITH PREVALANCE RATE OF 1-2.5 PER 10,000 POPULATON YET TO ACHIEVED.  PREVALENCE RATE :0.74 LEPROSY CASE PER 10,000 POPULATION.
    • LEPROSY PREVALENCE RATES,DATA REPORTED TO WHO AS OF BEGINNING JANUARY 2011
    • EPIDEMIOLOGICAL DETERMINANTS AGENT FACTOR: M.LEPRAE . MAN IS THE ONLY SOURCE AND HOST OF LEPROSY INFECTION ( MULTIBCILLARY CASE). . HOST FACTOR: . ALL AGE GROUP ARE AT RISK . M>>F . CELL MEDIATED IMMUNITY IS RESPONSIBLE FOR RESISTANCE TO INFECTION WITH M.LEPRAE.
    • EXACT MECHANISM OF TRANSMISSION OF LEPROSY IS NOT KNOWN FOLLOWING ARE WIDELY DEBATED 1.DROPLET INFECTION 2.CONTACT TRANSMISSION 3.OTHER ROUTES, E.G. TATTOING NEEDLE
    •  RIDLEY-JOPLING CLASSIFICATION::5 CLASSES ACCORDING TO IMMUNE STATUS OF PATIENT I. TUBERCULOID(TT) II. BORDERLINE(BL) III. BORDERLINE(BB) IV. BORDERLINE LEPROMATOUS(BL) V. LEPROMATOUS(LL).  CLINICAL CLASSIFICATION FOR CHEMOTHERAPY BY WHO: I. MULTIBACILLARY II. PAUCIBACILLARY
    • SIGNS OF ADVANCED DISEASE • LUMP IN THE SKIN OF FACE AND EARS • PLANTER ULCERS • LOSS OF FINGERS AND TOES • NASAL DEPRESSIN • FOOT DROP AND CLAW TOES
    • DRUGS  RIFAMPICIN  DAPSONE  CLOFAZAMINE  ETIONAMIDE & PROTINAMIDE  CLARITHROMYCIN  MINOCYCLIN WHO RECOMMENDED CHEMTHERAPY  MULTIBACILLARY 1.RIFAMPICIN -600 mg MONTHLY 2.DAPSONE -100mg DAILY 3. CLOFAZAMINE-300mg ONCE MONTHLY -50 mgDAILY  PAUCIBACILLARY:: 1. RIFAMPICIN-600mg ONCE MONTHLY 2. DAPSONE -100 mg
    •  NLEP 1983 WITH A GOAL TO REDUCE CASE LOAD TO <1 PER 10,000 POPULATION.  EDUCATE THE PEOPLE TRUE FACTS ABOUT ABOUT THE LEPROSY AND REMOVE WRONG SOCIAL BELIEFS AND SOCIAL STIGMA ASSOCIATED WITH LEPROSY.
    • REFERENCES: 1.PARK’S 21ST EDITION 2.WWW.WHO.INT