Leprosy introduction copy

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Leprosy introduction copy

  1. 1. LEPROSY INTRODUCTION  By MD ZAFAR EQEUBAL 2009 Batch JNMC,AMU  Moderators Dr M. Haroon Khan Dr Malik Shehnawaz Dr Srikant Kanoogo Dr Khushboo
  2. 2.  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]
  3. 3. 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.
  4. 4. 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.
  5. 5. LEPROSY PREVALENCE RATES,DATA REPORTED TO WHO AS OF BEGINNING JANUARY 2011
  6. 6. 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.
  7. 7. 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
  8. 8.  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
  9. 9. 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
  10. 10. 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
  11. 11.  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.
  12. 12. REFERENCES: 1.PARK’S 21ST EDITION 2.WWW.WHO.INT

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