This document provides an overview of leprosy, including its definition, epidemiology, signs and symptoms, treatment, and control measures. It defines leprosy as an infectious disease caused by Mycobacterium leprae, characterized by hypopigmented patches and loss of sensation. The presentation discusses the distribution of leprosy by time, place, and person. It also covers the disease's classification, pathophysiology, clinical features, diagnosis, complications, and treatment options involving multidrug therapy. The document concludes by outlining various methods for leprosy control, such as surveillance, early detection, chemotherapy, and health education.

1. Ms. Chanda Jabeen
PhD (Scholar) Epidemiology & Public Health
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2. 
OBJECTIVES
At the end of this presentation students will be able
to:-
 Define the Leprosy
 Discuss the Epidemiology and its etiology
 Describe its signs & symptoms.
 Explore Preventive measures and Control of
Leprosy
 Explain its complications.

3. 
 Leprosy is an infectious disease caused by
mycobacterium leprae and clinically characterised by
hypopigmented patches partial or total loss of
sensation presence of thickened nerves and presence
of acid-fast bacilli in skin smears.
 It is a chronic inflammatory disease and displays a
wide clinical spectrum related to host’s ability to
develop specific cell mediated immunity .
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introduction

4. Distribution
1. By time:
Climate more common in warm and humid climate.
2. By place:
• Poor environmental surroundings
• Low stander of living
• Poverty
• Substandard house
• Overcrowding
• Lack of education
• Unhygenic personal habit
• Use of common clothing and linen
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Epidemiological feature

5. 
3. By person :
• Age:
Person of any age suffers on exposure . A survey shows
70% of cases above 25 years of age and 80% of cases
above 20 years of age .a highly prevalence of disease
among children indicates that the disease is active and
spreading.
• Sex:
more commonly seen in Men’s then in women’s in
proportion of 2:1 .
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cont’s

6. 
• Race:
All humans races are susceptible.
• Susceptibility:
Genetic susceptibility(only small percentage infected
with disease due to genetic factor)
Married partners (not more then 5%)
Twin study (identical twin shows more similarity)
Migration (migration increased the spread of disease)
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Cont’s

7. 
A.Primary determinants:
Mycobacterium leprae ,an acid-fast bacilli resembling
TB occur in clumps or bundles.
B. Secondary deretminants:
Armadillos increase the risk of leprosy.
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Determinants of leprosy

8. 
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9. 
Reservoir of infection:
Men the active cases of leprosy are the chief resources .
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Cont’s

10. 
Portal of exit:
 Nose
 Upper respiratory tract
 Skin
As bacilli leave the body as indicated
 Skin= ulcer or breach of skin
 Nose= secretions and ulcer of nose
 Throat=coughing ,sneezing and speaking .
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cont’s

11. 
 Infectivity:
Highly infectious but low of pathogenicity.
 Attack rate:
It is 6.8 per 1000among contact
0.8 per 1000 without contact.
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Cont’s

12. 
1. Contact transmission: direct or indirect contact
between an infectious and healthy but susceptible
person’s.
2. Droplet infection: air born disease
3. Other routes: lapra bacilli have been found in
human milk.
Insect vector
Tattooing needles
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Mode of transmission

13. 
It is not exactly known .
Commonly between 2 to 5 years or more.
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Incubation period

14. 
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Classification of leprosy
1. Lepromatous
2. Non-lepromatous
• Tuberculiod
• Maculo-anaesthetic
• Polyneuritics
3. Borderline leprosy
4. Intermediate type

15. 
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Borderline leprosy
 Four or more lesion which my b flat raised,
hypopigmented or erythematous ,sensory
impairments or loss.

16. 
 Diffuse infiltration or numerous flat or raised poorly
defined shiny, smooth , symmetrically distributed
lesions.
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Lepromatous type

17. 
 Early cases with one or two vague hypopigmented
molecules and definite sensory loss.
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Intermediate type

18. 
M.laprae enters the body (skin ,nose, etc.)
attack
Peripheral nerves
Bind to schwann cell of axon
Demyelination of nerves
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pathophysiology

19. 
Loss of conductance
Deformity ((loss of pain, temprature, touch ,sensation)
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Cont.'s

20. 
Early signs
 Hypopigmented or erythematous patches on the skin
 Diffuse thickening of skin with a shiny appearance
 Loss of sweating or loss of hair over skin lesions
 Loss of sensation loss of pain, touch, temprature in hands
and feet
 Thickening of cutaneous nerves, especially ulnar, median
 Nodules in the skin(nose ,chin and ears)
 Thickening of ear lobes
 Recurrent wounds and ulcers which do not heal
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Clinical features

21. 
Late deformities
Primary deformities
 Primary paralytic deformities due to involvement of claw
hand , fingers ,foot drop , claws toes, corneal ulcer ,facial
paralysis.
 Non-paralytic deformities (due to infiltration of M.laprae
and damage of tissue).
• depression of the bridge of nose
• Wrinkles on facial skin
• Stiffness of joints of fingers
• Shortening and loss of joints and fingers and toe
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22. 
Secondary deformities
Due to carelessness in protecting anesthetics hands and
feet.
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23. 
Clinical examinations
 Presence of pigmented patches on the skin
 Thickening nerves
 Appearance of patch
 Testing of sensation
 Lepra reaction
 Identification of complications
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Diagnosis

24. 
Bacteriological examination
 Skin silt smears(scrape method material from skin is
obtained from active lesions)
 Skin biopsy
 Nerve biopsy
 Lepromin test(for detecting CMI)
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25. 
1. Immunologically mediated
2. Inflammatory episodes
3. Eye lagopathalmos discharge from eyes conjunctivitis
corneal ulcers
4. Nose mucopurulent foul smelling discharge nose
bleeding
5. Nerve neuritis cause sever pain tingling and numbness
6. Tropical ulcer on the feet
7. Fever
8. Testis (orchitis resulting in swelling and pain)
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Complication's

26. 
 Dapsone, which is bacteriostatic or weakly
bactericidal against M. leprae, was the mainstay
treatment for leprosy for many years until
widespread resistant strains appeared. Combination
therapy has become essential to slow or prevent the
development of resistance. Rifampicin is now
combined with dapsone to treat paucibacillary
leprosy. Rifampicin and clofazimine are now
combined with dapsone to treat multibacillary
leprosy.
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Treatment

27. 
1. Survey
2. Early detection
3. Chemotherapy
4. Follow up of cases
5. Selective isolation
6. Prevention of contact
7. Chemoprophylaxis
8. Immunoprophylaxis
9. Prevention of disabilities / rehabilitation
10. Health education
11. Social measure
12. Training of medical and auxiliary personnel.
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Method of leprosy
control

28. 
Basavanthappa, B. T. (2008). Community health nursing.
New Dehli, India: Jaypee Brothers Publishers.
Alam, N & Hussain, A. (2017). Community Medicine.
Faislabad, Punjab:Excel Publishers.
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References