BASIC FACTS OF BASIC FACTS OF LEPROSYLEPROSY

Presented byPresented byDR. Md. AsadozzamanDR. Md. AsadozzamanAsstt. Registrar of Asstt. Registrar of Dermatology Dermatology & &

Venereology,Venereology, MMCH MMCHChief Guide : Chief Guide :

Dr. Shahab Uddin Ahmed ChowdhuryDr. Shahab Uddin Ahmed ChowdhuryAsso. Prof. ofAsso. Prof. ofDermatology Dermatology & & Venereology,Venereology,

MMCHMMCHDate : 20.10.2003Date : 20.10.2003

•Origin of the Name Origin of the Name –Lepros – Greek Word Lepros – Greek Word means scalymeans scaly

–Kustha from ‘Kusthani’ Kustha from ‘Kusthani’ means eaten awaymeans eaten away

–Leper – means person Leper – means person suffering from leprosysuffering from leprosy

DefinitionDefinition

Most chronic, communicable, Most chronic, communicable, grannulomatous, infectious grannulomatous, infectious disease, primarily of skin & disease, primarily of skin & peripheral nerves but may peripheral nerves but may involve all organs of the body involve all organs of the body except CNS, GIT & Lungs, except CNS, GIT & Lungs, caused by Mycobacterium caused by Mycobacterium Leprae.Leprae.

Historical BackgroundHistorical Background

Oldest scourge of man kind Oldest scourge of man kind

Probably originated in India Probably originated in India

The Vedas written about The Vedas written about

instruction for prevention of instruction for prevention of

Leprosy in 1400 B.C.Leprosy in 1400 B.C.

Contd…………Contd…………

First authentic description and First authentic description and

treatment with chaulmoogra oil is treatment with chaulmoogra oil is

given in Sushruta Samita in 600 given in Sushruta Samita in 600

B.C.B.C.

The Hindo’s Lord Krishno’s son The Hindo’s Lord Krishno’s son

Samba had developed kusthaSamba had developed kustha

Contd……Contd……

Mycobacterium Leprae Bacilli first discovered Mycobacterium Leprae Bacilli first discovered

by Norway Scientist Hansen in 1873. He had by Norway Scientist Hansen in 1873. He had

made unsuccessful attempt to infect himself made unsuccessful attempt to infect himself

as well as his chief and Father-in-Law Dr. as well as his chief and Father-in-Law Dr.

Danielssen with material from leprosy patient.Danielssen with material from leprosy patient.

EpidemiologyEpidemiology Population at risk in the world – 1.6 Population at risk in the world – 1.6

BillionsBillions Total No of Leprosy cases in the world 1.5 Total No of Leprosy cases in the world 1.5

MillionsMillions Endemic areas – 83% of Leprosy cases Endemic areas – 83% of Leprosy cases

concentrated in only 5 countries – India, concentrated in only 5 countries – India, Brazil, Nigeria, Myanmar & Indonesia. Brazil, Nigeria, Myanmar & Indonesia. Nearly 75% of world’s Leprosy patients Nearly 75% of world’s Leprosy patients are in South East Asia.are in South East Asia.

Highest No of Leprosy – In India (Bihar, Highest No of Leprosy – In India (Bihar, Uttar Pradesh)Uttar Pradesh)

Contd………….Contd…………. Highly prevalent in Central AfricaHighly prevalent in Central Africa Incubation Period : 2 – 5 yearsIncubation Period : 2 – 5 years Source of Infection : Infected Human Source of Infection : Infected Human

considered as the only Source of considered as the only Source of LeprosyLeprosy

Mode of Transmission: Close & Mode of Transmission: Close & prolonged contact is necessary, the prolonged contact is necessary, the nose is the prime portal of exit of the nose is the prime portal of exit of the Bacilli.Bacilli.

High Natural Immunity – 95% High Natural Immunity – 95% Affects all ages & SexesAffects all ages & Sexes

Present Status of Leprosy in Present Status of Leprosy in BangladeshBangladesh

Reg. prevalence – 31/12/2002Reg. prevalence – 31/12/2002 Total Cases – 8943Total Cases – 8943

SLPB – 421SLPB – 421 PB – 4300PB – 4300 MB – 4222MB – 4222

Prevalence Rate : 0.63/10000Prevalence Rate : 0.63/10000 Detection – 9844Detection – 9844

SLPB – 851SLPB – 851

PB – 5489PB – 5489

MB – 3504MB – 3504

SSS : positive – 772SSS : positive – 772

Child : 1101Child : 1101

Detection Rate – 0.762/10000Detection Rate – 0.762/10000

BacteriologyBacteriology Common Name : Bacillus of HansenCommon Name : Bacillus of Hansen Morphology : Pleomorphic straight or Morphology : Pleomorphic straight or

slightly curved rod like, gram positive slightly curved rod like, gram positive bacteriabacteria

Staining Properties by the Zeil Staining Properties by the Zeil Neelsen Method. Bacilli appears as Neelsen Method. Bacilli appears as solid staining (viable), fragmented solid staining (viable), fragmented and granular (dead bacilli)and granular (dead bacilli)

Life Span – 6 months Life Span – 6 months Cannot grown in artificial media or Cannot grown in artificial media or

tissue culturetissue culture Generation Time : 10 – 14 daysGeneration Time : 10 – 14 days

Technique of Technique of Bacteriological Bacteriological

ExaminationExamination

Slit Skin SmearSlit Skin SmearNose Blow SmearNose Blow SmearNasal ScrapingNasal Scraping

Reading of Smears

BI – Density of Leprosy Bacilli in smears

MI – Percentage of living Bacilli among total

SFG – Percentage of solid, fragmented & granular Bacilli

TREATMENTMDT – Multi Drug TherapyFDT – Fixed Duration

TreatmentRFT – Release From Treatment