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