Leprosy is curable if treated on time with the right drugs. Treatment is free, and communities are urged to report to the nearest government health facilities for any rashes to rule it out.
This was said by Pinehas Iipinge, advocacy, communications and social mobilisation officer under the National Tuberculosis and Leprosy Programme (NTLP).
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It usually affects the skin and peripheral nerves, but has a wide range of clinical manifestations. The disease is classified as either paucibacillary or multibacillary, depending on the number of bacteria and number of skin lesions.
“It is a slow disease with a long incubation period, generally five to seven years. It presents with pale or reddish skin patches, which are typified by loss of (or decreased) feeling. Leprosy is caused by a type of bacteria (germ) called Mycobacterium Leprae,” explained Iipinge.
He said these bacteria get into and destroy nerves in the cooler parts of the body, especially the skin, limbs, eyes and nose. The disease is spread from person to person primarily through nasal droplets when an infected person coughs or sneezes. Furthermore, the disease is mildly contagious, meaning only a few people who are exposed ever get infected. It affects both sexes and can occur at all ages, ranging from early infancy to old age. The leprosarium at Mashare was closed down during the war of independence of Namibia, and leprosy cases were noted to occur anywhere within Namibia.
“However, Kavango region[s] still notify the highest number of new leprosy patients each year. In all regions, there are District Tuberculosis and Leprosy (DTLCs) coordinators, who supervise and ensure leprosy patients are taken care of and receive medicines for free from the health ministry’s facilities throughout the country,” added Iipinge.
As far as the ministry’s involvement is concerned, there is a Directorate of Special Programmes (DSP) with a sub-division dealing with leprosy, and a focal person for this disease. Medical officers and healthcare workers have been trained to screen, test and diagnose leprosy.
“Treatment is provided free of charge. Patients are also referred to social workers and rehabilitation officers to ensure holistic treatment. Patients are assessed for disability to enable them to receive disability assistance. There are specialist skin doctors (dermatologists) in hospitals who see a high volume of leprosy patients,” he noted.
The latest information provided to Vital Signs shows that in 2020, Namibia recorded 27 leprosy patients, an increase from 22 in 2019. The highest number recorded in the country was in 2010 when 42 cases were treated in the country.
Signs of leprosy include discoloured patches of skin, growths (nodules) on the skin, painless swelling or lumps on the face or earlobes, loss of eyebrows or eyelashes, loss or decreased feeling in the skin patch and thick, stiff or dry skin.
“Leprosy can also cause weakness of the hands, feet or eyelids. This can cause the affected areas to lose the ability to sense touch and pain, which can lead to injuries like cuts and burns.
Additionally, it causes nerves to become painful and if untreated, will result in disability,” stated Iipinge.
Did you know?
Leprosy bacteria are similar to tuberculosis bacteria.
Both Mycobacterium Tuberculosis (MTB) and Mycobacterium Leprae (ML) look similar, and are classified in the same family of bacteria called Mycobacteria.
The basic identification methods under
the microscope can also be similar, and both have been detected in ancient human populations.
“However, the pathogenesis of their respective diseases is very different. ML likes to multiply in the nerve endings of the cooler regions of the body, while MTB tends to go to the lungs where there is a lot of oxygen, and causes lung disease.
Tuberculosis disease (caused by MTB) however, is much more common than leprosy in its occurrence,” explained Iipinge.
Myths about Leprosy
Contrary to certain beliefs, leprosy is not hereditary and is not caused by curses, witchcraft or touching people with leprosy. Other myths include leprosy seen as the result of sin, or punishment from God, that leprosy no longer exists in our world today, or it makes bits of your body fall off.
“Another notable myth that we have heard is that only poor people get leprosy, and one shouldn’t touch anyone with leprosy because it’s highly contagious,” shared Iipinge.
He added: “Leprosy can be cured with the right medicines taken for the correct duration. These medicines are a combination of three antibiotics: rifampicin, clofazimine and dapsone, and are presented as Multi-Drug Therapy (MDT).
Treatment can take from six months to one year, sometimes longer. Most people are no longer contagious after one week of leprosy treatment. Patients must complete their treatment for the full duration as prescribed to prevent the non-reversible disabilities.”
Contact tracing:
Leprosy commonly occurs among people who have had prolonged contact with those who have the disease, as it spreads within close quarters.
All newly-diagnosed leprosy patients should be asked to bring along their household contacts for examination at the health facility.
A home visit should be conducted by the DTLC and environmental health worker, and all close contacts should be screened for leprosy. An examination of contacts should be performed within one month after diagnosis of leprosy in a patient, and all contacts should be taught to regularly look for suspicious lesions on their skin and/or signs of nerve-function impairment.
If they find any of the above, they should report to a health facility as soon as possible.