Thursday, January 28, 2010

Indian Journal of Leprosy and cure of leprosy

Leprosy Mailing List – November 11th, 2009

Ref.: Indian Journal of Leprosy and cure of leprosy

From: S. Deepak, Bologna, Italy


Dear Salvatore,

While going through the new issue of Indian Journal of Leprosy (January-March 2009) I saw the web-address and it was a pleasure to discover that finally this journal is available on internet at the following address:

http://www.ijl.org.in/index.html

The archives of the journal from 2000 to 2008 are already available on the website. Congratulations to all the persons, who made this possible and I hope that with time, older archives of the journal will also be made available.

In this same issue of the journal I saw a report about a meeting held in Orissa (India) in February 2009 about "Cure of leprosy". I think that in term of role of the health services the discussions on the cure of the disease focus almost exclusively on cure of the infection by leprosy bacillus while probably it would be useful to look at the issue of cure in the following terms:

(1) Cure of bacterial infection;

(2) Cure of the immunological disease processes caused by the infection - that is cure of reactions;

(3) Cure of the neurological disease processes resulting in disability caused by the infection.

With MDT, it seems that defining "cure" of bacterial infection is sufficiently clear, as evident also from the above-mentioned report in the journal. For majority of the affected persons, probably cure of the immunological disease processes can also be expected. However, I think that like so many other diseases such as hypertension, diabetes, the neurological disease processes would require lifelong treatment and no cure can be expected.

This is different from all other aspects such as stigma and discrimination, that may not covered by health services.

I can understand that vertical leprosy control programmes were focusing only on cure from bacterial infection, but if treatment of leprosy is part of primary health care, shouldn't cure be seen in all the different aspects of care required by affected persons?

With regards,

Sunil

Dr Sunil Deepak

Medical Advisor

AIFO, Bologna, Italy

www.aifo.it/english/

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