Leprosy Mailing List – September 3, 2013
Ref.: (LML) Leprosy training at Medical Colleges worldwide is lacking
From: Grace Warren, Sidney, Australia
Dear Pieter,
Very interested to read the letter from Dr. Sunil Deepak about the WHO Epidemiological Records of September 1, 2013.
It brings up the constant messages that I get, of cases who are not diagnosed. Often because they do not have loss of sensation in patches so do not fit the official WHO definition. It would be very interesting if we could find out how many e.g. Indeterminate cases are found in India as I heard there are many cases officially undiagnosed. My concern is do they still get treated? The situation in many countries is also that early lepromatous may not show definite patches, they have a diffuse infiltration and no sensory loss for many years (often 10-20) so according to WHO do not have leprosy. I could not count the number of early LL I have diagnosed ( via a slit skin smear) and treated over the years. Can such patients still benefit from free MDT?
My concern is that in Medical Colleges worldwide, leprosy is still virtually neglected even in highly endemic countries. Is there anything that can be done at the upcoming ILA conference to get this corrected? The article you mentioned in a previous LML letter (some months ago) sums this up. An article in the March edition of the Australian Medical journal shows an aboriginal who obviously had nodular lepromatous leprosy, who had been treated for years for ulcers on feet and legs but the fact he had nodular leprosy was not recognised till a Srilankan experienced doctor saw him! Here is Australia I am afraid very little is taught about leprosy -- one wonders how many mild cases are missed, till they are gross.
I would love to see the diagnosis figure going up as I would think students were being better trained.
Grace Warren
Previously Adviser for The Leprosy Misison in Asia in ( 1975-1995).
Now living in Australia - still consulting re leprosy.
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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