Leprosy Mailing List – January 23, 2020
Ref.: (LML) Free Access to leprosy articles for World Leprosy day
From: Diana Lockwood, London, UK
Dear Pieter,
The Royal Society of Tropical Medicine is marking World Leprosy day with 3 weeks of free access to recently published articles on leprosy in the journals Transactions of Hygiene & Tropical Medicine and International Health.
I have just published a review article highlighting the chronic aspects of leprosy which I think need to be considered more. This includes management of reactions and recognition of neuropathic pain. It would also be good to estimate the numbers of people living globally with leprosy related health problems.
The link is below and is active until Feb 14th.
https://academic.oup.com/trstmh/pages/world_leprosy_day
I would like to thank the RSTMH for taking this interesting initiative.
Chronic aspects of leprosy—neglected but important Diana N J Lockwood
Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 113, Issue 12, December 2019, Pages 813 817, https://doi.org/10.1093/trstmh/try131
The chronic aspects of leprosy are discussed here. They are a consequence of the peripheral nerve damage that affects many patients during their lifetime with leprosy. The peripheral nerve damage leaves people unable to feel and with weakness in their hands and feet. They are at risk of damaging their hands and feet, causing the disabilities and deformities that characterise late leprosy.
More than 200 000 new leprosy patients are diagnosed globally each year. Better data are needed from cohort studies to estimate the number of patients developing nerve damage and modelling studies are needed to estimate the number of patients who develop disabilities. For some of them, this will be a lifelong disability.
Nerve damage is caused by inflammation in leprosy-affected nerves. Patients with nerve damage of <6-mo duration need treatment with steroids. About 66% of multibacillary patients will develop nerve damage. Plastic graded monofilaments can be used to detect nerve damage in leprosy and diabetic clinics. Assessing nerve damage and treating patients with steroids in leprosy programmes needs to be strengthened. The World Health Organization has a successful programme for supplying antibiotics for treating leprosy infection to national leprosy programmes. They should take responsibility for providing steroids to national programmes since this is a core part of the treatment for >66% of multibacillary patients. Patients need to be asked about neuropathic pain symptoms and treated if necessary.
Treated leprosy patients are at risk of developing ulcers in their feet. Treatment and prevention need to be improved through health education, providing protective footwear and patient empowerment.
Diana Lockwood
Retired Professor of Tropical Medicine
London School of Hygiene & Tropical Medicine
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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