Leprosy Mailing List – November 26, 2024
Ref.: (LML) Continuing Impacts of Training New Hansenologists in Brazil
From: Joel Almeida, Mumbai, India
Dear Pieter and colleagues,
Re: LML 18 Nov 2024, Continuing Impacts of Training New Hansenologists in Brazil, from Prof. Claudio Salgado.
Relevant to this discussion, important findings about LL (lepromatous) HD (leprosy) patients were reported here:
doi: 10.1590/0074-02760220150
by Patricia Penna, Izabela Rodrigues Pitta, Robson Vital et al
Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy. Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 117: e220150, 2022
Among the findings:
At diagnosis, as many as a quarter of LL HD patients had shown no nerve thickening. After completing MDT 13 out of 14 LL HD patients showed acid-fast bacilli in nerve biopsies. Neuropathic pain was experienced by about two-thirds of the patients. Nerve conduction studies showed axonal and demyelination damage. Thalidomide and steroids did not suffice to control the problems experienced by the patients.
The article is worth reading in full.
Comment:
It has long been possible even in endemic areas to withhold anti-microbial protection from LL patients who complete MDT. Nobody suffers except the patient and any genomically susceptible persons who encounter as many as ten million viable bacilli per day in the nasal discharges of a patient with recurrent LL HD. This appears to be unacceptable to the people and professionals of Mato Grosso, Brazil. Are they misguided?
With all sincerity,
Joel Almeida
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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