(LML) ILA Congress, Beijing, 2016

Leprosy Mailing List – December 4,  2015

Ref.:    (LML) ILA Congress, Beijing, 2016

From:  Marcos Virmond, Bauru, Brazil

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Dear Pieter

I wish to thank the letters of Dr. Naafs (LML, Nobember 15, 2015) and Dr. Revankar (LML, November 26, 2015) about the next ILA Congress in Beijing (19^th ILC).  The points they raise are important ones.

As a matter of fact, leprosy science has changed tremendously in the last decades, incorporating new areas of knowledge and novel technologies.  The Scientific Committee is taking these modifications into account in formulating the scientific agenda of the Beijing Congress. An ample array of topics will be addressed during the congress. Although the contribution of basic science must be recognized as essential to the most relevant achievements in leprosy, unsolved questions remains in the daily activities of health workers and in the lives of persons affected by leprosy. Therefore all areas that can contribute to improve stopping transmission, prevent disabilities and promote inclusion will be prominent during the ILA Congress in Beijing.

I take the opportunity to extend my most friendly invitation to all readers of the LML to submit their Abstract (http://ciccst.org.cn/ILC2016/index.html) and to participate in the 19^th International Leprosy Congress organized jointly by the International Leprosy Association and the China Leprosy Association.

 

With kind regards

 

Marcos Virmond

ILA - President

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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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(LML) Draft WHO Leprosy Strategy 2016-2020

Leprosy Mailing List – December 3,  2015

Ref.:    (LML) Draft WHO Leprosy Strategy 2016-2020

From:  Chandrakant Revankar, New Jersey, USA

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Dear Pieter,

I am following up ongoing interesting discussion on the draft WHO Leprosy Strategy 2016-2020. One of the main concerns of many experts is on Uniform MDT (U-MDT) and its possible consequences. This is well appreciated.

We have travelled from lifelong treatment with DDS (monotherapy) to fixed duration MDT 12 and 6 months for MB and PB leprosy respectively and many of us have made long term observations in terms of success and failures with many reservations. A similar approach may be needed to make further critical observations on U-MDT. The following tips may be considered.

1. While adapting U-MDT ( may be some with concerns/fear), let us work on strengthening clinical and community based surveillance of post-U-MDT follow up  to detect relapses, neuritis ,nerve function impairment(NFI) etc.

2.Clinicians(including dermatologists) at their clinic level ( public or private) maintain minimum essential records of leprosy cases on U-MDT to keep an eye to detect and manage morbidity and disability management may be with the support of the leprosy programme.

3. Leprosy programmes should aim at strengthening community based surveillance system for each post-U-MDT patient for early detection and management of problems.

4. Diagnostic facilities centers should provide skin smear services and increase their capacity to diagnose relapses and resistance.

5. Capacity should be built up and sustained by the programme/institutions/partners to  detect, diagnose and manage relapse, neuritis, NFI, etc.

6. Research organizations to promote related research.

A simple but good clinical/programme recording system is essential to make long term observations which is really lacking today.

 

 

Regards,

Dr. CR Revankar

Consultant

Neglected Tropical Diseases

NewJersey.USA

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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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(LML) Draft WHO Leprosy Strategy 2016-2020

Leprosy Mailing List – December 3,  2015

Ref.:    (LML) Draft WHO Leprosy Strategy 2016-2020

From:  Jaison Barreto, Bauru, Brazil

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Dear Pieter,

 

Related to change in MDT schemes (LML, December 1, 2015), some aspects must be remembered:

-       Minocycline or quinolones are not safe for pregnant women or children under 5 years old. This fact avoids their administration without follow up from physicians.

-       The pigmentation induced by clofazimine depends on the patient’s infiltration, and it is self-limited.

-       Minocycline also can induce hyperpigmentation, sometimes more intense than clofazimine, and it is important to say that photosensitivity or even lupus erythematosus can develop after its administration.

 

Regards,

Jaison

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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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(LML) Draft WHO Leprosy Strategy 2016-2020

Leprosy Mailing List – December 2,  2015

Ref.:    (LML) Draft WHO Leprosy Strategy 2016-2020

From:  Wim Theuvenet, Apeldoorn, the Netherlands

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Dear Pieter,

 

Thanks to Dr Joel Almeida for his valuable comments (LML, 18-11-2015).

 

The proposal to monitor nerve function monthly for at least 2 years after the start of the MDT is an utmost sensible one, but then the proper tools to effectively treat nerve function loss are unfortunately lacking.

 

It is only a minority of the nerves with serious function loss and when treated with corticosteroids, etc., will recover to a functional level (protective sensation and muscle strength VMT grade 4 or 5).

 

Any recommendations?

 

Best regards,

 

Willem Theuvenet

 

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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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LML) Draft WHO Leprosy Strategy 2016-2020

Leprosy Mailing List – December 2,  2015

Ref.:    (LML) Draft WHO Leprosy Strategy 2016-2020

From:  Jaison Barreto, Bauru, Brazil

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 Dear Pieter

I fully agree with Dr Das' opinions (LML, 30-11-2015).

The problems in the field are several and knowledge about disease is disappearing. Many times, I wonder why the fall in detection is, indeed, due more to the lack of knowledge from health professionals, or the ignorance of people (once leprosy is a silent disease), or neglect of governments because leprosy is a marker of poverty.

Of course, 6 month of MDT will not cure a lepromatous leprosy patient, but also 24 doses will not, if this patient continues living with M.leprae daily.

Elimination of leprosy has been a question of discharge of the national register. Defaulters are not included in prevalence; despite they are still a source of infection, and, in some instances, drug resistant leprosy. Let’s wonder a situation: If all leprosy patients stopped MDT intake, at the same time, for more than 6 months, leprosy will be eliminated as a public health problem from the world!!!!!! Is this correct? Do we want really solve the problem, or are we trying to find a magical solution?

I believe that MDT can cure the patients. I have seen many of them without signs and symptoms after 10 years or more of discharge. But I also have seen, unfortunately, patients that developed relapses, and almost all had not their household contacts evaluated before, and, when we call them, we find new cases. This is the circle of leprosy.

M. leprae is extremely adapted, as long as it survived for thousands or millions of years with human kind, and it knows that neglect of problems is typical of its host.
Let’s change the way we think and fight, or the battle is lost!

Regards,

Jaison

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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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(LML) Madurai Health and Leprosy Relief Centre

Leprosy Mailing List – December 1,  2015

Ref.:    (LML) Madurai Health and Leprosy Relief Centre

From:  Maria Xavier Turtius, Tamil Nadu, India

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Dear Pieter, 

 

 

Greetings from Madurai Health and Leprosy Relief Centre, India. 

 

Celebrating Silver Jubilee year (1991-2016)

         Madurai Health and Leprosy Relief Centre celebrates its silver Jubilee this August 2016. On 9^th August 1991, our founder cum executive secretary Shri. S.  Maria Xavier Turtius and our Former President Shri. Maria Singarayor and the board member formed this society and registered it.  From that day onwards our organization has been functioning with an attitude of compassion and benevolence for the benefit of the brothers and sisters who suffer with leprosy.

In the past 25 years our organization has met so many ups and downs. In this quarter century we have done the following:

·         Thousands of leprosy patients have been detected and treated.

·         Many thousands of school students and the public have benefited through our awareness programmes

·         Thousands of medical camps have been conducted in villages.

·         We have given economic assistance to deformed persons affected by leprosy.

·         Through our rehabilitation self-employment activities, 60 families have benefited.

At this memorable time we gratefully remember our donors, supporters, volunteers and well-wishers and appreciate their generosity, munificence and goodwill. We trust in the Almighty who has been with us in all our endeavours.  

 

Thank you,

Dr.S.Maria Xavier Turtius,
Executive Secretary 
Madurai Health And Leprosy Relief Centre (MAHELERECEN).
12/10 Sister Rose Second Street,
Melaponnagaram,
Madurai-625016.
Tamil Nadu,India.
Phone 91-452-2360159, mobile:+91-9042484814
Email: mahelerecen@gmail.com
email: humanhealthserve@rediffmail.com
http://mahelerecen.org/

www.mahelerecen.50webs.com  

 

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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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(LML) Draft WHO Leprosy Strategy 2016-2020

Leprosy Mailing List – December 1,  2015

Ref.:    (LML) Draft WHO Leprosy Strategy 2016-2020

From:  Diana Lockwood, London, UK

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Dear Pieter,

 

I am replying to agree with the posting of Wim Van Brakel on Nov 19 in which he noted the probl ems that may be caused by giving all patients clofazimine.

A significant number of patients will develop in generally both pigmentation in their lesions and in their skin in generally. We don’t know quite how many because it has not been measured in any of the MDT trials.  However, I have treated patients in India, Ethiopia and London, who have complained about the problem.  One solution is to use the single monthly rifampin in combination with ofloxacin and minocycline. We have previously highlighted the need for these combinations to be tested in randomised controlled trials, and this would be a good opportunity to do so.

I also agree with Wim that a new strategy for improving care after MDT is needed and this should be developed whatever drug treatment is being given because many patients will present with reactions even after the current drug regimens.

Diana Lockwood
Prof Tropical Medicine
London School of Hygiene & Tropical Medicine.

- SIngle monthly ROM for all. Lep Rev 2012. Lockwood, da Cunha.

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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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