Leprosy Mailing List – January 26, 2015
Ref.: (LML) Infoleps Choice of new (e) publications on leprosy - 20150119
From: Grace Warren, Sidney, Australia
Dear Pieter,
Thank you for updating us. I have appreciated being able to look through the lists of papers and reading some. I was very interested in the one from India about the prevalence at present. I have heard that there is a high incidence of patients, in some countries at least, who do actually have the disease caused by M.leprae but do not fulfil the official WHO description for diagnosis ie a skin lesion that is anaesethetic!! I can certainly agree with that as in East Asia I have seen many patients with well-developed leprosy but who have no definite skin patches and no definite anaesthesia.
Then of course there are the pure primary neuritic leprosy which I first met in Burma but later saw in many countries in which there is no skin lesion but definite large nerves and neural deficits in many cases. I was asked to see a teenager with one of these hand problems and there was no doubt it was due to leprosy but the visiting WHO consultant who had seen him a week before said Oh No he has no skin lesion!!!!
Has anyone done an evaluation of how many of these are present as I suspect that the total of them would certainly increase the world wide statistics, if the ones we are given are for those who do comply with the WHO definition in the WHO book on diagnosis. Interesting thoughts - one wonders how many are missed by well-intentioned workers.
Best wishes to your readers as they try and reduce the deformities and problems of these patients.
Grace Warren
Previously consultant in Leprosy and reconstructive surgery in Asia for the Leprosy Mission International (1975-1995)
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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