Leprosy Mailing List – December 2, 2015
Ref.: (LML) Draft WHO Leprosy Strategy 2016-2020
From: Jaison Barreto, Bauru, Brazil
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
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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