Fw: Ref.: (LML) Detection of nerve damage in leprosy and timely treatment

Leprosy Mailing List – November 30,  2021

 

Ref.:  (LML) Detection of nerve damage in leprosy and timely treatment

 

From:  Joel Almeida, London and Mumbai

 

 

Dear Pieter & colleagues,

 

Thanks to Dr. Naafs for the important and detailed advice that can help patients to get better (not worse) once they are diagnosed. HD patients deserve respect and quality care. This includes regular nerve function monitoring as was introduced in the Brazilian national program on the initiative of Linda Lehman and associates. SORRI-BAURU is doing a great service to the world by maintaining production of these very helpful monofilaments.

 

There is no future in confining persons with HD or its sequelae to second-class care, or simply removing them from registers and forgetting about them. They are first class human beings like everyone else. Therefore, they deserve first class care. This includes at least quarterly nerve function monitoring during the first 2 years after the start of treatment, so that anti-inflammatory treatment can be started at the first sign of sensory impairment. Their nerves and limbs depend upon it.

 

Dr. Naafs and other esteemed colleagues will be able to advise on the best practical ways of testing for impaired temperature sensation in the field. Temperature is the first sensation to be impaired, and this year's Nobel Prize in Physiology or Medicine was awarded to David Julian and Ardem Patapoutian who discovered the unique molecular bases for separate receptors of temperature and touch respectively. Of course, in HD frontline workers had long recognised (from e.g., Nauru in the early 20C or perhaps even before) that temperature was the first sensation to be impaired. There are Nobel Prizes to be had for those brilliant minds who devote at least some of their time to studying HD, even if they find their greatest satisfaction from seeing patients get better.

 

Enlightened programs have taken specialist nerve function testing to the frontlines, by providing well trained specialist health workers with transport. This allows a single worker to provide competent nerve function testing services across a wide area. Even patients who cannot afford to travel can have these competent nerve function testing services provided regularly at their doorstep. This service is highly suited to NGOs, and it is attractive to the public and other donors. Those NGOs who provide this service are likely to fare better than others.

Best,

 

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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