Leprosy (Hansenosis, Hansen’s disease) - An ancient disease and is a leading cause of permanent physical disability among the communicable diseases. Causative Agent Mycobacterium leprae Modes of Transmission Airborne-droplet, Prolonged skin-to-skin contact Period of Communicability 5 ½ months Clinical Manifestations Early signs: Change in skin color – either reddish or white Loss of sensation on the skin lesion Loss of sweating and hair growth Thickened and painful nerves Muscle weakness or paralysis or extremities Pin and redness of the eyes Nasal obstruction or bleeding Ulcers that do not heal Late Signs: Madarosis Loss of eyebrows Inability to close eyelids (lagophthalmos) Clawing of fingers and toes Contractures Chronic ulcers Sinking of the nosebridge Enlargement of the breast (gynecomastia) Diagnostic Procedures Slit Skin Smear - determines the presence of M. leprae; optional and done only if if clinical diagnosis is doubtful to prevent misclassification and wrong treatment
Lepromin Test – determines susceptibility to leprosy Treatment Ambulatory chemotherapy through use of MDT Domiciliary treatment as embodied in RA 4073 which advocates home treatment
PAUCIBACILLARY (tuberculoid and indeterminate); noninfectious type Duration of treatment: 6 to 9 months
Procedure: Supervised: Rifampicin and Dapsone once a month on the health center supervised by the rural health midwife Self-administered: Dapsone everyday at the client’s house MULTIBACILLARY (lepromatous and borderline); infectious type Duration of treatment: 24-30 months Procedure: Supervised: Rifampicin, Dapsone, and Lamprene Prevention Avoid prolonged skin-to-skin contact BCG vaccination – practical and effective preventive measure against leprosy Good personal hygiene Adequate nutrition Health education Nursing Management Isolation and medical asepsis, psychological support
