Leprosy is also known as Hansen’s disease. It is a disease that attacks the skin, peripheral nervous system, mucous membranes in the upper respiratory tract and eyes. This disease can cause skin injuries, nerve damage, muscle weakness, and numbness.
Leprosy is caused by the bacterium Mycobacterium leprae. This bacterium takes 6 months to 40 years to develop in the body and the symptoms can appear 1 to 20 years after bacteria infect the patient’s body.
Actually, Hansen’s disease is a treatable disease, but the presence of negative stigma in the community often causing discrimination against sufferers. This negative stigma and discrimination result in the new case finding and delayed treatment.
The symptoms and signs of this disease are not obvious and run very slowly. In fact, the symptom can appear 20 years after bacteria multiply in the patient’s body. Some of the leprosy symptoms are:
- Numbness in the sensations of changes in temperature, touch, pressure or pain.
- Pale and thickened lesions appear on the skin.
- Wounds appear but do not hurt.
- Nerve enlargement usually occurs in the elbows and knees.
- Muscle weakness to paralysis, especially in the leg and hand muscles.
- Loss of eyebrows and eyelashes.
- The eyes become dry and rarely blink, even can cause blindness.
- The loss of fingers.
- Nasal damage that can cause nosebleeds, nasal congestion, or loss of nasal bones.
Based on the severity of symptoms, leprosy is grouped into six types, namely:
- Intermediate Leprosy. This type is characterized by several flat lesions that sometimes heal on their own but can develop into more severe types.
- Tuberculoid Leprosy. This type is characterized by several flat lesions of which are large and numb. In addition, some nerves can also be affected. This type also can heal by itself but can last long enough or even develop into a more severe type.
- Borderline Tuberculoid Leprosy. Lesions that appear in this type are similar to those in tuberculoid leprosy but smaller and more numerous. This type can last a long time or turn into tuberculoid type, and even at the risk of becoming a more severe type. Nerve enlargement that occurs in this type is only minimal.
- Mid-Borderline Leprosy. This type is characterized by a reddish plaque, moderate levels of numbness, and swollen lymph nodes. This type can heal, survive, or develop into more severe types.
- Borderline Lepromatous Leprosy. This type is characterized by numerous lesions (including flat lesions), lumps, plaques, nodules, and sometimes numbness. Just like mid-borderline type, this type can heal, survive, or develop into a more severe type.
- Lepromatous Leprosy. This is the most severe type of leprosy which is characterized by lesions containing bacteria and large numbers, hair loss, nerve disorders, weakened limbs, and body shape changes. Damage that occurs cannot return to normal.
Hansen’s disease is caused by the bacterium Mycobacterium leprae. This bacterium grows rapidly in cooler parts of the body such as hands, face, feet, and knees.
M. Leprae is a type of bacteria that can only develop in certain human and animal cells. The way the bacteria are transmitted is thought to be through fluid from the nose that usually spreads into the air when a person coughs or sneezes. Then it is inhaled by other people. However, this disease is not easy to transmit and takes several months of frequent contact with the sufferer.
Before it was discovered that leprosy was caused by germs in 1873, this disease was very closely related to the negative stigma which is a punishment or curse given to sufferers because of sin or mistakes made by that person. The impact of the stigma continues to this day. So, sufferers often experience discrimination and exclusion from social life.
It should be cleared that leprosy is a disease caused by a bacterial infection. A person will not get this disease if only shakes hands with the patient, sits next to the sufferer, sits together at the dinner table, or even has sexual relations with the sufferer. Leprosy is also not transmitted from mother to fetus.
There are several factors that can increase a person’s risk of suffering from this disease. Some of these risk factors of Hansen’s disease include:
- Make physical contact with animals that spread leprosy bacteria without gloves. Among these intermediaries are armadillos and chimpanzees.
- Residing in the leprosy endemic area.
- Have genetic disorders that affect the immune system.
Most cases of Hansen’s disease can be diagnosed based on clinical findings in the form of pale or red spots on numb skin and nerve thickening. After that, skin smears can be done. In areas with a high incidence, diagnosis can be made even though skin scraping shows negative results according to the WHO classification of leprosy, namely:
- Paucibacillary. There are skin lesions with negative skin scrapings.
- Multibacillary. There are skin lesions with positive skin scrapings.
Positive skin scrapings mean that bacteria are found when examined under a microscope.
The sufferers will be given a combination of antibiotics for 6 months to 2 years. The type, dosage, and duration of antibiotic use are determined based on the type of this disease. Some examples of antibiotics used for the treatment of leprosy are rifampicin, dapsone, and clofazimine.
Surgery is generally done as an advanced process after antibiotic treatment. The purpose of the surgical procedure is to:
- Normalize damaged nerve function
- Improve the body shape of patients with disabilities
- Restore limb function
The risk of complications can occur depending on how quickly the disease is diagnosed and treated effectively. Some complications that might occur if leprosy is treated late are:
- Blindness or glaucoma.
- Kidney failure.
- Erectile dysfunction and infertility in men.
- Changes in face shape.
- Permanent damage to the inside of the nose.
- Permanent nerve damage outside the brain and spinal cord, including the arms, legs, and soles.
- Muscle weakness.
- Progressive defects, such as loss of eyebrows, defects in the toes, hands, and nose.
In addition, discrimination experienced by sufferers can result in mental disorders such as depression and can lead to suicide attempts.
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The integrated movement to provide information about leprosy to the community, especially in endemic areas is an important step in encouraging sufferers to be examined and get treatment. So, they are not ostracized by the community.
Until now, there has been no vaccine to prevent this disease. Early diagnosis and appropriate treatment are the best prevention to prevent disability and prevent wider transmission.