Leprosy

Leprosy is an infectious disease caused by Mycobacterium leprae. Leprosy affects the skin, the peripheral nervous system and organs such as the eyes and testes. Management of leprosy and its complications involves many disciplines and, importantly, the people affected by leprosy themselves. Multidrug therapy (MDT) provides an effective cure and is now globally available. Post-exposure chemoprophylaxis for contacts of leprosy patients, using a single dose of rifampicin (SDR-PEP), is a new intervention now recommended by the WHO and being rolled-out in an increasing number of countries. New impairments may occur before, during and after treatment, highlighting the importance of preventing disability during every stage of the disease. The social stigma is almost universal and continues to hinder the early presentation of new cases and treatment adherence. It also threatens the social integrity of the people affected in most countries where leprosy is endemic. Evidence in recent years has shown that disability and stigma lead to a very high prevalence of mental health problems, such as depression and anxiety, among persons affected by leprosy and their family members. People affected by the long-term consequences of leprosy should be offered rehabilitation, mental health care and other services to facilitate their inclusion in society. Epidemiological analysis indicates that new cases will continue to appear for many years. However, transmission has been interrupted in many countries and sub-national areas, as indicated by the absence of new child cases. WHO has targeted global interruption of transmission and zero new leprosy cases in 120 countries by 2030. Even when these milestones are reached, effective, sustainable leprosy rehabilitation and control services continue to be needed during post-elimination surveillance as an integral part of the general health services.