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Leprosy is not going away anytime soon, but it is coming

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Published By:
Peeyush Ghalot
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Published On:
25-07-2022
(Image Courtesy: - Medical World News)

The traditional phrase of elimination as a public health concern has recently, but fairly quickly, given way to a new emphasis on the cessation of transmission among the leprosy research community. Leprosy has a long incubation period, so once transmission has ended, the illness will eventually go away, although it may take some time. The number of new cases will fall swiftly, but those who have leprosy will live normal lives. For decades, there will be a need to manage their leprosy-related disabilities and lessen prejudice. Since a few years ago, there have been discussions on treatments to stop transmission, with an emphasis on post-exposure prophylaxis (PEP) and the potential for a leprosy-specific vaccine. In order to more precisely assess the epidemiological condition, much contemporary leprosy research focuses on developing better preventive strategies and improved tests to identify infection and sickness (currently, the Achilles heel of leprosy control). The lack of autochthonous (locally transmitted) leprosy in children is currently the key sign that transmission has been stopped. If there haven't been any new instances of leprosy in children under the age of 15 for the previous five years, a nation is said to have achieved that stage. Most nations (especially those in Europe and the Americas) have advanced to this point, while many continue to diagnose cases in elderly or immigrant patients. Other nations are close to accomplishing this feat, and many more may do so at the sub-national level in specific regions of the country. Infrequent cases of leprosy among travellers from an endemic region to a nation where transmission has ceased have not, in practise, resulted in any secondary cases, according to decades' worth of experience. Though leprosy case counts will drop and severe disabilities should occur significantly less frequently, it will take decades to completely eradicate leprosy-related disabilities. Investigating and reporting child disabilities is a top priority in order to improve the relevant preventative interventions. Disability can be avoided if PEP or a vaccination stops the development of new cases, and it can also be avoided by properly identifying and managing reactive instances. LepVax, a particular subunit vaccination, may offer some protection against nerve injury if administered as a therapeutic vaccine in conjunction with multidrug treatment, according to animal research. It is getting more and more practical to individualise case management as the number of cases declines. Typically, this entails assisting those who have leprosy in becoming more cognizant of their illness, evaluating their current situation, and taking an active role in their own treatment. Support for such programmes via a phone hotline might be quite helpful. Ongoing research is being done to improve the practise of self-care. Additionally, mental health is getting greater emphasis. The inclusion of peer counselling in primary care services is a significant advancement that offers comfort and essential treatment while also assisting in the fight against stigma. In some circumstances, a referral for specialised care will be required.

Reference: - https://journals.lww.com/ijmr/fulltext/2022/01000/the_end_of_leprosy_is_not_imminent,_but_it_is_on.1.aspx