Madagascar sees surge in leprosy cases

Oct 7, 2011 | Amy L. Sonricker Hansen | Outbreak News



One hundred and thirty countries submitted reports of leprosy to the World Health Organization (WHO) at start of 2011, with 228,474 new cases reported in 2010. Madagascar is one of many countries continuing to work to eliminate the disease. Political uprisings in 2002 and 2009 halted progress towards elimination as treatment programs were disrupted and road blockages and fuel shortages made travel impossible to some already hard-to-reach mountainous areas. In recent months the village of Antalaha on the eastern coast of Madagascar has seen a surge of newly diagnosed cases. Unofficial reports state that between five and nine new cases of leprosy are being diagnosed each month in Antalaha and surrounding small villages.

Antalaha is not the only place seeing a resurgence of leprosy. The state of Maharashtra, India reported an alarming 9,984 cases in 2010, a number that continued to rise into March 2011 to 10,433 new cases. More than 50% of new leprosy cases in the world occur in India.

While most countries have successfully eliminated leprosy (defined as less than one case per 10,000), it remains a public health problem in parts of Angola, Bangladesh, Brazil, Burma, Central African Republic, China, DR Congo, India, Indonesia, Madagascar, Mozambique, Nepal, Nigeria, The Philippines, Sri Lanka and Tanzania. In countries such as Madagascar, national control programs are working not only to ensure people in high-risk areas have access to treatment, but also to change the image of leprosy through community education programs.

Leprosy, or Hansen’s disease, is a chronic infectious disease caused by the bacillus Mycobacterium leprae. Transmitted through droplets from the nose and mouth, leprosy mainly affects the skin, peripheral nerves, and mucosa of the upper respiratory tract. Since 1995 the recommended 6-12 month course of a multidrug therapy has been freely available from the WHO to all patients worldwide. Despite treatment availability, many obstacles exist to prevent disease elimination: stigma associated with the disease that prevents some from seeking treatment, logistical difficulties in delivering drugs to remote locations and misdiagnosis due to the prevalence of other dermatological ailments in tropical climates. Left untreated the disease can cause permanent damage to the skin, muscles, and nerves. Early diagnosis and treatment are essential in preventing permanent disability and further transmission of disease (particularly in poorer areas where many are likely to have weakened immune systems due to poor nutrition).  

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