The word “Leper” originates from a Greek word meaning scaly. It is one of the oldest diseases known to mankind. In India, leprosy has been known since ancient times as kushtha rog. The disease has always been stigmatized in India. Leprosy affects mainly the skin and peripheral nerves, although as it advances, organs such as the eyes, testes, bones and internal organs could also be affected.
More characteristically, it has the following features: As the disease progresses, there is a break down of the skin with the formation of ulcers, a likelihood of the hands and feet to be affected by trauma or burns, especially since they experience no sensation in the affected region. This results in deformities of the hands and face. Also, the nerve supply to muscles can be affected resulting in foot drop, claw toes etc. Thus, the disease does not kill but causes permanent and progressive physical disability including severe mutilation of the face and extremities, and widespread damage to the nerves, bones, eyes and vital organs. If a piece of skin or nerve is taken and examined, the organisms can be seen. The leprosy bacilli resist de–colorization when stained with acid fast stains (stains also used for staining the tuberculosis organisms). They usually occur in clumps and can be seen both inside and outside the cells. It is, however, difficult to grow these organisms outside the human body. This has made the development of vaccines difficult.
Sulfa drugs are used in the treatment of leprosy, and it has had a great impact on the treatment of the disease ever since it was first introduced in 1943. The National Leprosy Control Program was launched in 1955. It was later redevised in India in 1983 and called the National Leprosy Eradication Program.
The estimates for 1996 indicate that there are about 1.3 million cases of leprosy in the world. Over the last 10 years, the leprosy problem has been scaled down by about 83%. By the beginning of 1996, more than 90% of registered leprosy patients were being treated with MDT and, so far, about 8 million of them have been cured through this treatment.Leprosy continues to be a problem in Third World countries. They account for 90% cases worldwide.
India Leprosy still remains a major public health hazard in India. The country accounts for about one third of the leprosy cases in the world, and has by far the largest number of registered cases among individual countries. Due to migration, leprosy is increasingly being seen in urban areas in India.
The states/UTs that have the dubious distinction of a higher than national average are Orissa, Bihar, Jharkhand, West Bengal, Tamil Nadu, Nagaland, Assam, Madhya Pradesh and Daman and Diu.
Social stigma and leprosy Leprosy is often referred to as a “Social Disease”. The social stigma attached to leprosy is due to the deformities it results in.