26 cases of leprosy already recorded for 2017 - Programme Director

26 cases of leprosy already recorded for 2017 – Programme Director

Mar 23, 2017 News

– says misdiagnosis can cause disease to fester

Although Guyana has achieved leprosy elimination at the national level, a number of cases have still been arising over the years. In fact the National Leprosy Programme has already recorded a total of 26 cases for this year.
“This has been something that has been trending since last year,” says Director (ag) of the National Leprosy Programme, Dr. Nikita McKenzie, who is concerned about the numbers rising, if keen efforts are not made to detect and treat the disease.
Leprosy is a chronic disease caused by a bacterium called Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and also the eyes.
Although leprosy is curable with multidrug therapy (MDT), it is sometimes not easily diagnosed. But according to Dr. McKenzie, “It is one of the diseases that often go misdiagnosed, because it is confused with a lot of other diseases, and physicians are sometimes genuinely not thinking about leprosy.”
Dr. McKenzie made this disclosure as she delivered a presentation during a Neglected Diseases Stakeholders meeting on Tuesday at the Regency Hotel, Georgetown.
According to the Leprosy Programme Director, efforts to educate persons, including health personnel, about the disease has included raising awareness about the fact that the disease could manifest by a hyper-pigmented spot that remains intact for years, despite the use of some treatment.
She added, “It can be confused with ‘lotta’ and also it can be confused with ring-worm; it looks a lot like ‘ring-worm’ lesions. Physicians can also confuse it with an allergic reaction because oftentimes it looks like that…but with allergic reactions you will have some amount of pain, inching and burning, which doesn’t happen in cases of leprosy.”
Compounding the misdiagnosis situation is the fact that the disease is known to have a long incubation period. While its incubation period could last five years, Dr. McKenzie disclosed that it has been known to extend to as much as 10 or even 20 years. And according to her, prolonged symptoms of leprosy without treatment could lead to disfigurement and impairment.
Among the known symptoms are: appearance of skin lesions that are lighter than normal skin and remain for weeks or months; patches of skin with decreased sensation (touch, pain and heat); muscle weakness; numbness in the hands, feet, legs and arms; eye problems; enlarged nerves, especially in the elbows or knees; stuffy nose and nosebleeds; curling of the fingers and thumb, caused by paralysis of small muscles in the hand and ulcers on the soles of the feet.
“It’s one of these diseases that patients would come in and say ‘oh I have this tingling or numbness to my feet’ and doctors might say ‘oh it’s because of your diabetes or it is because of your hypertension’. But they never think of leprosy and this is also one of the reasons why this disease often goes misdiagnosed,” Dr. McKenzie explained.
Added to this, she pointed out that there are some forms of leprosy that require medical personnel to examine the nerves rather than merely check for spots usually associated with the disease.
According to Pan American Health Organisation’s Technical Officer, Dr. Jean Alexandre, despite the fact that leprosy is no longer a global threat since it was eliminated in 2000, and Guyana has achieved leprosy elimination at the national level, efforts are still being made to combat it at the sub-national level. In fact, Dr Alexandre considered that “its elimination is still a target in some outlying regions.”
Dr. Alexandre, who also addressed the recent meeting, underscored that the three strategies for elimination are diagnosis, accurate treatment and stigma reduction. The PAHO Technical Officer also highlighted that mass drug reduction (MDA) is known to reduce the density of the parasites and the prevalence of infections in the community.

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