Sri Lanka commemorated World Leprosy Day on January 26 with the aim of creating awareness of the presence of the disease and educating the public on treatment available.
A revelation perhaps for many citizens, Sri Lanka is not yet free of Leprosy. In fact the country has seen a modest rise in recent times according to the Deputy Director of Health Services, Dr. Sarath Amunugama. However the Ministry of Health along with the Anti-Leprosy Campaign has put the Anti-Leprosy program into high gear with the aim of eradicating the disease.
Leprosy
Leprosy has been around since ancient times, often surrounded by terrifying, negative stigmas and tales of leprosy patients being shunned as outcasts. Till recent times Leprosy was feared as an incurable, mutilating, and contagious disease giving rise to establishing Leper Colonies in societies.
The disease is a chronic infection caused by a slow growing bacterium called the bacterium Mycobacterium leprae and Mycobacterium lepromatosis. While the bacteria affect skin and nerves, transmission of leprosy is caused by droplet infection (through the Respiratory System). Left untreated, leprosy can be progressive, causing permanent damage to the skin, nerves, limbs and eyes. However contrary to common belief leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of secondary infections; these occur as a result of the body’s defences being compromised by the primary disease. Secondary infections, in turn, can result in tissue loss causing fingers and toes to become shortened and deformed, as cartilage is absorbed into the body. It is believed that around 95 percent of people are naturally immune to the disease. At highest risk are those living in endemic areas with poor conditions such as inadequate bedding, contaminated water, and insufficient diet, or other diseases that compromise immune function.
Currently Leprosy is found in 115 countries around the world with a reported 189,018 patients by the end of 2013 according to the World Health Organization.
History
In Sri Lanka segregation of Leprosy patients began with the discovery of a group of patients in Colombo in the year 1708. The Dutch established the Hendala Leprosy Hospital the same year to contain the disease. The patients who were ferried across the river were imprisoned here for life in a bid to stop the spread of the disease. Though the Dapsone monotherapy treatment was introduced to treat patients in late 1940, segregation was the main mode of control carried out till the early 1970s.
New patients
Today an average of 2,000 new Leprosy patients are reported from Sri Lanka annually while patients are reported from all 25 districts of the country according to the Health Education Bureau. Sri Lanka is among the 16 countries that report over 1000 Leprosy cases a year. 44% of the patients are reported to be from the Western province and highest number of cases is from the Colombo District. In 2013 around 438 patients were discovered from the district.
According to the Regional Director of Health Services, Dr. V.T.S.K Siriwardene in the Western Province most leprosy patients are reported from areas such as Moratuwa, Dehiwala, Kaduwela and Kolonnawa. While Dr. Ruwan Wijayamuni of the Colombo National Hospital pointed out that due to high density of population there is also a spread of leprosy in Maradana, Mattakuliya, and Grandpass areas. Child patients are high in districts such as Jaffna, Vavuniya, Matale, Colombo and Kalutara, 177 children were diagnosed in 2013. Amounting to 9 percent of new patients it indicates active transmission of the disease from undiagnosed individuals.
Sri Lanka is also said to have a high percentage of patients with visible deformities at the time of diagnosis. This is perhaps because of the stigma surrounding the disease which discourages patients to seek treatment and lack of awareness. Such patients’ amount to 7 percent of the cases diagnosed yearly. According to Anti-Leprosy Program Director Dr. Nilanthi Fernando, it is important to dispel the common misconception that Leprosy has been eradicated from Sri Lanka. “The disease is still among us as we as a society lost focus on it along the way” she said.
Detection
Detection and treatment of the disease is paramount to its eradication. Speaking at the World Leprosy Day conference Dr. Nilanthi Fernando was of the opinion that the disease cannot be eliminated if patients are not identified at an early stage and treated.
Leprosy can be identified through various signs. “Namely large spots covering a vast skin area, dry skin around the spots, Stiff nerves near the neck and elbow areas, muscle weakness, lesions and bumps on the skin, wounds that do not heal, stuffy nose” says Dr. Indira Kahawatta, listing the common signs of Leprosy. “As the disease progresses there can also be visible facial and physical changes,” she further stated.
Dr. Nilanthi Fernando wants to impress on the public that Leprosy is not hereditary and therefore cannot pass between family members and also cannot be contracted through touch. However it is contagious making it possible for more than one family member to contract the disease. “But it is important to understand that 70 percent of patients are incapable of spreading the disease” explained Dr. Kahawatta.
Leprosy can be fully cured. In the last two decades, more than 14 million people with leprosy have been cured. Starting from 1983, the multi drug treatment can cure patients from 6 months to a 12 month period of time and is offered free of charge in government run skin clinics. It must be noted that even pregnant patients can take this treatment without any side effects while all patients can carry on with their daily routine during treatment. However stating that 20 percent of the patients do not complete treatment, Dr. Kahawatta stressed that the disease can return if not treated fully. “Today there’s no reason for segregation or shunning of leprosy patients, such a stigma should not exist as it’s a fully curable disease with timely treatment,” says Dr. Indira Kahawatta.
For more information call the Health Education Bureau on 011 2696606
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