“LEPROSY”

Leprosy –is a chronic disease of the

skin and peripheral nerves caused by
Mycobacterium Leprae or Hansen’s
bacillus.
Causes of Leprosy:
Leprosy is an acquired infectious disease that can
affect individuals of all ages. It is caused by the acid-
fast,
rod-shaped bacteria Mycobacterium leprae, which was
discovered in 1873 by G.A. Hansen.

 Because the bacterium multiplies very slowly, the

signs and
symptoms of leprosy may not develop until much later
after exposure
to M. leprae (ranging from several weeks to 20 years or
more).
 Though humans are the major reservoir and host for infection
with
M. leprae, other animals such as armadillos, chimpanzees, and
Mangabey monkeys also serve as reservoirs of infection.

 Leprosy is thought to be transmitted via droplets from the nose

and
mouth during close prolonged contact with affected individuals,
though
the exact route of transmission has yet to be proven definitively.

 Not all individuals infected with M. leprae will go on to develop

leprosy, because only 5%-10% of the population is thought to be
susceptible to the infection because of immunological reasons.
Signs and Symptoms

Early Signs of Symptoms:

Change in skin color – either reddish or white.

 Loss of sensation on the skin lesion.
 Decrease/ loss of sweating and hair growth over the
lesion.
 Thickened and/ or painful nerves.
 Muscle weakness or paralysis of extremities.
 Pain and redness of the eyes.
 Nasal obstruction or bleeding.
 Ulcer that do not heal.
Late Signs and Symptoms:

 Loss of eyebrow- madarosis.

 Inability to close eyelids- lagophthalmos.
 Clawing of fingers and toes.
 Contractures.
 Sinking of the nose bridge.
 Enlargement of the breast in males or gynecomastia.
 Chronic Ulcers.
Methods of Transmission

 Prolonged skin-to-skin contact.

 Droplet infection.

Susceptibility
Children especially twelve years are more susceptible.

Prevention
 Avoidance of prolonged skin-to-skin contact especially with a
lepromatous case.
 Children should avoid close contact with active, untreated
leprosy case.
 BCG vaccination.
 Adequate Nutrition.
 Health Education.
Management/ Treatment
 Ambulatory chemotherapy through use of Multi-drug
therapy
 Domiciliary treatment as embodied in R.A. 4073 which
advocates treatment.

WHO classification of Leprosy which is the basis of modern

management or Multi-Drug Therapy:
 Paucibacillary (tuberculoid and indeterminate) Non-
infectious types.
Duration of treatment 6-9 months.
 Multibacillary- (Lepromatous and Borderline) Infectious
types.
Duration of treatment 23-30 Months.
Completion of Treatment
All patients who have complied with the above
mentioned
Treatment protocol are considered cured and no longer
regarded
as a case of leprosy, even if some sequelac of leprosy
remain.

RESPONSIBILITIES OF THE NURSE

Prevention
•Recognize early signs and symptoms of leprosy and refers
suspects to the RHU physicians or skin clinic for diagnosis
and treatment.
•Take patient and family history and fills up patients records.
•Conducts epidemiological investigation and report findings to
MCO.
•Assists physician in physical examination of patients in the
clinic/home.
•Assesses health family members and other households
contacts.
•Integrates case finding of leprosy cases in other activities
Such as MCH, EPI, inspection/ examination of school
children and other programs.

Management and Treatment

The shift institutional to domicilliary care of Hansenites
placed a greater responsibility on public health workers
especially the public health nurse.
•Promotes healthful living by teaching the value of good
personal hygiene, proper nutrition, adequate rest and sleep.
•Helps patient/family understand and accept the problems
brought about by the illness and asses their capacities to deal
with them.
•Provides and arranges for provision of nursing care of patients
at home.
•Prevents secondary injury by teaching patients/family to protect
Cases from burns and rough/sharp objects. Use of pads and
Wooden handles of utensils are advised to protect hands and
Special shoes with padded soles should be worn to protect the
feet. Any injury to hands, feet and eyes should be treated early
To prevent deformities.
•Guides and support patients/family throughout the treatment
phase by giving them information on the importance of
sustained therapy, correct dosage, effect of drugs and the need
For medical check-up from time to time.
•Gives mental and emotional support by encouraging
self-confidence and self-reliance on the part of the
patients/family and by maintaining an understanding and
objectives attitude.
•Refers patient to other health and allied workers as the
•physicians, dentist, social workers, physiotherapist, mental
•Hygienist, occupational therapist as need.

•Rehabilitation
The objectives of rehabilitation is to keep the patients,
•in so far as he/she is capable, to be an active, self-respecting
•Member of society. To help him/her attain this, the nurse:

•Helps create a congenial atmosphere essential to progressive

recovery.
•Must be kind and maintain attitude of professional concern
and interest.
•Encourage patient’s participation in occupational activities
suited to his interest, experience and capacity.
•Refers patient to other person’s mental and social rehabilitation.
FAMILY HEALTH

Promotes family health by:

•Providing information education to patient and his/her family

on family planning and nutrition.
•Encouraging utilization of available family planning and nutrition
service.
•Providing counseling and guidance aimed at improving health
of every member of the family.
Community Health

•Participates in community assemblies and shares information

on leprosy and its management.
•Participates in seminars/workshops/consultative meetings of
other Gos and NGOs on leprosy control.
•Participates in tri-media dissemination of leprosy facts and
NLCP- MDT program.
Training, Supervision and Research

•Conducts orientation of students nurses, midwives and other

students on leprosy and the control program.
•Participates in orientation of new RHU/BHS staff on leprosy
and its control.
•Participates in studies on leprosy and its management.