Disabilities and their lifelong burden in people affected by leprosy in India

Abstract

Disabilities in persons affected by leprosy pose a life-long disease burden, both for patient and the responsible medical service. The obligate intracellular pathogen Mycobacterium leprae affects skin, as well as peripheral nerve cells, and can result in leprosy reactions, which can be intensifications of the host’s immune response, or antibody reactions to immune complexes. Leprosy can thus lead to disabilities, that are currently graded in three categories. The proportion of grade-2 disabilities in newly diagnosed leprosy patients (G2D) is one of the main indicators for leprosy monitoring. In total numbers, G2D are declining according to the size of the analyzed populations. The G2D-Rate per 1 Million persons however, shows fluctuations, which correspond to the efforts made in case-finding, and the public awareness concerning early reporting. Furthermore, no global data has been published yet, regarding the development of grade-0 and grade-1 disabilities throughout the course of treatment and beyond. The practical prevention of disabilities, and the exacerbation of those in already impaired persons, poses a great difficulty, especially in India, where historically stigmatization is present, the integration of leprosy services into the public health sector was described as failure, and funding is scarce, due to the fact, that leprosy was officially eliminated on a public health level in 2005.