Intern Experience: Dr. M.Shivakumar
Early diagnosis and effective management of leprosy and its complications can stop stigma and
discrimination
As everyone knew that there’s so much stigma attached to leprosy disease mainly because of
people living with disabilities and deformities. Leprosy patients can develop immune-mediated
inflammation of their nerves which results in nerve damage to their hands and feet. This puts
them at risk of developing deformities. About 40% of leprosy patients will develop these
immune-mediated reactions. It is important to note that only a proportion of persons affected
by leprosy develops deformities and that can be prevented by early reporting, identification &
management of nerve damage.
Huge challenges remain with leprosy because the disease, even when cured, leaves patients
with chronic problems of nerve damage which can be lifelong. Many patients, despite being
cured, have nerve damage even at the time of diagnosis. And this nerve damage can progress.
Because people have anaesthetic hands and feet, they are at risk of injuring their extremities.
People should know that any change in their skin can be suspected of leprosy and report to
nearby public health facilities for diagnosis and treatment. A functioning referral system is
necessary to manage patients with atypical presentation and complications. A primary level at
the block level, secondary at the district level and tertiary at the state level or in medical
colleges to be equipped with trained personnel and infrastructure with the established network
to manage all types of leprosy patients.
Persons affected by leprosy with disabilities and deformities require both medical and social
rehabilitation. Medical rehabilitation involves ensuring people practice home-based self-care
and have protective hands and footwear to prevent them from developing ulcers. The
correction of deformities by performing specialised surgeries through the transfer of tendons
helps the person in rehabilitating affected limbs and eyes.
Prevention of disabilities, deformities among new leprosy cases and medical rehabilitation of
persons affected by leprosy with disabilities would certainly reduce stigma and discrimination in
society.
