Akpan
(2007) stated that the management of leprosy is aimed at stopping infection and
minimising potential physical deformities. Management of leprosy includes the
responsibility of contact tracing to identify subjects who may have been
exposed to and offer screening if appropriate. Antibiotics that are used as
first-line to eliminate organisms include dapsone, rifampicin and clofazimine. Varying regimens are used
depending on the type of leprosy and the severity of infection. This may be a
combination of two or three antibiotics given over varying lengths of time (up
to years). Other antibiotics include minocycline, ofloxacin and clarithromycin.
(2007) stated that the management of leprosy is aimed at stopping infection and
minimising potential physical deformities. Management of leprosy includes the
responsibility of contact tracing to identify subjects who may have been
exposed to and offer screening if appropriate. Antibiotics that are used as
first-line to eliminate organisms include dapsone, rifampicin and clofazimine. Varying regimens are used
depending on the type of leprosy and the severity of infection. This may be a
combination of two or three antibiotics given over varying lengths of time (up
to years). Other antibiotics include minocycline, ofloxacin and clarithromycin.
In
addition, leprosy education is paramount. Leprosy can be cured but it is
essential to take the full course of medication. It is no longer infectious once
management has begun. Individuals should be instructed on how to deal with
existing nerve damage for example protecting numb feet from injury. Physical,
social and psychological rehabilitation is a necessary for those neglected as a
result of the disease.
addition, leprosy education is paramount. Leprosy can be cured but it is
essential to take the full course of medication. It is no longer infectious once
management has begun. Individuals should be instructed on how to deal with
existing nerve damage for example protecting numb feet from injury. Physical,
social and psychological rehabilitation is a necessary for those neglected as a
result of the disease.
Clinical Management of Leprosy
The
Federal Ministry of Health (2008) highlighted the clinical management of
leprosy thus:
Federal Ministry of Health (2008) highlighted the clinical management of
leprosy thus:
v
All individuals should have access to free medical care for leprosy
All individuals should have access to free medical care for leprosy
v
Interview individuals in depth with the aim to:
Interview individuals in depth with the aim to:
(i)
Identify possible sources of the infection
Identify possible sources of the infection
(ii)
Identify those close contacts who require clinical examination
Identify those close contacts who require clinical examination
Contact Tracing and Screening
The
Federal Ministry of Health (2008) stated the for effective management of
leprosy, there should be adequate contract tracing and screening should be
carried out in the following ways:
Federal Ministry of Health (2008) stated the for effective management of
leprosy, there should be adequate contract tracing and screening should be
carried out in the following ways:
v
Close contracts should be examined for signs of leprosy, this requires a
detailed examination of the skin and of the peripheral nervous. Any
abnormalities detected (e.g. hypopigmented skin patches, thickened peripheral
nerves) should be documented either on body map or a photography and retained
in the contracts clinical notes.
Close contracts should be examined for signs of leprosy, this requires a
detailed examination of the skin and of the peripheral nervous. Any
abnormalities detected (e.g. hypopigmented skin patches, thickened peripheral
nerves) should be documented either on body map or a photography and retained
in the contracts clinical notes.
v
Any skin abnormalities can be further checked by performing slit skin
smears to be examined for acid fast base and if changes suggestive of
lepromatous leprosy are present additional smears can be taken from earlobes,
eyelids and dorsum of hands. However, these smears should only be undertaken by
or under the direction of a health professional familiar with the technique.
Any skin abnormalities can be further checked by performing slit skin
smears to be examined for acid fast base and if changes suggestive of
lepromatous leprosy are present additional smears can be taken from earlobes,
eyelids and dorsum of hands. However, these smears should only be undertaken by
or under the direction of a health professional familiar with the technique.
v
Any new cases of leprosy identified through either the clinical
examination or the earlobe smear need to be referred to a physician for
clinical investigation and management.
Any new cases of leprosy identified through either the clinical
examination or the earlobe smear need to be referred to a physician for
clinical investigation and management.
v
All very close contacts should continue to be examined once annually for
at least 5 years.
All very close contacts should continue to be examined once annually for
at least 5 years.
v
The use of a single dose of Rifampic in far certain contacts may also be
prescribed by the managing physician as part of most recent leprosy screening
management.
The use of a single dose of Rifampic in far certain contacts may also be
prescribed by the managing physician as part of most recent leprosy screening
management.
v
Ensure management adherence through medical and assessments.
Ensure management adherence through medical and assessments.
v
The case management team
The case management team
v
Monitors the management causes and ensure health records are current.
Monitors the management causes and ensure health records are current.
v
Ensures management adherence
Ensures management adherence
v
Ensure completion of management with adequate regimen.
Ensure completion of management with adequate regimen.
v
Determines clinical and bacteriological outcomes.
Determines clinical and bacteriological outcomes.
v
If deceased determine cause of death.
If deceased determine cause of death.
Rehabilitation of Individuals who suffered from
Leprosy Back into the Society
Leprosy Back into the Society
The basic concepts behind rehabilitation are that
the persons affected with leprosy should be restored back to normal social life
or as near as possible. Rehabilitation means restoration of economic
productivity leading to economic independence. Rehabilitation of the leprosy individuals
is a multi faceted and a long drawn process. Consistent efforts in various
directions are necessary to bring success (International Federation of Anti-Leprosy Association,
2011).
the persons affected with leprosy should be restored back to normal social life
or as near as possible. Rehabilitation means restoration of economic
productivity leading to economic independence. Rehabilitation of the leprosy individuals
is a multi faceted and a long drawn process. Consistent efforts in various
directions are necessary to bring success (International Federation of Anti-Leprosy Association,
2011).
The peculiar social connotations of the disease
need to be paid adequate attention while discussing the rehabilitation of a
leprosy affected person. The social stigma and the consequent resentment and
ostracism often make the life of leprosy sufferers unbearable after
rehabilitation back into the society. Great emphasis should be laid on what may
be called “Preventive Rehabilitation”. Accordingly all possible measures should
be taken to prevent the need of any special rehabilitation service. Early diagnosis
and early management with due importance to the prevention of deformity can be
the most effective preventive rehabilitation (Noordeen, 2010). Rehabilitation of a leprosy affected person
begins when the disease is first diagnosed. Therefore the doctors and the health
workers should be trained to look out for early signs and to advise individuals
on how to prevent more severe damages and correct the damages already present.
need to be paid adequate attention while discussing the rehabilitation of a
leprosy affected person. The social stigma and the consequent resentment and
ostracism often make the life of leprosy sufferers unbearable after
rehabilitation back into the society. Great emphasis should be laid on what may
be called “Preventive Rehabilitation”. Accordingly all possible measures should
be taken to prevent the need of any special rehabilitation service. Early diagnosis
and early management with due importance to the prevention of deformity can be
the most effective preventive rehabilitation (Noordeen, 2010). Rehabilitation of a leprosy affected person
begins when the disease is first diagnosed. Therefore the doctors and the health
workers should be trained to look out for early signs and to advise individuals
on how to prevent more severe damages and correct the damages already present.
International
Federation of Anti-Leprosy Association (2011) highlighted that one of the essential rehabilitation of an
individual is socio economic rehabilitation to create a suitable condition in
the community for social acceptance of leprosy cured persons through effective
advocacy methods. While planning their rehabilitation, specific attention must
be paid to the social and economic aspects. It is now increasingly realized
that the economic reinstatement of a leprosy individuals will hasten the
process of his social rehabilitation and acceptance in the community.
Federation of Anti-Leprosy Association (2011) highlighted that one of the essential rehabilitation of an
individual is socio economic rehabilitation to create a suitable condition in
the community for social acceptance of leprosy cured persons through effective
advocacy methods. While planning their rehabilitation, specific attention must
be paid to the social and economic aspects. It is now increasingly realized
that the economic reinstatement of a leprosy individuals will hasten the
process of his social rehabilitation and acceptance in the community.
In a country such as Nigeria where there is
tremendous scope for self employment, full advantage should be taken of the
several opportunities presently available. Various job projects for self
employment can be worked out taking in to account the local needs and the aptitude
and interest of the person. Expert saddled with the responsibilities of
rehabilitating individuals from leprosy should always bear in mind that normalization
of the life of the individual should be the final objective of all the
interventions that they are planning. Changing support systems, from vertical
to horizontal, segregated to integrated may not solve all the problems of the
leprosy affected and displaced persons. Nevertheless, transforming these
systems will greatly help them to lead normal, useful lives with dignity within
their communities (Akpan, 2007).
tremendous scope for self employment, full advantage should be taken of the
several opportunities presently available. Various job projects for self
employment can be worked out taking in to account the local needs and the aptitude
and interest of the person. Expert saddled with the responsibilities of
rehabilitating individuals from leprosy should always bear in mind that normalization
of the life of the individual should be the final objective of all the
interventions that they are planning. Changing support systems, from vertical
to horizontal, segregated to integrated may not solve all the problems of the
leprosy affected and displaced persons. Nevertheless, transforming these
systems will greatly help them to lead normal, useful lives with dignity within
their communities (Akpan, 2007).
