As
stated by Queensland Tuberculosis Control Centre (2012) leprosy can be manage
as listed below:
stated by Queensland Tuberculosis Control Centre (2012) leprosy can be manage
as listed below:
v Public
Health Management
Health Management
v Ensure
early assessment and commencement of treatment
early assessment and commencement of treatment
v Initial
actions should include:
actions should include:
·
Determine patient infectivity and
the impact on pubic health
Determine patient infectivity and
the impact on pubic health
·
Assessment of the need for
hospitalization or isolation
Assessment of the need for
hospitalization or isolation
·
Assessment of the need to limit
mobility, work study or travel i.e. aircraft.
Assessment of the need to limit
mobility, work study or travel i.e. aircraft.
v Case
management of leprosy patients includes the responsibility of contact tracing
to identify subjects who may have been exposed to and offer screening if
appropriate.
management of leprosy patients includes the responsibility of contact tracing
to identify subjects who may have been exposed to and offer screening if
appropriate.
Clinical management
v All
patients have access to free medical care for leprosy
patients have access to free medical care for leprosy
v Interview
the patient in depth aiming to.
the patient in depth aiming 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
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.
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 AFBS (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.
skin abnormalities can be further checked by performing slit skin smears to be
examined for AFBS (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.
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.
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 treating physician as part of most recent leprosy screening management.
use of a single dose of Rifampic in far certain contacts may also be prescribed
by the treating physician as part of most recent leprosy screening management.
v Ensure
treatment adherence by regularly checking drug regimens and doses through
medical and assessments.
treatment adherence by regularly checking drug regimens and doses through
medical and assessments.
v The
case management team
case management team
v Monitors
the treatment causes and ensure health records are current.
the treatment causes and ensure health records are current.
v Ensures
treatment adherence
treatment adherence
v Ensure
completion of treatment with adequate regimen.
completion of treatment with adequate regimen.
v Determines
clinical and bacteriological outcomes.
clinical and bacteriological outcomes.
v If
deceased determine cause of death.
deceased determine cause of death.