Leprosy (Hansenosis, Hansen’s disease)

- An ancient disease and is a leading cause of permanent physical disability

among the communicable diseases.

Causative Agent
Mycobacterium leprae

Modes of Transmission
Airborne-droplet, Prolonged skin-to-skin contact

Period of Communicability
5 ½ months

Clinical Manifestations
Early signs:
Change in skin color – either reddish or white
Loss of sensation on the skin lesion
Loss of sweating and hair growth
Thickened and painful nerves
Muscle weakness or paralysis or extremities
Pin and redness of the eyes
Nasal obstruction or bleeding
Ulcers that do not heal

Late Signs:
Madarosis
Loss of eyebrows
Inability to close eyelids (lagophthalmos)
Clawing of fingers and toes
Contractures
Chronic ulcers
Sinking of the nosebridge
Enlargement of the breast (gynecomastia)

Diagnostic Procedures
Slit Skin Smear - determines the presence of M. leprae; optional and done only if
clinical diagnosis is doubtful to prevent misclassification and wrong treatment

Lepromin Test – determines susceptibility to leprosy

Treatment
Ambulatory chemotherapy through use of MDT
Domiciliary treatment as embodied in RA 4073 which advocates home treatment

PAUCIBACILLARY (tuberculoid and indeterminate); noninfectious type

Duration of treatment: 6 to 9 months
Procedure:
Supervised: Rifampicin and Dapsone once a month on the health center supervised by the
rural health midwife
Self-administered: Dapsone everyday at the client’s house

MULTIBACILLARY (lepromatous and borderline); infectious type

Duration of treatment: 24-30 months
Procedure:
Supervised: Rifampicin, Dapsone, and Lamprene

Prevention
Avoid prolonged skin-to-skin contact
BCG vaccination – practical and effective preventive measure against leprosy
Good personal hygiene
Adequate nutrition
Health education

Nursing Management
Isolation and medical asepsis, psychological support