Leprosy in Tanzania

Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae). It mainly affects the skin, peripheral nerves, and mucous membranes. It is a disease mainly of human beings, which affects people of all races, all ages, and both sexes. Similar to TB, leprosy bacilli are mainly transmitted through infectious droplets that are spread by an infectious individual through coughing and sneezing.

Patients carrying many leprosy bacilli are called multibacillary (MB) patients. They are the main source of infection. People may carry the bacilli but not develop the disease. These people, called healthy carriers, are also probably able to transmit the bacilli to others. Individuals with few bacilli in their body are called paucibacillary (PB). Like healthy carriers, they are not a significant source of infection.

The leprosy control strategy in Tanzania includes the following:

• Expansion of opportunities to further reduce the disease burden through timely case-finding and treatment, contact-tracing, BCG vaccination, and improved socioeconomic conditions.
• Close monitoring of the rate of new cases with grade 2 disabilities in the population.
• Strengthening of leprosy control activities in areas where a high proportion of new cases with grade 2 disabilities are being detected.
• Promotion of the use of community-based rehabilitation to improve the quality of life of persons and families affected by leprosy.
• Efforts to integrate leprosy control into general health care services.
• Application of cost-effective methods to improve community awareness, acceptance, and involvement to combat stigma and discrimination against persons and families affected by leprosy.

The diagnosis of leprosy must be based on the proper history and careful clinical examination of the person for signs of leprosy. In rare instances, there is a need to use a laboratory and other investigations to confirm a diagnosis of leprosy.

Multidrug therapy is the only adequate chemotherapy that will kill bacilli. MDT is a combination of a minimum of two anti-leprosy drugs, prescribed in the correct dosage, taken regularly for a period of six to 12 months. MB patients are treated for a period of 12 months, and PB cases are treated for six months. Treatment of leprosy with only one drug will result in development of drug resistance; therefore, monotherapy should be avoided. Treatment of leprosy reactions and other complications are part and parcel of leprosy management and control