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Tuesday, February 14, 2012

Leprosy Elimination: Still Unfinished Business

During a three-day WHO Western Pacific regional meeting of national leprosy program managers, it was revealed that the Philippines registered the highest number of new cases in the Western Pacific region in 2010 as some areas remain leprosy hotspots.

A report cited that according to Former Health Secretary Alberto Romualdez, leprosy hotspots in the Philippines include some areas in Cebu City, Metro Manila, Davao City, Ilocos Sur, Tarlac, Nueva Ecija, Tawi-tawi and Sulu.

Romualdez heads the Culion Foundation, a non-government organization working for the prevention and control of communicable diseases like leprosy. The foundation apparently got its name from Culion Island in Palawan, a former leper colony where patients with leprosy throughout the archipelago are brought for isolation (and incarceration) as there was no cure for leprosy at that time.

According to ILEP, leprosy existed in the country even before the arrival of the Spanish colonizers. And its incidence was said to be fairly high during the time of the American occupation thus the creation of the Culion leper colony which at its peak held over 5,000 people.

In 1986, the National Leprosy Control Program was established in the Philippines. Since then, the incidence has decreased. Although the disease is considered eliminated in the Philippines (elimination = less than one case per 10,000 of population), with a current Philippine prevalence rate of 0.31 per 10,000 people (2,041 new cases), there remain to be pockets of leprosy cases. The social stigma of leprosy is still believed to be present making it difficult to really see all leprosy patients as some patients would try to hide their condition because of shame. This age-old stigma as WHO mentioned "is an obstacle to self-reporting and early treatment."

Leprosy is a chronic disease caused by Mycobacterium leprae, an acid-fast bacilli (like tubercle bacilli) affecting the skin, peripheral nerves, mucosa of the upper respiratory tract and also the eyes among others with an incubation period of about five years. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.

IT IS CURABLE with Multidrug therapy of dapsone, rifampicin and clofazimine. However for treatment to reach all patients, treatment needs to be integrated into general health services. Community awareness must also be promoted to combat leprosy social stigma and encourage self-reporting so that patients will voluntarily seek treatment. Monitoring of treatment performance is also important.


Indeed we still have a lot to do to complete the business of truly eliminating leprosy in our country.


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