01425nas a2200193   4500000000100000008004100001260001600042653001100058653001200069653002500081100001400106700001600120245001300136300001200149490000800161050001700169520103100186022001401217       2004                            d  c2004 Apr 1010aHumans10aleprosy10aMycobacterium leprae1 aBritton W1 aLockwood DN00aLeprosy.  a1209-190 v363  aBRITTON 20043 a<p>Leprosy remains an important health problem worldwide. The disease is caused by a chronic granulomatous infection of the skin and peripheral nerves with Mycobacterium leprae. The clinical range from tuberculoid to lepromatous leprosy is a result of variation in the cellular immune response to the mycobacterium. The resulting impairment of nerve function causes the disabilities associated with leprosy. This review summarises recent advances in understanding of the biology of leprosy, clinical features of the disease, the current diagnostic criteria, and the new approaches to treatment of the infection and the immune-mediated complications. Supervised multi-drug therapy (MDT) for fixed durations is highly effective for all forms of the disease. The widespread implementation of MDT has been associated with a fall in the prevalence of the leprosy but as yet no reduction in the case-detection rate globally. Thus, leprosy control activities must be maintained for decades to interrupt transmission of infection.</p>  a1474-547X