TY - ECHAP KW - Eradication KW - leprosy AU - Crawford CL AB - Leprosy is one of the so-called “neglected tropical diseases” (NTD), although it differs from the other diseases because of the availability of large amounts of charity money. As a result of the multiple drug treatment (MDT), some 15 million patients have been cured. Even before the MDT mass treatment program was initiated in the early 1980s, there was substantial evidence that the prevalence of leprosy had declined substantially following the use of dapsone monotherapy. For example, in a province in northern Nigeria, it fell from 40 per 1,000 to two per 1,000 over 15 years. In the village of Igabi, it declined from 67 per 10,000 to 2 per 10,000 over the same period. There was also a decline in incidence in the control groups in the BCG trials in Uganda and the Karamui region of New Guinea. Declines in prevalence also occurred in the former French territories of West Africa. Here, and in northern Nigeria, treatment with dapsone took place in villages and by mobile clinics, whereas in other endemic areas treatment was based on the leprosaria. Attempts to develop a vaccine to prevent leprosy have failed and, in any case, have been found to be unnecessary because of the success of mass treatment. Despite the fear of contracting the disease, some 186,000 thousand patients in India received domilicilary MDT following radio and television programs organized by the BBC. Since the introduction of MDT, new cases of leprosy fell from about 407,000 in 2004 to 228,000 at the end of 2010, a decline of 44%, thus confirming WHO's conclusion that the most effective way of preventing disabilities in leprosy, as well as preventing further transmission of the disease, lies in early diagnosis and treatment with MDT. The fall was especially prominent in Africa, where only 25,000 cases were recorded. This trend should continue, leading to complete interruption of transmission, even though according to PLos Neglected Tropical Disease journal there has only “been progress in controlling the disease,” and leprologists are pessimistic about eradicating the disease in the near future, emphasizing the alleged long incubation period of the disease. It should now be possible to develop a specific diagnostic test for the disease using an antigen derived from human peripheral nerves rather than from an antigen in Mycobacterium leprae. A positive test would help to define the incubation period and determine whether there is a sub-clinical form of the disease. It should also be possible to find out whether transmission has finally ceased in a previously endemic area. BT - Advances in Medicine and Biology LA - eng N2 - Leprosy is one of the so-called “neglected tropical diseases” (NTD), although it differs from the other diseases because of the availability of large amounts of charity money. As a result of the multiple drug treatment (MDT), some 15 million patients have been cured. Even before the MDT mass treatment program was initiated in the early 1980s, there was substantial evidence that the prevalence of leprosy had declined substantially following the use of dapsone monotherapy. For example, in a province in northern Nigeria, it fell from 40 per 1,000 to two per 1,000 over 15 years. In the village of Igabi, it declined from 67 per 10,000 to 2 per 10,000 over the same period. There was also a decline in incidence in the control groups in the BCG trials in Uganda and the Karamui region of New Guinea. Declines in prevalence also occurred in the former French territories of West Africa. Here, and in northern Nigeria, treatment with dapsone took place in villages and by mobile clinics, whereas in other endemic areas treatment was based on the leprosaria. Attempts to develop a vaccine to prevent leprosy have failed and, in any case, have been found to be unnecessary because of the success of mass treatment. Despite the fear of contracting the disease, some 186,000 thousand patients in India received domilicilary MDT following radio and television programs organized by the BBC. Since the introduction of MDT, new cases of leprosy fell from about 407,000 in 2004 to 228,000 at the end of 2010, a decline of 44%, thus confirming WHO's conclusion that the most effective way of preventing disabilities in leprosy, as well as preventing further transmission of the disease, lies in early diagnosis and treatment with MDT. The fall was especially prominent in Africa, where only 25,000 cases were recorded. This trend should continue, leading to complete interruption of transmission, even though according to PLos Neglected Tropical Disease journal there has only “been progress in controlling the disease,” and leprologists are pessimistic about eradicating the disease in the near future, emphasizing the alleged long incubation period of the disease. It should now be possible to develop a specific diagnostic test for the disease using an antigen derived from human peripheral nerves rather than from an antigen in Mycobacterium leprae. A positive test would help to define the incubation period and determine whether there is a sub-clinical form of the disease. It should also be possible to find out whether transmission has finally ceased in a previously endemic area. PB - Nova Science Publishers PY - 2012 SN - 978-162257-348-6 SP - 117 EP - 128 T2 - Advances in Medicine and Biology TI - Towards the Eradication of Leprosy UR - https://www.novapublishers.com/catalog/product_info.php?products_id=41353 ER -