Evaluation of interventions to prevent disability in leprosy: Evaluatie van interventies ter voorkoming van handicaps door lepra

What is leprosy? Leprosy is an infecti ous disease dati ng back to ancient ti mes before Christ. Most likely, the infecti on spread slowly from Asia to Europe and from there to the Americas, Australia and New Zealand. In Europe, the number of infected people reached its peak in the 13th century. Aft er the 16th century, leprosy was on the decline over most of Europe and the number of people aff ected by leprosy fell rapidly. Nowadays, many people only know leprosy from stories, pictures or books since the disease has become less and less prevalent. Cause. Leprosy is caused by the bacillus Mycobacterium leprae. Leprosy bacilli are most probably spread through ti ny droplets from the nose or mouth from infected and untreated individuals. Most people will never know that they have been infected because their immune system functi ons well. But when the immune system fails to respond eff ecti vely to the anti gens of the bacilli, the disease will develop. The ti me between infecti on and the fi rst visible signs of leprosy varies greatly and is usually between two and twelve years, but someti mes more than 20 years. Signs, symptoms and classification. To confi rm whether a person has leprosy, at least one of three signs should be found during a clinical examinati on: loss of feeling in typical skin patches, enlargement of peripheral nerves and the presence of leprosy bacilli in a skin smear. In the early stage of leprosy, called indeterminate, one or few unusual spots or patches on the skin may occur. Oft en the disease heals spontaneously, but someti mes the disease progresses to an advanced form. This depends mainly on how the immune system of an individual responds.