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Leprosy in East Asia


The epidemiology of leprosy in East Asia has significantly changed over the past 100 years. There is interesting diversity between countries but the general trends have been similar. Over this period, the approach to leprosy control has changed from segregation to case detection and treatment with effective chemotherapy. The introduction of short course multidrug therapy in the 1980s and 1990s produced a dramatic fall in the number of patients registered for treatment of around 95%. Despite the introduction of effective chemotherapy, disability and discrimination due to leprosy remain a challenge often due to late diagnosis and complications of nerve injury. There has been no dramatic impact of chemotherapy on incidence of leprosy but there is a gradual decline in new case detection which in many countries predates the introduction of short course chemotherapy. This decline may be due to long term implementation of chemotherapy, either dapsone or multidrug therapy, use of BCG vaccine, and improving socio-economic circumstances. New targets, based on sero transmission, are now being pursued across East Asia based on novel approaches to new diagnostic tools and prophylaxis as well as early case finding and active contact management.

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