Leprosy, also known as Hansen’s disease, is a chronic granulomatous infectious disease which primarily affects the skin and the peripheral nerves. It might affect the eye, the mucosa of the upper respiratory tract, muscle, bone and testes. The causative agent is an acid-fast bacterium, Mycobacterium leprae, first identified in 1873 by the Norwegian physician, Gerhard Henrik Armauer Hansen.
Leprosy is one of the oldest diseases known to mankind. In Nepali, it called as Kushtha Rog. There may be few or multiple hypo -pigmented skin lesions with loss of sensation, loss of hair and impaired sweating. It may present as thickened ear lobes and nodules on face, arm and other part of the body. Nerve damage in leprosy affects sensory, motor and autonomic function of peripheral nerves. As a result of anaesthesia of skin and muscle weakness, there may ulcers on hands and feet, inability to close eyes and difficulty in the holding things. In past, leprosy was deemed an incurable disease, causing severe deformities and disabilities, thus resulting in severe stigmatization. This has resulted in double suffering by victims, both from the disease itself and from public discrimination.
Leprosy can occur at any age group. Males are more affected than females Untreated patients are the main sourse of infection.The route of transmission of the disease is uncertain but is probably primarily through nasal droplet infection. Other modes of transmission have been documented and include contact with infected soil. Skin-to- skin contact is thought not to be an important route of infection.
In 1991, the World Health Organization (WHO) and its member states committed themselves to eliminate leprosy as a public health problem by the year 2000. Elimination is defined as a prevalence of less than 1 case per 10,000 population. Nepal has reached the goal of elimination in 2009. Currently more than 3000 new leprosy cases has been detected, among which 3.38% had already developed Grade 2 visible deformities and child cases 3.66 %. Registered prevalence: 0.83/10,000 population. To sustain elimination is also an important issue for the government of Nepal.
Leprosy, which was endemic in Western Europe in the medieval period, was eliminated from Scandinavian countries in early twentieth century, before the advent of antibiotic therapy. Obviously, this decline must be attributed to improvement in living standards, better housing, clean water supplies, and improved nutrition and hygiene.