2. OBJECTIVES
At the end of the class student will
be able to
Define leprosy
Its type
Cause and risk factor
Sign and symptoms
Pathophysiology
Transmission
Prevention
Diagnosis
Management
3. INTRODUCTION
Leprosy (Hanson’s disease) is a chronic infection
caused by the bacteria Mycobacterium Laprae or
Mycobacterium Lapromatosis. Symptoms that
develop include granulomas of the nerves,
respiratory tract, skin and eyes. This may result in
lack of ability to feel pain and thus loss of parts of
extrimities due to repeated injury.
4. DEFINITION
Leprosy is a chronic infectious and
communicable disease caused by
Mycobacterium laprae . Its principal lesion occur
in the cooler tissues of body; Skin , superficial
nerves , nose and larynx , pharynx ,etc.
5. INCIDENCE
Worldwide , two to three million people are
estimated to be permanently disable
because of leprosy. India has the greatest
number of cases , with brazil second and
indonesia third.
Children are more susceptible then adult.
A family history of leprosy probably means
highest susceptibility to infection .
6. TYPESLapromatous leprosy: Generalized form of
disease and is found in individuals with low
degree of resistance. Skin lesion appear as
yellow or brown infiltrated nodules that effect
the mucus membranes of the eyes, nose, and
throat .
Tuberculoid leprosy:This is a localized form of
disease and is found in patients with high degree
or resistance. Skin lesions appear as light red or
purplish spots.
7. Conti……
Borderline type : In this type of leprosy the
lesions produced possess characteristics of
both lapromatus and tuberculoid lesions .
Indeterminate type : In this type of leprosy
the lesions produced often resemble maculo
– anesthetic patches which are neither
characteristics of lepromatous nor
tuberculoid type .
8. Causeandriskfactor
Cause : 1) Microbactrium laprae
2) Genetics : several genes have been
associated with a susceptibility to leprosy .
Risk factors :
1)Living in areas with polluted water and poor diet.
2) Immunocompromised people .
3) Travel to an area that has experienced a leprosy
attack.
4) People who handle certain animal that are known to
carry the bacteria ( african chimpanzee , armadillos )
are at high risk .
5) Those who live in the areas where leprosy is
endemic.
9. SIGNANDSYMPTOMS
Numbness and loss of touch, pain,
temperature sensation .
Granulomas of the nerves ,respiratory tract
,skin and eyes
Painless ulcer
Skin lesions
Loss of digits
Facial disfigurement
11. Loss of axonal conductance
Deformity(loss of pain,
temperature,touch,sensation)
12. TRANSMISSION
Droplet infection : leprosy is believed to
transmit through nasal discharge .
Contect infection : studies indicate that
leprosy is transmitted through direct skin
contact.
Vector –born infection.
Trough placenta and milk .
13. PREVENTION
Isolation of bacteriologically positive cases in
endemic areas .
Avoid close physical contact with untreated
patient.
Keep away from the animal which are suspe
cted to the bacteria .
Use of mask and gloves while handling the
patient .
vaccination – BCG vaccine (at birth,
intramuscular, 0.o5 ml )
14. DIAGNOSIS
Clinical examination
Interrogation
Physical examination
Bacteriological examination
Smear (scrapings from lesions , nasal mucosa,
nerve biopsy ,etc)
Routine test
CBC , LFT , Creatinine test
Other test
Lepromin test
PCR
15. complication
◊ Partial or complete deformity / handicap .
◊ Complete isolation from the society .
◊ Social and mental tension.
◊ Sensory loss .
◊ Paralysis.
◊ Muscle weakness .
◊ Progressive disfigurment ( eyebrow lost ,
disfigurement of the toes , fingers and nose )
◊ Loss of manpower / national loss.
16. MANAGEMENT
MEDICAL MANAGEMENT :
Multidrug therapy : rifampicin , dapsone ,
clofazimine ,ethionamide , quinolones ,
minocycline ,etc are used .
Corticosteroids : these are used to treat nerve
damage associated with leprosy
Aspirin and thalidomide are used to control
inflammation.
17. Conti…
Surgical management:
Neural surgery
Nerve grafting
Amputation
Cosmetics surgery :
nasal reconstruction
Removal of excess skin
Replacement of eyebrows
18. Conti…
Nursing care
Detect the disease in the initial stage and keep
watch over other susceptible patients .
Take care of localized wound .
Rehabilitation of cured persons .
Provide health education.
Provide shelter and social support, moral
support.
Provide follow- up service .
19. SUMMARY
Leprosy is a chronic infection caused by M.
laprae. Immunosupress people are at high
risk of infection .The sign and symptoms of
these disease are numbness and loss of
senstion and the sign are painless ulcer, skin
lesions, eye damage , etc. leprosy is
transmitted by droplet infection and direct
contact with untreated people .It is
diagnosed by bacteriological examination ,
lepromin test , PCR, etc .
20. CONCLUSION
From this lesson plan we are know about
leprosy its type, cause and risk factors , sign and
symptoms , pathophysiology, its transmission ,
prevention, diagnosis, complication, and its
management.
21. BIBLIOGRAPHY
PARK K : textbook of preventive and social
medicine , 22nd edition published by M/S
Banarsidas Bhanot, Jabalpur,2013, page no –
287-299
SWANKAR KESHEV : community health nursing
, 3rd edition published by N.R. brother ,indore ,
2011 page no – 539 – 541
ANANTHANARAYAN et al : textbook of
microbiology , 8th edition , published by
universities press, Hydrabad , 2009 , page no –
364 – 370 .
22. Conti….
BEESON et al : textbook of medicine , 12th
edition , published byW. B. saunders
company , Philadelphia and London , 1968,
page no – 296- 300.
en.wikipedia.org/wiki/leprosy.com