Leprosy is a complicated disease even for health staff
unless they have received some specialized training in the subject. So it is
even more difficult for the lay patient to understand the disease and the
possible harmful consequences of ignoring medical advice (non-compliance).
These are some of the factors that complicate the management of leprosy:
- People with the disease are still stigmatized.
- The patches in paucibacillary patients only disappear some years after MDT has been stooped and the patient is told that he is cured.
- Leprosy reactions with complications such as paresis, paralysis or blindness disabilities are often irreversible if patients report very late. They may have expected their disabilities to be “cured”, therefore this leads to disappointment and may influence their compliance with treatment.
- Even with MDT the treatment period is still quite long (6 months to 2 years) and this causes problems with the regular intake
In these circumstances, it is clear that education of
leprosy patients must be a painstaking task which requires patience and
understanding of the patient’s way of thinking and his individual
circumstances.
What a diagnosed leprosy patient should know
- Leprosy is an infectious disease caused by bacilli (bacteria) not by a curse, witchcraft, or anything similar.
- The patient may have infected several other people with whom he lives in close contact. He should therefore encourage such people to have themselves checked for leprosy when they develop patches.
- Leprosy bacilli are killed by MDT if the drugs are taken regularly for the recommended period.
- Much of the damage that had been done to nerves and tissues before the patient was started on MDT cannot be reversed.
- During (and after) MDT, patients are no longer infectious and are therefore no danger at all for the family or the community.
- In PB patients patches will still be present when the MDT course is already finished. The patches will disappear slowly over a period of 1-3 years.
- Tablets need to be taken daily, as prescribed, and preferably at the same time each day.
- Drugs have to be collected from the clinic every four weeks. On the clinic day the patient takes rifampicin and clofazimine under supervision, and collects dapsone and clofazimine to be self-administered at home. Keep the drugs out of reach of children.
