February 7th took place the 71stth daytime world patients of Meadow in Burundi. According to reports of the PNILT (National Integrated Leprosy-Tuberculosis Program), there has been an increase in leprosy cases since 2018 (382 in 2018 against 497 in 2022). A look back at the clinical aspect of this disease, but also at its realities in Burundi.
Leprosy was scientifically identified in 1873 by a Norwegian doctor, Gerhard Armauer Hansen, hence the name « Maladie de Hansen ». It has been classified by the WHO as a neglected tropical disease. It is transmissible by the respiratory route, including by sneezing or coughing, since the causative bacteria (Hansen’s bacillus) is eliminated through the nose and in saliva.
Although this disease is contagious, close and prolonged contact (for weeks, months or even years) with the patient is required to become infected. In addition, only patients who are not treated and who have the multibacillary form are contagious. From now on, you will understand that as soon as the patient is treated, he is no longer contagious.
A surprising thing: did you know that the incubation period for Hansen’s bacillus is on average 5 years? This means that if you are infected today, you will not show the first symptoms for 5 years. Therefore, it becomes difficult to make an early diagnosis in the absence of symptoms. In addition, the patient, during this incubation period, may silently transmit the disease to his or her loved ones.
To remedy this challenge, Dr Pancrace Ntibarufata, head of the leprosy management department at PNILT, explains that as soon as a case is detected, they also monitor the condition of the people closest to the patient over a period of a year, giving them chemoprophylaxis, if necessary.
What to know about the symptoms
Classically, leprosy patients first present a hypochromatic (depigmented) spot on their skin, painless and insensitive. Then, the disease will progress through nerve damage which results in a loss of sensitivity (leading to puncture wounds which heal poorly), deformations (hands and toes in claws), paralysis (facial paralysis), to name but a few. that. Unwelcome complications follow, including blindness or loss of certain organs (fingers, toes, etc.). But do not worry, reassure Dr Ntibarufata, “leprosy is treated free of charge in Burundi in all health facilities”.
Dr GM works in a hospital in Makamba (one of the 7 provinces the most endemic) for about 2 years. During these years, he encountered about 5 cases of leprosy: « Of those who came for treatment, most were already in the advanced stages of the disease. Only one came at the early stage. At this stage, the patient has spots on the skin. It may even have nodules. In the advanced stage, the patient presents sores. A few times he has already lost his toes. »
Leprosy in Burundi
According to reports from the PNILT (National Integrated Leprosy-Tuberculosis Program), there has been an increase in leprosy cases since 2018 (382 in 2018 against 497 in 2022). In addition, each year, the number of cases of multibacillary leprosy outweighs paucibacillary leprosy (320 multibacillary versus 62 paucibacillary in 2018, 334 multibacillary versus 163 paucibacillary in 2022). This means that more patients with the contagious form have been recorded than those with the non-contagious form.
Dr Pancrace Ntibarufata gives us a reason behind these figures: “During screening campaigns, there are patients who stay at home. They tend to hide because of the discrimination they experience “. Faced with this alarming situation, the question that arises is: how to act? And above all, what can be done to completely eradicate this disease in Burundi?
« At the community level, we organize associations of former leprosy patients and community health workers to help us raise awareness. », informs Dr Ntibarufata. For him, it will also be necessary to reverse the trend in terms of figures. That is to say, if we want to record 0 cases of leprosy in 2030 (WHO objective), we will first have to be able to detect more cases in the non-contagious form than in the contagious one.
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2024-02-09 10:16:22