2023-08-15 04:40:27
Brazil leads the cases of leprosy in Latin America
The new cases in Mexico have put the focus on this disease, although infections have dropped drastically throughout the continent. Experts advocate more surveillance to make an early diagnosis.
Known in the academic world as Hansen’s disease, leprosy has been decreasing its presence throughout the globe, going from more than 5 million cases in the 1980s to 133,802 registered cases in 2021, according to the latest data from the World Organization of Health (WHO). Latin America has experienced the same downward trend, although some regions, such as Brazil, Paraguay or Colombia, have a higher rate of cases.
“Leprosy maintains its challenging status in terms of public health in various parts of the world, especially in developing nations,” Dr. Miguel Ángel Cáceres Durán, a researcher at the Federal University of Pará in Brazil, tells DW.
Mexico has been the last to report new cases. According to a bulletin published by the Ministry of Health of the Mexican government, in the epidemiological week of July 16 to 22 of this year, 12 municipalities were identified as “priority for leprosy”, concentrated in a total of seven states: Jalisco, Michoacán, Morelos , Nuevo Leon, Oaxaca, Sinaloa and Yucatan. Even so, the national count of leprosy in Mexico -which dates from the end of 2022- stands at 300 registered cases, 35 less than at the end of 2021. Despite this slight year-on-year decrease, since there has also been a decrease 98% compared to 1989, Mexico “continues at the national level ‘in the process of eliminating leprosy as a public health problem,'” the agency said.
Brazil leads the cases of leprosy in the region
According to the Pan American Health Organization (PAHO), the leprosy situation in Latin America has shown a downward trend in the last decade. Between 2005 and 2019 there was a 28% decrease in the number of new cases detected, from 41,780 to 29,936. Between 2019 and 2020, one of 36.3%. However, in 2021, the number of new cases increased slightly, to 19,826 (631 more cases than the previous year).
As Santiago Nicholls, PAHO’s regional adviser on neglected infectious diseases, explained to DW, in 2021, out of 49 countries and territories, 22 reported new cases of leprosy, the vast majority, 92% (18,318) in Brazil. After this country, the latest data from regions with the highest incidence of leprosy cases were reported in Paraguay (281), Colombia (272), Venezuela (239), the Dominican Republic (148), Argentina (143), Mexico (133) and Cuba (81).
Nicholls highlighted that Uruguay, some Central American countries and several Eastern Caribbean islands “are candidates to eliminate leprosy transmission in the next 5 years.”
For Cáceres Durán, a geneticist and molecular biologist, these figures “are not enough” and he stresses that “the lack of notification of cases is not equivalent to the non-existence of the disease.”
“Active Surveillance”
In an interview with DW, Cáceres Durán attributes the persistence of leprosy transmission to the fact that this is not really an eradicated disease, and to the absence of a specific vaccine, as well as the fact that its diagnosis presents difficulties.
“There are few specialists capable of making an adequate diagnosis, and, generally, it is common for patients to seek specialized care when the disease is already in an advanced state, causing irreversible damage in many cases,” he points out.
For this reason, he advocates making early diagnoses. “It is of the utmost importance to maintain active surveillance,” he maintains. The researcher sees the number of new diagnoses as likely to remain stagnant and even increase, unless healthcare institutions implement intervention strategies globally.
In comments for DW, Dr. Mirna Patricia Salomón, a medical epidemiologist in the Dominican Republic, also emphasized surveillance actions, and training health personnel to notify early.
disease and treatment
Leprosy is caused by bacteria Mycobacterium leprae and Microbacterium lepromatosis. A communicable disease, although not very contagious, according to PAHO. “For a person to become infected, close and prolonged contact, over months or years, with an infected person is required,” Nicholls said.
“The initial symptoms are light or dark spots on the skin that result in lesions and loss of sensation in the affected area,” says the agency. And although medical advances have made leprosy less dangerous today, if left untreated, it can cause “deformities, nerve and eye damage, and some other systemic manifestations,” says Cáceres Durán.
PAHO emphasizes that all new cases can be cured, and that the treatment -provided free of charge- consists of a combination of three antibiotics -dapsone, rifampicin and clofazimine- that are given in continuous 28-day cycles for 6 or 12 months .
The WHO described leprosy as a “neglected” tropical disease, and in April 2021 launched the “Global Strategy against Leprosy 2021-2030 ‘Towards zero leprosy'”, with the aim of expanding prevention, combating the disease in countries where it is endemic, as well as the stigma derived from it.
(cp)
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