Leprosy in China: Difference between revisions

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==What is being done to address this problem==
==What is being done to address this problem==
Include anything being done by the local government or groups as well as efforts by non-local groups.
 
A leprosy control program was initiated during the 1950s by the Ministry of Heath in China. The Ministry of Heath and the National Centre for STD and Leprosy Control also initiated the National Leprosy Recording and Reporting System, which is a database to monitor all leprosy patients in the People’s Republic of China and the epidemic trend of the disease.  From the 1950s to 1980s, China’s main focus was to control the infectious sources of leprosy.  After the infectious sources of leprosy were controlled, the next step was to eliminate the disease and rehabilitate those affected.
 
Mass surveys were given in communities and schools to educate the public about the symptoms of leprosy.  The survey found that the peak of the disease was during the 1960s, however, after 1970, it decreased annually with the help of multidrug therapy coverage.  By 1998, leprosy was well controlled in parts of China, and the prevalence was 0.05 per 10,000 population.  Although leprosy is very well controlled in certain areas of China, it not fully eliminated.  Leprosy is still present in about 10% of the country where communities are economically poor with low health care.
 
In recent years, WHO has been trying to sustain the control over the disease with leprosy awareness campaigns and integrating leprosy services into general health services.  This will decrease the leprosy burden as well as make leprosy services available for newly detected patients.
 
==What else could be done to address this problem==
==What else could be done to address this problem==
Are there solutions that could be successful but haven't been implemented due to political or economic reasons?  Are there successful efforts in other countries?  Are there reasons why these efforts may or may not be successful in the country you've focused on?   
Are there solutions that could be successful but haven't been implemented due to political or economic reasons?  Are there successful efforts in other countries?  Are there reasons why these efforts may or may not be successful in the country you've focused on?   

Revision as of 01:39, 27 August 2009

Introduction

Leprosy, also know as Hansen’s disease, is a chronic disease caused Mycobacterium leprae. Mycobacterium leprae was discovered in 1873 by Aramauer Hansen and was identified as the first bacterium to cause a human disease. Leprosy dates back to biblical times, with the first recording of leprosy in 600 BC. There are even accounts of leprosy cases in the oldest human civilizations. Leprosy has since affected every continent. Even to this day, leprosy is present. With the availability of antibiotics and vaccinations, the number of reported cases has dramatically decreased. However, the disease still very well present. As of 2006, the World Health Organization reported 219,826 cases.

Description of [insert name of disease]

Leprosy is an infection of the skin, peripheral nerves, mucous membranes of the respiratory tract, and eyes. If it is not treated, it leads to gradual and permanent nerve damage. Mycobacterium leprae is spread in the repiratory tract and accumulates in body extremities. The bacterium infects Schwann cells of the peripheral nervous system. Infected Schwann cells can no longer produce myelin and as a result, nerves are damaged and there is sensory loss.

Symptoms

Symptoms of leprosy include skin lesions, enlarged peripheral nerves, sensory loss, disfigurations, and disabilities. Symptoms can take up to twenty years to appear. Depending on a person’s immune system and response to bacterial infection, leprosy can take on many forms. Severe cases are due to a weak response of the immune system to the infection, as opposed to milder cases in which immune responses are more effective. Milder cases can be cured, but can also worsen into a more serious form of leprosy. Leprosy is curable. If treated in early stages, permanent damage can be avoided. Antibiotics are available and are very effective to target the bacterium causing the disease.

Treatment

Since the discovery of Mycobacterium leprae in 1873, thorough research on the microbe was done to come up with a solution. Finally, in the 1940’s, treatment for the disease was found in the form of the dapsone drug. However, within a span of twenty years, Mycobacterium leprae developed a resistance to the drug and this resistance spread. In 1981, a breakthrough was made when the World Health Organization (WHO) enacted a multidrug therapy, or MDT, which consists of the drugs dapsone, rifampicin, and clofazimine. MDT was successful in killing the pathogen and has now become accepted as the cure to leprosy. Since 1995, MDT has been made available and has been distributed for free by WHO.

Description of the microbe

Include a link if there is an existing microbewiki page. Ex. Salmonella typhi

Transmission of disease

How is it transmitted? Is there a vector (animal/insect)?

Cell wall

Why is this disease a problem in China

China had been suffered from Leprosy since at least two thousand years ago. The discovery of treatments and drugs such as Dapsone, Rifampicin, and Clofazimine has relieved sufferers at early stage from permanent damages of the skin, nerves, limbs, and eyes. Leprosy prevalence rate was peaked during 1960s, more than 2 per 10,000 populations, but the rate decreased annually to 0.05 per 10,000 populations in 1998. Currently, the prevalence of Leprosy in China is lower than 1 in 100000; However, stigma and prejudice about the disease and patients who affected before, and the uneven distribution occurrences in the country still cause problems in China. Due to the deep rooted social stigma and prejudice of Leprosy, patients and their families try to hide or not to admit that the disease resides in their households while sufferers do not show obvious symptoms. This social phenomenon causes an early stage of disease which is definitely curable, turning into an incurable disease or at least into the one that leaves permanent marks on patients. Patients who either carry now or used to, will also be eventually abandoned from their families as well as their villages. Abandoned patients are left with one choice to join the “lepers’ villages”, concentrated in mountain areas in Southwest of China. Once forsaken, even though cured, they hardly have any chance of rejoining the society and the community outside of their “lepers’ villages”. For the reason that measuring the accurate level of infection and the incidence of Leprosy is impossible, the epidemiology of the disease itself is still a problem in China. This problem becomes more difficult and complicated by the unwillingness and reluctance of the patients seeking help to cure the disease under the influence of social stigma.

What is being done to address this problem

A leprosy control program was initiated during the 1950s by the Ministry of Heath in China. The Ministry of Heath and the National Centre for STD and Leprosy Control also initiated the National Leprosy Recording and Reporting System, which is a database to monitor all leprosy patients in the People’s Republic of China and the epidemic trend of the disease. From the 1950s to 1980s, China’s main focus was to control the infectious sources of leprosy. After the infectious sources of leprosy were controlled, the next step was to eliminate the disease and rehabilitate those affected.

Mass surveys were given in communities and schools to educate the public about the symptoms of leprosy. The survey found that the peak of the disease was during the 1960s, however, after 1970, it decreased annually with the help of multidrug therapy coverage. By 1998, leprosy was well controlled in parts of China, and the prevalence was 0.05 per 10,000 population. Although leprosy is very well controlled in certain areas of China, it not fully eliminated. Leprosy is still present in about 10% of the country where communities are economically poor with low health care.

In recent years, WHO has been trying to sustain the control over the disease with leprosy awareness campaigns and integrating leprosy services into general health services. This will decrease the leprosy burden as well as make leprosy services available for newly detected patients.

What else could be done to address this problem

Are there solutions that could be successful but haven't been implemented due to political or economic reasons? Are there successful efforts in other countries? Are there reasons why these efforts may or may not be successful in the country you've focused on? etc. etc.

References

[Sample reference] Takai, K., Sugai, A., Itoh, T., and Horikoshi, K. "Palaeococcus ferrophilus gen. nov., sp. nov., a barophilic, hyperthermophilic archaeon from a deep-sea hydrothermal vent chimney". International Journal of Systematic and Evolutionary Microbiology. 2000. Volume 50. p. 489-500.

Edited by [insert your names here!], students of Rachel Larsen



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