Leprosy in China

Leprosy was said to be first recognized in the ancient civilizations of China, Egypt and India, according to the World Health Organization (WHO).[1] Leprosy, also known as Hansen's disease, was officially eliminated at the national level in China by 1982, meaning prevalence is lower than 1 in 100,000. There are 3,510 active cases today. Though leprosy has been brought under control in general, the situation in some areas is worsening, according to China’s Ministry of Health. In the past, leprosy sufferers were ostracized by their communities as the disease was incurable, disfiguring and wrongly thought to be highly infectious.

Epidemiology

Numbers

500,000 cases of leprosy were registered in China between 1950 and 2002.[2] Most of these sufferers have been cured but approximately 6,000 active cases remain today and about 2,000 new cases are detected and registered every year. Many more cases are not registered, partly through ignorance, but also because of the stigma associated with the disease.

There are estimates that show that there are 200,000 people in China today who have recovered from the disease but more than half (110,000) are disabled due to the disease, with conditions ranging from blindness to disfigurement. Although these former leprosy sufferers were cured in the last 50 years, many of them still suffer serious pain and difficulties because of these disabilities/deformities and the stigma. This social stigma has become the main problem in leprosy diagnosis and treatment, today.

Areas affected

Mostly, cases of infection remain in impoverished parts in the southwestern provinces of Yunnan, Guizhou and Sichuan, and Tibet in the west and Hunan in the South. Other provinces/municipalities affected on a smaller scale, are Anhui, Qinghai, Chongqing, Guangdong and Shaanxi.

Transmission and pathology

Contrary to popular belief, leprosy ranks lowly in terms of infectiousness and is not congenital. It is passed via respiratory droplets among people in close and prolonged contact. The transmission rate is low and 95 percent of people are naturally immune to it. Caused by the bacterium Mycobacterium leprae, leprosy affects the skin, mucous membranes, peripheral nerves and eyes. As nerve damage is permanent, even those who have recovered can not feel pain. Minor cuts and abrasions on fingers and toes often turn into gaping, inflamed ulcers because of unsanitary living conditions. These open sores overrun the digits, which slowly shrink and many sufferers end up with stumps. Some have legs amputated.

Treatment

In China, dapsone was used from 1946 to treat leprosy, but treatment of the disease took a leap in 1982 with the introduction of a largely successful multidrug therapy (MDT) using dapsone, rifampicin and clofazimine. Today, therapy takes six months to a year. MDT treatment has been made available by the WHO free of charge to all patients worldwide since 1995, and provides a simple yet highly effective cure for all types of leprosy.[3] If diagnosed and treated early, the disease leaves no traces. But in some places in China, stigma still surrounds the disease and victims do not seek treatment until it is too late.

Stigma

China officially stopped sending lepers to colonies from the mid-1980s and the majority are now treated at home. But there is still existence of hundreds of "leper colonies" in China because of the deep-rooted ignorance and prejudice in parts of the society about the disease, medical experts and aid workers say, despite the proven advances in treatment.

Isolation

Many of those people affected by leprosy have been isolated in remote villages since the 1950s, and they and their offspring - most of whom have never been infected - have little chance of rejoining society because of the strong prejudice, and their own fears. Due to strong stigma of the disease, many children have been abandoned, while others are deprived of proper care because their parents/families are concerned that their extended family may be ostracised. There have been cases of people that have recovered from leprosy who have been permanently spurned by their family after being sent away by parents for medical help. They instead have been told (by their families) to remain in the leper colony. These cases include those who have lived in leper colonies for over 40 years.

Deterioration

Ignorance and fear of the disease prevent sufferers and their families from seeking medical help. As many people try to hide the disease, families rarely publicly admit to having any sufferers in their households, because of the fear that the entire village will cut them off. This leads to extreme complications. Those who are afflicted tend to seek help only when their illness - which can permanently damage the skin and nerves, particularly in the limbs and around the eyes - is at an advanced stage and unbearable.

See also

References

  1. ↑ WHO | Leprosy Factsheet
  2. ↑ Chen XS, Li WZ, Jiang C, Ye GY (2001). "Leprosy in China: epidemiological trends between 1949 and 1998". Bull. World Health Organ. 79 (4): 306–12. doi:10.1590/S0042-96862001000400007. PMC 2566398Freely accessible. PMID 11357209.
  3. ↑ WHO | Leprosy Today
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