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    Phillip Ching
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    Leprosy has been a public health problem in the Philippines for decades. In 1989, Multiple Drug Therapy was implemented nationwide after successful pilot programs. In 1991, the Philippines joined efforts to eliminate leprosy. While prevalence rates have decreased, new case detection rates remain high in certain areas. Leprosy disproportionately affects 8 cities and 5 provinces. It is caused by Mycobacterium leprae and primarily infects nerves, causing disabilities if left untreated.

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    LEPROSY PPT LECTURE

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    Leprosy Chn

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    Leprosy has been a public health problem in the Philippines for decades. In 1989, Multiple Drug Therapy was implemented nationwide after successful pilot programs. In 1991, the Philippines joined efforts to eliminate leprosy. While prevalence rates have decreased, new case detection rates remain high in certain areas. Leprosy disproportionately affects 8 cities and 5 provinces. It is caused by Mycobacterium leprae and primarily infects nerves, causing disabilities if left untreated.

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    269 views14 pages

    Leprosy CHN

    Uploaded by

    Phillip Ching
    Leprosy has been a public health problem in the Philippines for decades. In 1989, Multiple Drug Therapy was implemented nationwide after successful pilot programs. In 1991, the Philippines joined efforts to eliminate leprosy. While prevalence rates have decreased, new case detection rates remain high in certain areas. Leprosy disproportionately affects 8 cities and 5 provinces. It is caused by Mycobacterium leprae and primarily infects nerves, causing disabilities if left untreated.

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    LEPROSY

    Leprosy has been a public health problem in the


    Philippines for several decades. In 1989 Multiple Drug
    Therapy (MDT) was implemented nationwide after a
    successful implementation of the MDT pilot study in Cebu
    and Ilocos Norte in 1985. In 1991, Philippines joined the
    movement to eliminate leprosy as a public health problem.
    Since then great progress has been made in decreasing
    the number of persons afflicted with leprosy. By the end of
    2005, the prevalence rate is 0.36 which is 5.8% lower in
    2004. However the New Case Detection Rate for 2005 is
    2.55 which is 39% higher than 2004. The disease is
    unequally distributed throughout the country. Leprosy is still
    a public health problem in 8 cities ( Laoag, Candon, Vigan,
    San Jose, Cagayan de Oro, Oroquieta, Iligan, and Isabela)
    and 5 provinces ( Ilocos Norte, Ilocos Sur, Basilan, Sulu
    and Tawi-Tawi).
    Leprosy is an ancient disease and is a
    leading cause of permanent physical
    disability among the communicable
    diseases. It is a chronic mildly
    communicable disease that mainly
    affects the skin, the peripheral nerves,
    the eyes and mucosa of the upper
    respiratory tract.
    Over view of Pathophysiology
    Leprosy, also known as Hansen's disease, is a chronic infectious
    disease caused by Mycobacterium leprae, a microorganism that has a
    predilection for the skin and nerves. The disease is clinically
    characterized by one or more of the three cardinal signs:
    hypopigmented or erythematous skin patches with definite loss of
    sensation, thickened peripheral nerves, and acid-fast bacilli detected on
    skin smears or biopsy material. M. leprae primarily infects Schwann
    cells in the peripheral nerves leading to nerve damage and the
    development of disabilities.
    Sign and Symptoms
    a. Early Signs and Symptoms
    > Change in Skin color – either reddish or white
    > Loss of sensation on the skin lesion
    > Decrease/loss of sweating and hair growth over the lesion
    > Thickened and or painful nerves
    > Muscle weakness or paralysis of extremities
    > Pain and redness of the eyes
    > Nasal obstruction or b;eeding
    > Ulcers that do not heal

    b. Late Signs and Symptoms


    > Loss of eyebrow – Madarosis
    > Inability to close the eyelids – lagopthalmos
    > Clawing of fingers and toes
    > Contractures
    > Sinking of the nosebridge
    > Enlargement of the breast in males or gynecomastia
    > Chronic ulcers
    Infectious Agent
    Mycobacterium Leprae an acid fast, rod – shape bacillus which can be detected by Slit Skin Smear

    Method of transmission
    > Airborne – inhalation of droplets/spray from coughing or sneezing of untreated leprosy patient
    > Prolonged skin to skin contact

    Diagnosis
    Diagnosis of leprosy is currently based on clinical signs and symptoms especially if there is history of
    contact with person with leprosy. Only in rare instances is there really a need to use laboratory and
    other investigations to confirm a diagnosis
    Susceptibility
    Children especially 12 yrs old and below are more susceptible

    Prevention
    > Avoidance of prolonged skin to skin contact especially with a
    lepromatous case
    > Children should avoid close contact with active untreated leprosy
    case
    > BCG vaccination
    > Good personal hygiene
    > Health education

    Management/ Treatment
    >Ambulatory chemotherapy through use of Multi Drug Therapy
    > Domicilliary treatment as embodied in R.R.4073 which advocates
    home treatment
    WHO Classification of Leprosy which is the basis of modern
    management or Multi Drug Therapy:
    > Paucibacillary (tuberculoid and indeterminate)
    Non infectious types
    Duration of treatment 6 to 9 months
    > Multibacillary ( Lepromatous and borderline)
    Infectious type
    Duration of treatment 24 to 30 months
    Public Health Nurse Responsibilities
    Prevention
    > Health education of patients, families and the community
    > Advocate Healthful living
    > BCG vaccination

    Casefinding
    >recognize early signs and symptoms
    > takes patient family history and fills up patients records
    > conducts epidemiological investigation and report finding to MHO
    > assists physician in physical examination of patients in the clinic or
    home
    >assess the health of the family members and other household
    contacts
    > integrates casefinding leprosy cases in other activities
    Management and Treatment
    > Promote healthy living
    >Help the patient and the family understand and accept the problem brought by
    the disease
    > Provides and arranges for provision of nursing care of patients at home
    > Prevents secondary injury
    > Guides and support patients and family throughout the treatment
    > Gives mental and emotional support
    > Refers the patient to other health and allied workers

    Rehabilitation
    > Helps create a congenial atmosphere essential to progressive recovery
    > Must be kind and maintain attitude of professional concern and interest
    > Encourage patients participation in occupational activities suited to hi interest,
    experience and capacity
    > Refers patient to other persons/agencies who can help his/her physical,
    mental and social rehabilitation
    Family health
    Promote family health by:
    > Providing information education to patient and his her family on family
    planning anf nutrition
    > Encourage utilization of available family planning and nutrition service
    > Providing counseling and guidance

    Community Health
    > Participates in community assemblies and shares information on leprosy and
    its management
    >Participates in seminars, workshops, consultative meetings of other Gos and
    NGOs on leprosy control
    > Participate in tri media dissemination of leprosy facts and NLCPMDT program

    Training, Supervision and Research


    > Conducts orientation of student nurses, midwives and other students on
    leprosy and its management
    > Participates in orientation of new RHU/BHS staff on leprosy and its control
    > Participates in studies on leprosy and its managements

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