Leprosy treatment: reality or myth?

There is a myth that quite a number of people believe, even in Nigeria: that leprosy cannot be treated – this is not true. Leprosy can be treated. As a matter of fact, it is easy to treat.

• In 1995, the World Health Organisation (WHO), developed a multi-drug therapy that cures all forms of leprosy. The leprosy drugs are available for free all over the world, including Nigeria. And about 16 million people who were suffering from leprosy have been treated in the last 20 years. The multi-drug therapy involves the use of two or more antibiotics in treating leprosy. The antibiotics used kill the leprosy-causing bacteria (Mycobacterium leprae). They work well as they stop the disease from progressing.
• It is preferable to use two or more antibiotics at the same time to prevent the leprosy bacteria from developing resistance to the drugs. Leprosy treatment depends on the type of leprosy – in other words, the form of leprosy determines the duration of administration of the drugs, the dosages, as well as, the antibiotics to be given. The antibiotics are given to treat the leprosy infection for about six months to one year. Severe leprosy is treated with antibiotics for a longer time than the milder form of leprosy because it contains a larger number of the leprosy-causing bacteria.
• The three antibiotics used in treating multibacillary (severe) leprosy are clofazimine, dapsone, and rifampicin. While two antibiotics are used in treating pauciballary (milder) leprosy – they are rifampicin and dapsone. Rifampicin is included in the treatment of multibacillary and paucibacillary forms of leprosy because it is the most important anti-leprosy drug.
• The reason some people think that leprosy cannot be treated is that the damage, disabilities and some of the disfigurement caused by leprosy (in its advanced stages) cannot be reversed – they are permanent. The anti-leprosy drugs stop the disease from progressing further but they do not reverse the damage that has been done. So, after the infected person has completed his/her treatment, the person no longer has leprosy (although he/she still has certain disabilities caused by the disease). The damage that has been done by the disease before the drugs are taken cannot be reversed (example: nerve damage). Therefore, it is important to start leprosy treatment early before the damage occurs.
• For leprosy treatment to be successful, the person has to take the drugs strictly following instructions given by the doctor.
• Plastic/cosmetic surgeries can be carried out for people who had leprosy. But it should be done when skin smear tests reveal that there are no detectable leprosy bacteria, and also after the person has finished taken the antibiotics prescribed by the doctor and has been pronounced cured.
• Surgeries may also be done to try and repair neural and muscle function.
• Sometimes amputation of certain affected parts of the body is necessary.

After treatment, those who have suffered from leprosy should be followed up because a small percentage of people can relapse.