Management of leprosy patients in the era of COVID‐19

Abstract

Leprosy or Hansen's disease (HD), a chronic granulomatous infection caused by the intracellular parasite Mycobacterium leprae or Mycobacterium lepromatosis, has affected humans for more than 4000 years with high degree of stigmatization even now. Leprosy is dominantly a disease of peripheral nerves, skin, and mucosa. Upper respiratory tract impairment has been reported in the majority of leprosy patients as M. leprae spread through droplet infection. Idris et al noted that M. leprae invasion into microvessel endothelial cells occurs before invading the Schwann cells, and the most important region for M. leprae to invade microvessel endothelial cells is identical to the region involved in the invasion into nasal mucosa epithelial cells. 1

Epidemiology of leprosy in China, 2021: an update

“…The current situation of leprosy cases in China in 2021 was similar to that in 2020, which might be attributable to the hindrance of the discovery and tracking of leprosy cases during the COVID-19 pandemic. [14][15][16] In 2021, the detection rate of leprosy globally was 17.8 per million, which was 66 times higher than the rate in China (0.27 per million). 6 This demonstrates that leprosy is in a relatively low endemic situation in China.…”

“…The current situation of leprosy cases in China in 2021 was similar to that in 2020, which might be attributable to the hindrance of the discovery and tracking of leprosy cases during the COVID-19 pandemic. 14-16…”

Nano Based Approach for the Treatment of Neglected Tropical Diseases

“…Currently, research has been taken place in all five interventions; however, several of these NTDs can be controlled with a mass treatment using chemotherapeutics (Lustigman et al, 2012). For instance, rifampicin and streptomycin (buruli ulcer) (Phillips et al, 2020), benznidazole and nifurtimox (chagas disease) (Jackson et al, 2020), acetaminophen (dengue) (Ferreira et al, 2020), metronidazole or thiabendazole (dracunculiasis) (Horton, 2017), albendazole (echinococcosis) (Darvishi et al, 2020), amphotericin B (leishmaniasis) (Berenguer et al, 2020), rifampicin, clofazimine and dapsone (leprosy) (Abdelmaksoud and Gupta, 2020). It is really important that people who are affected by any of the NTDs are handled exactly as prescribed, finish the prescription, and take the complete medications.…”

Impact of the coronavirus disease 2019 on the diagnoses of Hansen's disease in Brazil

“…HD is an infectious, chronic, and granulomatous disease caused by Mycobacterium leprae (with high infectivity and low pathogenicity), which was quite prevalent in Europe during the 16th century and currently affects 200,000 people globally 1,8 . Clinically, HD cases are classified as paucibacillary (PB), with up to five lesions on the body, or multibacillary (MB), with more than five lesions; the latter has greater potential for transmission due to the high bacillary load and the spread of bacillus through the upper airways 1,8 . HD mainly affects the peripheral nervous system, skin, and mucosa, with symptoms varying depending on the immune response of the patient to bacterial infection.…”

“…During transmission by droplets, Mycobacterium leprae affects the nasal mucosa capillary endothelial cells and, subsequently, reaches the Schwann cells of the nervous system. This way, infection of the olfactory bulb can occur and lead to olfactory dysfunction, which is clinically characterized as hyposmia or anosmia and is similar to some of the symptoms of COVID-19 8 .…”