Global drug researchers are closely working to develop newer drugs which could cure leprosy totally. At present, medications with steroids have been used to treat nerve damage associated with leprosy but the studies have demonstrated no additional benefit.
Specialists at the Hokkaido University in Japan, in collaboration with Kissei Pharmaceutical organization have been trying to develop newer drugs with fluoroquinolones, said Dr. Ravikeerthy M, Consultant, and HOD, Department of Internal Medicine, Gleneagles Global Hospital, Bengaluru.
On the occasion of the World Leprosy Day on January 28 with the theme as ‘Beat Leprosy,’ there is need to bring awareness and prevent disabilities. India stands fourth all around in prevalence of this disease and social stigma has led to delayed medical intervention.
Leprosy is curable through multidrug treatment. It is a granulomatous disease caused by Mycobacterium Leprae, acid-fast bacilli.
It mainly involves damage to the skin, eyes, nerves and respiratory system. Visible disabilities and sequela are associated with the historical social stigma of this disease. It is also called as Hansen’s disease.
As these bacteria are slow growing, and difficult to isolate in vitro cultures, sometimes symptoms may appear as long as 20 years after contraction of the disease.
WHO has introduced MDR with Rifampicin, Clofazimine, and Dapsone. Novartis has been the world’s largest supplier of these drugs and supports leprosy treatments globally.
New drugs that are approved the treatment are Quinolones like Pefloxacin and Ofloxacin, Minocycline and Clarithromycin. Free MDT was at first funded by The Nippon Foundation, and since 2000 it is donated through an agreement with Novartis which recently committed to extending its donation to 2020. At present not much of clinical trials are being done for drugs in India, he added, he included.
Globally 4 million patients have the disease and 7,50,000 new cases are detected every year. Off these, 70% patients are from India. The epidemic is present in many countries of Asia, Africa, and Latin America, such as Angola, Bangladesh, Brazil, China, the Democratic Republic of the Congo, Ethiopia, Indonesia, Madagascar, Mozambique, Myanmar, Nepal, Nigeria, Philippines, Sri Lanka, Sudan, and the United Republic of Tanzania. During 2016, 2,743 cases of leprosy relapse were reported by 54 countries. Brazil reported 1431 cases, India 536 and Indonesia 229; the remaining 547 cases were reported by 51 countries, said Dr. Ravikeerthy.
The incidence in India is declining through the National Leprosy Eradication program. In 2005, India achieved elimination of leprosy as a public health problem. Notwithstanding, it reported the largest number patients and pockets of high endemicity report a huge number of new cases every year.
In 2015, 127 326 new cases were detected accounting for 60% of the global new cases, compared with 125 785 new cases in 2014. Delhi, Lakshadweep, Chandigarh, and Odisha, reported increased prevalence a year ago. Leprosy is more common in males than in females.
Its diagnosis depends on the clinical signs and symptoms which are easy to observe and elicit by any health worker after a short period of training. In order to diagnose this condition, a skin biopsy, nasal smears, or both are used to evaluate for acid-fast bacilli using the Fite stain.
PCR and recombinant DNA technology have allowed for the development of gene probes with M leprae–specific sequences, said Dr. Ravikeerthy.