After years of conflict, the Federal Republic of Somalia is revitalizing its health infrastructure to enhance the reach of services to people in need in all parts of the country. As part of this, the Neglected Tropical Diseases (NTD) unit was reconstituted which is taking care of leprosy. Active leprosy case finding campaigns were taken up, initially covering camps of internally displaced persons (IDP) and subsequently expanding to other affected regions in the country. WHO provided technical know-how and channelled funding for the campaigns made available from The Nippon Foundation. Close to 5000 new leprosy cases were detected in a span of less than four years; the number of patients increased from 107 in 2015 to 2610 in 2018.
On 29 January 2019, WHO’s disease surveillance focal point in north-east Syria informed the WHO country office (WCO) in Damascus of a suspected case of leprosy in Al-Hol camp, Al-Hasakeh governorate. The patient, an eight-year old girl, had recently arrived at the camp and had no history of treatment for the disease. Her symptoms included loss of sensation in both palms, resorption of fingers and early collapse of nose. WHO immediately shared its leprosy guidelines with the physicians investigating the case. The diagnosis was confirmed. The patient and her family had been displaced several times in the area near the Iraq-Syria border. Al-Hol camp has admitted approximately 27 000 people over the past two months. Most new arrivals have been from areas controlled by the Islamic State of Iraq and the Levant.
Informal consultation on treatment of reactions and prevention of disabilities in leprosy 11-13 December 2018; Chennai, India
Reactions are acute exacerbations of signs and symptoms of leprosy occurring during the natural history of the disease affecting skin, nerves, eyes, limbs. Left untreated or improperly managed, reactions can lead to nerve function impairment and subsequently to disabilities affecting hands, feet and eyes. Reactions and neuritis remain an enigma for many frontline health staff treating leprosy. The problem is more noticeable in an integrated health care setting. Data collected from national programmes showed that 7332 patients were treated for Type 1 reaction (also known as reversal reaction) and 5370 patients have been treated for Type 2 reactions (or erythema nodosum leprosum).
The Global Leprosy Programme has released the Guidelines for the diagnosis, treatment and prevention of leprosy. The Guidelines provide state-of-the-art knowledge and evidence on leprosy diagnosis, treatment and prevention based on a public health approach in low and middle-income countries. The target audience of this document includes policy-makers in leprosy or infectious diseases in the ministries of health (especially but not limited to endemic countries), nongovernmental organizations, clinicians, pharmaceutical companies, donors and affected persons. These leprosy guidelines have been developed by strictly following WHO's GRADE approach wherein all available evidence published in English has been taken into consideration. Funding support for their development was received from The Nippon Foundation.
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Leprosy in WHO Regions
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