Most of us think of leprosy as an ancient disease, the afflicted banished to colonies cut off from society. It still lingers today, but is being cornered, treated and cured through creative medical approaches.
Researchers at USF鈥檚 (COPH) are moving closer to helping eliminate the disease by focusing on cases in Ecuador. A report of their findings, 鈥�,鈥� was published in the journal Tropical Medicine and Infectious Disease.
Although Ecuador has effectively applied global guidelines for the control of leprosy in the past quarter century, a few cases remain in some parts of the country, said Santiago Hernandez-Bojorge, lead author of the study and a COPH PhD candidate in global communicable disease.
Image captured during a training that occurred at the Gorgas Diploma Course in Peru. (Photo courtesy of Dr. Izurieta)
鈥淲hile tangible progress is being made, continued efforts are needed to halt the transmission of leprosy in Ecuador and ultimately reach the goal of leprosy elimination,鈥欌�� he said. 鈥淚t鈥檚 imperative to maintain surveillance, prevention and control strategies in regard to higher risk of leprosy detection and protecting the most vulnerable populations.鈥欌��
Leprosy 鈭� also called Hansen's disease 鈭� is a chronic infectious condition caused by the bacteria Mycobacterium leprae. Its symptoms are skin lesions, loss of sensation, thickened and painful nerves, blindness, disfigurement and ulcers on hands and feet. People affected by the deformity of leprosy for centuries have faced stigmatization and discrimination. But the disease can be prevented and people treated in the early stages can avoid serious disfigurement.
In their study, the USF researchers note that Ecuador has gone through a significant reduction in new cases, from 106 to 12 over a 23-year period, according to data collected from the Ecuadorian Ministry of Public Health. This suggests 鈥渁 trend towards zero leprosy鈥欌�� in that country.
鈥淚t鈥檚 extremely important to study the distribution of leprosy in Latin America, especially Ecuador, which has been shown to effectively apply global guidelines for the control and elimination of leprosy in the past two decades,鈥欌�� Hernandez-Bojorge said.
Image captured during a training that occurred at the Gorgas Diploma Course in Peru. (Photo courtesy of Dr. Izurieta)
Globally, leprosy can be an elusive challenge, one reason for its classification as a Neglected Tropical Disease (NTD). It has one of the highest numbers of incidence cases annually 鈥� more than 200,000 鈭� when compared to other NTDs around the world, the report states.
鈥淟eprosy is one of the 21 NTDs caused by a variety of pathogens and associated with devastating health, social and economic consequences,鈥欌�� Hernandez-Bojorge added. 鈥淚t is estimated that NTDs affect more than 1 billion people, while the number of people requiring NTD interventions is 1.6 billion.鈥欌��
Leprosy is categorized as neglected because it has been almost absent from the global health agenda. NTDs have very limited resources and are almost ignored by global funding agencies. These diseases can be found primarily among poor populations with limited education and health systems.
While one out of five people worldwide are at risk of contracting one of these diseases, Hernandez-Bojorge said 鈥渕any people aren鈥檛 aware of the existence of NTDs.鈥欌��
The USF report follows in the footsteps of a 2021 World Health Organization strategy called Towards Zero Leprosy, a road map to break the chain of transmission and eliminate the disease. Specific targets under this strategy include the reducing of indigenous leprosy cases to zero in 120 countries, a 70% reduction in the annual number of new cases, and a 90% reduction in the rate per million of new child cases. According to WHO, this can happen through active monitoring for early case detection and by administering multidrug therapies.
Other contributing authors from USF include Jeegan Parikh; Dr. , COPH associate professor; Neil Rupani; and Dr. Ismael Hoare, COPH alumnus and associate professor.