Hitaa Gandhi

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Leprosy (Hansens Disease)

• Hitaa Gandhi

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What is Leprosy?

• It is a disease
• World's oldest recorded disease
• Stigmatized disease
• Gerhard Henrick Armauer Hansen

Every year January 27 is World Leprosy Day
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What causes it?

• Mycobacterium leprare
• Rod Shaped
• First bacterium disease in humans
• Humans and Armadillos are only known natural hosts

http//www.aaas.org/news/releases/2005/images/0512
leprosy.jpg
http//www.worldproutassembly.org/leprosy20patien
t20holding20flower.jpg
http//genomenewsnetwork.org/articles/02_01/Lepros
y.shtml
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Types of Leprosy

• Depending on clinical features, leprosy is
  classified as
• Indeterminate Leprosy (IL)
• Paucibacillary Leprosy (PB)
• Borderline Tuberculoid Leprosy (BT)
• Borderline borderline Leprosy (BB)
• Borderline lepromatous Leprosy (BL)
• Multibacillary Leprosy (MB)

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What are the symptoms?

• Paucibacillary (PB) Leprosy symptoms are
• Well defined skin lesions that are numb
• Multibacillary (MB) Leprosy symptoms are
• Chronically stuffy nose and many skin lesions and
  nodules on both sides of the body

• Mycobacterium leprare multiplies very slowly
• Symptoms can take as long as 20 years to appear

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Who is at risk?

• It can affect all ages and both sexes

• 95 of people who are exposed do not develop

• Mainly affects
• Skin
• Eyes
• The peripheral nerves
• Mucosa of the upper respiratory tract

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Who is at risk?
bp2.blogger.com/.../s320/lepromatous_leprosy.jpg
http//www.leprosymission.org/web/pages/leprosy/im
ages/girlwithleprosypatch.jpg
http//microbes.historique.net/images/lep3.jpg
http//www.leprosymission.org/web/pages/leprosy/le
prosy.html
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Goals of Treatment

• Major goals of treatments are

• Early detection of patients
• Appropriate treatment
• Adequate care for the prevention of disabilities
  and rehabilitation

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Pharmaceutical Treatment

• Multiple Drug Treatment (MDT)

• There are several effective chemotherapeutic
  agents
• Dapsone (diaphenylsulfone, DDS), Rifampicin
  (RFP), Clofazimine (CLF), Ofloxacin (OFLX), and
  Minocycline (MINO) constitute the backbone of the
  multidrug therapy (MDT) regimen.

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Treatment

• Drug Dapsone was introduced in early 1940s.
• In the early 1950s resistance to Dapsone was
  discovered
• In the early 1960s the other two (2) components
  of MDT Rifampicin and Clofazimine were discovered
  and later introduced as part of the treatment

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Structure of Dapsone (DDS)
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About Dapsone

• It was dicovered by German chemists Fromm and
  Wittmann in 1908
• Was not utilized as a treatment until decades
  later
• Available in 25mg 100 mg tablets
• Rated a pregnancy risk category C by the American
  Food and Drug Administration

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Structure of Rifampicin
http//images.google.com/imgres?imgurlhttp//www.
bmb.leeds.ac.uk/mbiology/ug/ugteach/icu8/images/an
tibiotics/nitrofurantoin.gifimgrefurlhttp//www.
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About Rifampicin

• In the U.S. Rifampicin is marketed as
• Rifadin (Aventis)
• Rifater ( in combination with isoniazid and
  pyrazinamide) (Aventis)
• Rimactane (Novartis)
• Do not wear contact lenses while taking
  Rifampicin
• Rated a pregnancy risk category C by the American
  Food and Drug Administration

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Structure of Clofazimine
http//www.rxlist.com/images/rxlist/clofazimine_s.
gif
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About Clofazimine

• Brand Name Lamprene Generic Name Clofazimine
• Initially known as B663, was first synthesized in
  1954 by Dr. Vincent Barry and his team as an
  anti-tuberculosis drug
• Is marketed under the trade name Lamprene by
  Novartis
• Rated a pregnancy risk category C by the American
  Food and Drug Administration

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Dosage
http//images.google.com/imgres?imgurlhttp//uplo
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/en.wikipedia.org/wiki/Leprosyh258w400sz24h
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Dosage Contd......
Multidrug Therapy for Paucibacillary (PB) Leprosy
PB patients treated with MDT are cured within six
months
RFP monthly doses are given under supervision
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Dosage Contd......
Multidrug Therapy for Multibacillary (MB) Leprosy
MB patients treated with MDT are cured within 12
months
RFP and CLF monthly doses are given under
supervision
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Cost of MDT

• Since 1995, WHO has supplied MDT FREE of cost to
  all leprosy patients in the world.
• Initially drug funds were provided by Nippon
  Foundation
• Since 2000, donations are provided by Novartis
  and the Novartis Foundation for Sustainable
  Development

FREE
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Side Effects

• Occasional cutaneous eruptions
• A slight reddish coloration of urine, sweat, and
  tears
• Brownish Black discoloration and dryness of skin

• Dapsone (DDS)
• Rifampicin (RFP)
• Clofazimine (CLF)

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Cases in US
http//www.hrsa.gov/hansens/images/30years.gif
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Cases around the World
http//upload.wikimedia.org/wikipedia/commons/9/91
/Lepra_2003.png
A 20 annual decrease in new cases detected
globally since 2001
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A Day in the Patients Life
Mother Teresa
http//i193.photobucket.com/albums/z96/whengzky/FR
20Joy20pix/641c.jpg
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To Be Researched.....

• Interview a doctor who recently started
  treatment for a Leprosy patient
• How the drugs work?
• How does all the 3 drugs work in conjunction?

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Leprosy (Hansens Disease)
Questions

• Hitaa Gandhi