New treatment for persons exposed to Hansen’s Disease

New treatment for persons exposed to Hansen’s Disease

In response to the World Health Organization (WHO)’s Global Leprosy Strategy 2016-2020, the Ministry of Health, through its Hansen’s Disease Control Unit (HDCU), will introduce Post-Exposure Prophylaxis (PEP) to persons in close contact with Hansen’s disease patients.

 

Previously, only persons who were diagnosed with Hansen’s disease received the complete        Multi Drug Therapy (MDT) treatment regimen. Under this new treatment regimen, persons who are confirmed to have the disease will continue to receive the complete MTD treatment.

Additionally, as a preventative measure, persons who are exposed to the disease will now be offered the Single Dose Rifampicin (SDR) after proper evaluation of eligibility.

 

SDR is an antibiotic that is already widely used in the management of mycobacterial infections, including in the treatment of Leprosy and Tuberculosis. This drug will be given to persons who voluntarily give consent.

 

Furthermore, from 2021, HDCU will engage in active case mapping of cases detected from 2012 to date, using the Ministry’s Geographic Information System (GIS). This will not only assist in stopping the transmission of Hansen’s disease, but will also improve care for persons affected.

 

For more than 40 years MDT has an unparalleled record of success globally in terms of efficacy, safety and prevention of emergence of resistant strains. By 2005, the use of MDT reduced the rate of new case detection to less than one per 10,000 population in all countries.

 

However, after 2005, the new case detection rate did not reduce as expected in spite of having a highly effective treatment for Hansen’s disease. To address the slow decline in new case detection and the higher occurrence of Hansen’s disease in contacts of existing cases of Hansen’s disease, WHO published the following two documents. The Ministry has based its new treatment on these WHO guidelines:

  1. Guidelines for the diagnosis, treatment and prevention of leprosy (2018); a first-time evidence-based treatise.
  2. The Technical Guidance on Leprosy/Hansen disease: Contact tracing and post-exposure prophylaxis (2020).

Hansen’s disease is a chronic disease caused by a type of bacteria called Mycobacterium leprae that mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and the eyes.

·         The disease spreads through droplets from the nose or mouth of a patient to the skin and respiratory tract of another person. Transmission requires close and frequent prolonged contact with an untreated, infected person. About 95% of people have natural immunity against Hansen’s disease.

·         The bacteria multiply slowly, and the average time from exposure to the bacteria to development of symptoms is 5 years. In some cases, symptoms may occur within 1 year, but can also take as long as 20 years to occur.

·         Hansen’s disease is curable with multidrug therapy (MDT), and treatment in the early stages can prevent disability.

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