The World Health Organization reports that at the beginning of 2005, the number of leprosy patients under treatment throughout the world was approximately 300,000 (Leprosy pp). During 2004, roughly 400,000 new cases were detected, among them, 47% were multibacillary cases, 12% were children, and 4% were diagnosed with severe disabilities (Leprosy pp). During the past three years, the global number of new cases detected has continued to decrease at a reduction rate of about 20% a year (Leprosy pp). Although leprosy control efforts have intensified, full control of the disease has eluded many parts of Angola, Brazil, India, Madagascar, Mozambique, Nepal, and the United Republic of Tanzania (Leprosy pp).
Until AIDS came into existence, leprosy was the most feared of infectious diseases (Storrs pp). It is called the "big disease" by many Asians and Africans because of the damage done to soul and body (Storrs pp). Since time immemorial, leprosy has afflicted humanity, and at one time it affected every continent (Leprosy pp). Throughout the ages, it has left behind a terrifying image in history and human memory of mutilation, rejection and exclusion from society (Leprosy pp). It has been striking fear in human beings for thousands of years, and was recognized in the oldest civilizations of China, Egypt and India (Leprosy pp). Over the millennia, the cumulative total of the number of individuals who have suffered the incurable disfigurement and physical disabilities of this disease can never be calculated (Leprosy pp). Leprosy has always been regarded by the community as a contagious, mutilating and incurable disease, and even today there are many countries in Asia, Africa and Latin America with a significant number of leprosy cases (Leprosy pp). There is an estimated one to two million people who are visible and irreversibly disabled due to past and present leprosy, and require to be cared for by their communities (Leprosy pp).
Leprosy is a chronic granulomatous disease, caused by Mycobacterium leprae, an obligate intracellular acid-fast bacillus, which affects principally the skin and peripheral nervous system (Harrop pp). The M. leprae was first discovered by Armauer Hansen in Norway in 1873, and was the first bacillus to be associated with human disease, yet, it was not initially believed to be an infectious disease (Harrop pp). Animal reservoirs of leprosy have been found in three species: nine banded armadillos, chimpanzees, and mangabey monkeys (Harrop pp).
The most common areas affected by leprosy are the superficial peripheral nerves, skin, mucous membranes of the upper respiratory tract, anterior chamber of the eyes, and testes, areas that tend to be cooler parts of the body (Harrop pp). Tissue damage is caused by the degree to which "cell-mediated immunity is expressed, the extent of bacillary spread and multiplication, the appearance of tissue-damaging immunologic complications (ie, lepra reactions), and the development of nerve damage and its sequelae" (Harrop pp).
There are approximately 6,000 patients with leprosy in the United States, of which 95% acquired the disease in developing countries (Harrop pp). There are roughly 200-300 cases reported in the United States each year, with the largest proportion of new cases found in states with large immigrant population, such as California, New York, and Florida, and small endemic foci existing in Texas, Louisiana, and Hawaii (Harrop pp).
Severe cases of leprosy that are left untreated can cause significant debilitating deformity, however, antibiotic treatment has dramatically improved patients' outcomes, and early diagnosis and effective antimicrobial treatment can arrest and even cure the disease (Harrop pp). Leprosy occurs in all races, however, the majority of affected persons live in the tropics and subtropics, and is found more often in rural areas than urban (Harrop pp). African blacks report a higher incidence of tuberculoid form of leprosy, while people with light skin and Chinese individuals have a higher incidence of lepromatous type of leprosy (Harrop pp). In adults, the lepromatous type of leprosy is more common in men than women, with a male-to-female ratio of 2:1, and in children, the…