Nigeria records over 2,000 leprosy cases annually, say experts

As Nigeria joins the global community today to mark the 2024 World Leprosy Day, medical experts say the disease is still a major problem in the country, estimating that over 2,000 cases are recorded annually.

The experts lamented that the lack of accurate information about the disease had led to widespread stigma and discrimination against people with leprosy.

According to them, many people still believe that leprosy is a highly contagious disease, and therefore afraid of coming in contact with those that have it.

World Leprosy Day is observed internationally every year on the last Sunday of January to increase public awareness of leprosy or Hansen's Disease.

‘Beat Leprosy' is the theme for the 2024 celebration, which aims to sum up the day's two main goals of eradicating the stigma attached to the disease and advancing the dignity of those who are impacted by it.

The World Health Organisation described leprosy, which is also known as Hansen's disease, as a chronic infectious disease caused by a type of bacteria known as Mycobacterium leprae.

The global health body explained that the disease, which predominantly affects the skin and peripheral nerves, may cause progressive and permanent disabilities if left untreated.

According to the WHO, the disease is transmitted through droplets from the nose and mouth. Prolonged, close contact over months with someone with untreated leprosy is needed to catch the disease.

Symptoms include light-coloured or red skin patches with reduced sensation, numbness and weakness in hands and feet.

Speaking with PUNCH Healthwise in commemoration of the 2024 World Leprosy Day, the physicians called for more public awareness campaigns about the disease, including accurate information about how it is transmitted and how it can be treated.

While stressing that there has been an improvement in treatment with the introduction of multidrug therapy for leprosy patients, the experts noted that there are growing concerns that involve a low index of leprosy suspicion, low leprosy detection, ongoing transmission, and recycling of leprosy cases amidst dwindling clinical skills.

A Consultant Dermatologist and Venereologist, Dr Sebastine Oiwoh, said Nigeria is still among the 17 countries that still report more than 1,000 cases of leprosy annually.

Oiwoh, who is the Chairman, National Committee on Neglected Tropical Diseases, stressed the need to deal with the social and psychological problems associated with leprosy.

The dermatologist stated that leprosy is an ancient infection plaguing man, maintaining that the disease should be picked at the earliest possible time and not when it had caused disabilities.

Quoting the 2022 data from the National Tuberculosis, Leprosy, and Buruli Ulcer Control Program, the physician said 2,393 new cases were recorded with the majority having multibacillary leprosy.

He added that the data showed that more than a third of females (37 per cent) and less than a tenth of children (6 per cent) were affected.

The dermatologist explained, “Leprosy is a chronic stigmatising bacterial infection that mainly affects the skin and nerves but can affect other body parts. It is a disabling or deforming infection if care is not taken.

“It can be classified going by the extreme ends of the spectrum of its presentations into lepromatous leprosy and tuberculoid leprosy but there are other types between the two types mentioned above that we know as borderline varieties.

“It is important to say that there has been improvement with the introduction of multidrug therapy for leprosy patients. However, there are ongoing concerns that involve a low index of leprosy suspicion, low leprosy detection, ongoing transmission, and recycling of leprosy cases amidst dwindling clinical skills.”

The physician, however, said there was  a need to stop the stigmatisation associated “with this highly disabling yet curable infection means the dignity and respect that are deserved should be accorded to all patients with leprosy. Their human rights to access and afford timely, effective, and efficiently safe health care must never be denied.”

On the symptoms and signs, the dermatologist explained, “It is advocated that leprosy should be picked at the earliest possible time, not when there are disabilities.

“Those pale-coloured/copper-coloured/reddish skin rashes where the sensation of pain is lost with little to no sweating may just be what is needed for early diagnosis.

“Swollen nerves especially around the elbow, knee, and sides of the neck accompany other symptoms and signs of leprosy. There can also be temperature loss (hot or cold), light touch, and pain, especially on the hands and feet. This may show first as painless ulcers or burns on these sites that last longer than expected to heal.

“Other presentations may also include swellings (papules and nodules), ulcers (neuropathic ulcers), abnormal nerve functions like numbness among others, inability to close the eyes because of paralysis of the upper eyelid (lagophthalmos), etc.”

He added that concerted efforts by everyone will help eliminate leprosy.

He stressed, “Appropriate clinical care, social and psychological support to persons with leprosy is paramount stopping the stigmatisation and social ostracization for which the infection has been known in the past when there was no available cure.”

Corroborating his statement, an epidemiologist at Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Dr. Tope Agboola, explained that in the past, people with leprosy were often ostracised and isolated from society, but this is no longer the case.

According to Agboola, while there is still much work to be done to eradicate leprosy, the efforts of the government and international organisations such as the WHO have been making a positive impact.

The epidemiologist stressed that sustained efforts and investment are needed to fully eliminate leprosy in Nigeria, noting that early detection and treatment of the disease can prevent disability and improve quality of life.

She emphasised the need for a multi-sectoral approach to addressing the problem of leprosy, including involvement from the education, health, and social sectors.

While acknowledging the progress made so far, she maintained, “Leprosy is a curable disease, but it requires a long-term commitment to tackle the root causes and ensure that everyone has access to the care and support they need.

“We need to continue to invest in public health infrastructure and ensure that the needs of people with leprosy are prioritized in the country's development agenda.

“Leprosy is a complex issue that requires a holistic response. It is not just a medical problem, but also a social and economic issue. We need to ensure that people with leprosy have access to education and employment opportunities, as well as the necessary social support.”

Agboola noted that stigma and discrimination against people with leprosy are still major challenges in Nigeria, and more work needs to be done.

To address the problem of stigma, she stressed the importance of raising awareness about the disease, as well as changing attitudes and beliefs.

“It is not enough to simply provide medical care, we also need to address the societal factors that perpetuate the stigma against people with leprosy,” she concluded.