THOUSANDS of people are still being diagnosed with leprosy in Nepal and other countries in South-East Asia each year, even though the disease has been officially declared eliminated.
Charities working in the region fear that the impact of the pandemic means that many more people with leprosy will come forward too late, when they are already facing life-changing disabilities.
Leprosy has been most prevalent in crowded and impoverished communities, but can be cured if treated early, avoiding disability.
The St Francis Leprosy Guild said that in Nepal alone, 2304 cases of leprosy were diagnosed in 2020 — a fall on the previous year, because doctors on their diagnosis programmes had to switch to working on the pandemic. The real figure was likely to be similar to that of 2019, when 3844 new cases were diagnosed.
Globally, about 200,000 leprosy cases are diagnosed each year, mostly in South-East Asia.
Clare McIntosh, from the Guild, said that the declaration of the elimination of leprosy, made by Nepal in 2010, had been disastrous for sufferers, as money had been directed away from diagnosis and treatment, even though the disease was still “festering away” in many areas.
“My greatest fear is that people with leprosy who are undiagnosed and untreated will pass on the disease to others in their community, or go on to develop terrible disabilities,” she said.
“Historically, when the term ‘leprosy elimination’ has been used at a national, regional, or global level, it hides the fact that leprosy still exists, undiagnosed, at a local level, in hidden, endemic pockets.
“I urge any government to think long and hard before declaring that any disease no longer exists at a general or statistical level, whether it’s Covid-19 or leprosy. Our experience with leprosy shows that it can hide, undiagnosed, without symptoms, years before slowly re-emerging, with disastrous consequences.”
Dr Ramesh Sharma, a dermatology consultant at Green Pastures Hospital, Pokhara, in central Nepal, works in partnership with the Guild and treats many leprosy patients.
He said: “When elimination was declared in 2010, our NGO partners and donors withdrew their interest and their funding. Today, our hospital is packed full of people needing treatment for leprosy.”
Experienced health-care professionals could struggle to diagnose leprosy in its early stages, when the disease was easily confused with scabies, psoriasis, or other skin disorders, Dr Sharma said.
“Even dermatologists can misdiagnose leprosy, and the younger doctors have never been exposed to leprosy. Who is going to suspect a disease that has been declared eliminated?”
The Guild runs programmes to seek out people suffering from leprosy. Sufferers tend to hide symptoms, because of the stigma attached to the disease, particularly in India and Nepal, where known sufferers may be ostracised and forced to leave their homes.