NTA Level 4 • Semester 1 • PST04102

Identification of Patients with Leprosy

Disease Control and Prevention • Source Session/Topic 29

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Session 29: Identification of Patients with Leprosy

Total Session Time: 120 minutes + 2 hours Assignment

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• Describe Cause(S) of Leprosy

• Describe Mode of Transmission of Leprosy

• Describe Major Signs and Symptoms of Leprosy

• Explain Treatment of Leprosy

• Explain Prevention and Control of Leprosy

Resources Needed

• Flip charts, marker pens, and masking tape

• Black/white board and chalk/whiteboard markers

• Computer and LCD Projector

SESSION OVERVIEW

SESSION CONTENTS

STEP1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing

STEP 2: Causes of Leprosy (15minutes)

• Leprosy is a chronic infectious disease caused by mycobacterium leprae

(M. leprae)

• Mainly affects the skin, peripheral nerves, and mucous membranes

• The disease affects people of all ages and sexes

STEP 3: Mode of Transmission of Leprosy (15 minutes)

|Activity: Brainstorming (5 minutes) |

| |

|ASK students to brainstorm on the following question: |

| |

|What is the mode of transmission of leprosy? |

| |

|ALLOW few students to respond |

| |

|WRITE their responses on the flip chart/ board |

| |

|CLARIFY and SUMMARISE by using the content below |

• Leprosy bacilli are mainly transmitted through infectious droplets that

are spread by an infectious individual through coughing and sneezing

• Patients carrying many leprosy bacilli are called multibacillary (MB)

patients

o They are the main source of infection

• Individuals with few bacilli in their body are called paucibacillary (PB)

o They are not a significant source of infection

• Healthy carriers are people carrying the bacilli without developing the

disease

o They are not a significant source of infection

• Skin contact with leprosy patients not a means of transmitting leprosy

infection

• Leprosy has a very long incubation period of 3-30 years, with an average

of five years

STEP 4: Sign and Symptoms of Leprosy (20minutes)

|Activity: Buzzing (10 minutes) |

| |

|ASK students to pair up and buzz on the following question for 2 |

|minutes |

| |

|What are the signs and symptoms of leprosy? |

| |

|ALLOW few pairs to respond and let other pairs to add on points not |

|mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

• One or more pale or reddish, hypo-pigmented patch(es) on the skin with

diminished or loss of sensation

• Painless swelling or lumps in the face and/or earlobes

• Enlarged and/or tender nerves

• Burning sensation of the skin

• Numbness or tingling of hands and/or feet

• Weakness of eyelids, hands, and/or feet

• Painless wounds or burns on the hands and/or feet

• The skin lesion can be single or multiple and in many cases less

pigmented than the surrounding skin. Sometimes lesion is reddish or

copper-coloured

• The skin lesion may show loss of sensation on light touch, a key feature

in leprosy

• Lesions can present in different ways, but macules (flat), papules

(raised) or sometimes nodules are the most common

STEP 5: Treatment of Leprosy (30 minutes)

• The aim of leprosy control is to:

o Cure patients

o Detect and treat leprosy reactions

o Prevent further damage to nerves and other tissue in patients with an

already existing disability

o Prevent further transmission to other community members

• Multi Drug Treatment (MDT) is the only adequate chemotherapy that will

kill bacilli

• MDT is a combination of a minimum of two anti-leprosy drugs, prescribed

in the correct dosage, taken regularly for a period of 6-12 months

• Multi bacillary (MB) patients are treated for a period of 12 months

• Paucibacillary (PB) patients are treated for 6 months

• Treatment of leprosy with only one drug will result in development of

drug-resistance

• Treatment is given according to WHO recommended MDT regimens based on the

• classification of Multibacillary or Paucibacillary

• The patient receives a combination of rifampicin, dapsone and clofazimin

in case of MB or rifampicin and dapsone in case of PB

• The patient should thus attend the nearest clinic where she/he is

registered to collect

• blister pack and for clinical assessment.

• The patient takes the first dose under direct observation of a health

worker

• In the following 27 days the patient then takes the medicine without

being supervised by the health worker

[pic]

STEP 6: Prevention and Control of Leprosy ( 15 minutes)

• Early diagnosis and prompt treatment with Multi Drug Therapy

o Case holding and patient compliance

o Early detection of leprosy reactions and prompt treatment with

prednisolone to prevent disabilities

STEP 6: Key Points (20 minutes)

• Leprosy is a chronic infectious disease caused by Mycobacterium leprae

• The cardinal signs are skin lesion with loss of sensation, one or more

enlarged peripheral nerves and a positive skin smear.

• Treatment is given according to WHO recommended MDT regimens based on the

classification of Multibacillary or Paucibacillary.

• Early detection and prompt treatment are important measures

STEP 7: Evaluation (5 minutes)

• What causes leprosy?

• How is leprosy transmitted?

• What are the major signs and symptoms of leprosy?

• Hat is the treatment of leprosy?

• Explain prevention and control of leprosy

• What are the preventive and control measures of leprosy?

STEP 8: Assignment (5 minutes)

|Activity: Take Home Assignment (5 minutes) |

| |

|ASK the students to work individually on the following Assignment |

|Explain preventive measures that you will take to control leprosy |

|ALLOCATE time for students to do the assignments and submit |

| |

|REFER students to recommended references |

References

Cook, G., & Zumla, A. (2003), Manson’s Tropical Diseases. (21st ed.).

London: Saunders

Eshuis, J. & Manschot, P (1992). Communicable diseases, (1st ed). Nairobi:

AMREF

GoT (2004).National Infection Prevention and Control (IPC) Guidelines for

Healthcare Workers. Dar es Salaam: MOHSW

GoT (2013) Standard Treatment Guidelines & National Essential Medicines

List (4thed). Dar es Salaam: MOHSW

GoT (2013) National Tuberculosis and Leprosy Programme: Manual for the

management of tuberculosis and leprosy (6thed) Dar es Salaam: MOHSW

Kingondu, T. et al. (2007), Communicable Disease, Nairobi: AMREF

Nordberg, E. (1999): Communicable Diseases, A Manual for Health Workers in

Sub-Saharan Africa, Nairobi: AMREF

Nordberg, E., Kingondu, T., & Mugambi, E., et al. (2008) Communicable

Diseases. (4th ed.). Nairobi: AMREF

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