Early leprosy diagnosis prevents deformity

Myths and facts

In an ‘Interaction on achievements and issues remaining challenges in Leprosy with Journalists and Artists’ held at Anandaban Hospital’s Training Centre, Lele on January 27, Gopal Pokharel, Training Co-ordinator at the hospital, informed about the disease, mode of transmission and methods of prevention along with the availability of the medical service in and around the country. The medicines are available for free in the health centres of the country.

Many people believe that one suffers from leprosy because they have committed sins. However, Pokharel informed, “Leprosy is a bacterial infection and is not a result of sins committed.”

There is also a strong myth that leprosy-affected people should not be burnt after death as the smoke will affect other healthy people. Saying ,”There is not truth related to such a story, “ Pokharel informed that the final rites of people can be done as per the dead person’s religion.

People do not eat pumpkins after getting leprosy. Then there are stories that people constructing houses on land in the shape of a gagro — a utensil used in Nepal to fill water — are supposed to suffer from leprosy. Pokharel said that these nothing more than mere myths.

Lele, Lalitpur

Soni Lal Chaudhary, 70, of Morang is on a bed in Anandaban Hospital, Lele. His fingers of both his hands are deformed and his foot is bandaged. He has lost his eyebrows too. Surgery on his foot has been done to prevent further complications of leprosy. His hands deformed some 10-15 years ago.

A small brownish patch had appeared on his nape but he did not know that it was a symptom of leprosy. Later he suffered sores on his hands and feet. “It was already late when I went to the hospital. I had already lost my fingers and toes,” he said.

He also talked about the pain of ostracisation. “People in my community didn’t let me touch their children as they felt I would transmit the disease to them. Being discriminated against was more painful than the disease,” Chaudhary said.

“Untreated, leprosy can cause progressive and permanent damage to skin, limbs, eyes and nerves,” informed Dr Mahesh Shah, Senior Consultant Dermatologist at Anandaban Hospital.

Chaudhary is an example. With an aim to raise awareness about the disease, mode of transmission and ways to prevent it, the World Leprosy Day is celebrated every year on the last Sunday of January. This year it was celebrated with the slogan ‘Samayemanai Kustarogko Upachaar Garaun, Aapangata Hunabata Bachaaun’ (Treat Leprosy on Time, Prevent Loss of Limbs) in the country.

Shanti Chaudhary, 20, of Parsa smiled and said “Namaste” to this reporter inside the hospital’s female ward. She talked as she ate the meal provided by the hospital. “A surgery on my foot has been done. Foot drop is what I have suffered from,” she informed.

Foot drop is a term used to describe the difficulty in lifting the front part of the foot. She had to drag the front part of her foot when she walked. There was a sore in her foot. “It occurred as I suffered from leprosy. It has already been 10 weeks that I have been here,” Shanti shared.

Lalsari Khadka, 25, and her son Bishal Khadka, 7, too are admitted in the hospital. Looking at the mother-son duo’s faces one can easily notice that their skin is comparatively thicker than others’. “My husband had leprosy earlier,” said Khadka.

Leprosy is transmitted via droplets from nose and mouth, and living in close, frequent contact with untreated cases. The mother-son is example of how it gets transmitted via frequent contact with infected persons.

To bring down such a  mode of transmission, the government has come up with Leprosy post-exposure Prophylaxis (LPEP), where a single dose Rifampicin is given to contacts of newly diagnosed leprosy patients to decrease their risk of leprosy transmission, control leprosy and reduce  disability to a greater extent. “This project was started in the country as a pilot project in Jhapa, Morang and Parsa in 2014/15,” said Dr Basu Dev Pandey, Deputy Director of Leprosy Control Division, Ministry of Health and Population, Department of Health Service, Teku.

The LPEP intervention has started in Dhanusha, Rupandehi and Kapilvastu since 2016. But it is not given to children below the age of two years, pregnant women and those who have already taken Rifampicin.

Condition in the country

Though the goal of leprosy elimination in the national level was achieved in 2009 and declared in 2010 in the country, a total of 3,053 new cases with New Case Detection Rate (NCDR) 11.01 case per 100,000 population, and 2,461 patient under treatment with Prevalence Rate (PR) 0.89 case per 10,000 population, had been reported in the fiscal year 2014/15, according to the annual report 2014/15 of Leprosy Control Division, Teku. Similarly, 135 (4.42 per cent) people with grade 2 disability and female proportion of 1,100 (36.03 per cent) among new cases were reported. The proportion of child cases among the new is 236 (7.33 per cent), which indicates that there is still ongoing transmission in the community.

Jhapa, Sarlahi, Dhanusha, Rautahat, Mahottari, Bardiya, Parsa, Banke, Nawalparasi, Morang, Kailali, Bara, Rupandehi, Siraha are the most affected areas. Most of the people from Tarai region are leprosy affected. Dr Mahesh Shah, Senior Consultant Dermatologist at Anandaban Hospital revealed the reason saying, “One suffers from the disease when there is low immunity in the body. Immunity depends upon nutrition, sanitation, among others. People in the Tarai region live in very confined spaces. Because of poverty, they are unable to maintain personal hygiene, take nutritious food and maintain a pollution-free environment where they are living.”

The data of Leprosy Control Division further reveals that the highest case load is in the central region with 39.06 per cent of the total new cases in the country, and the PR is highest in eastern region of Nepal with 0.94 case per 10,000 population. According to Dr Pandey, the disease is quite common in Muslim women in the country as women from this community are quite reluctant to get their bodies checked medically. In a recent campaign conducted by the Leprosy Division in Banke and Bardia, 200 new patients were found in four days, as per Dr Pandey. This shows that there are various hidden cases of the disease in the country.

If there is swelling of the face and red spots are seen on skin, then the persons should be checked for leprosy. Som BK, 34, of Ramechhap currently admitted in the hospital is an example. “I came to the hospital as I suffered from painful nodules, face swelling and red spots on my skin,” informed BK.

There are chances for one to re-affect from the disease. “Even after getting a treatment for the disease, there are chances for its recurrence. Therefore one should be careful,” shared Dr Shah.

According to official reports received from 138 countries from all World Health Organisation (WHO) regions, the global registered prevalence of leprosy at the end of 2015 was 1,76,176 cases (0.2 cases per 10,000 people) — based on population of countries that reported leprosy to WHO; not the total world population. The number of new cases reported globally in 2015 was 2,11,973 (2.9 new cases per 100 000 people). In 2014, 2,13,899 new cases were reported, and in 2013, 2,15,656 new cases, as per WHO (www.who.int).

Leprosy in art

LELE: Paintings depicting various aspects of leprosy-affected people, on display at Anandaban Hospital, Lele  on January 27, provided useful information about the infection and the condition of people.

Paintings of deformed fingers with a message about the need for timely treatment of leprosy, and pots used

by leprosy-affected people were among 20 artworks showcased in the exhibition.

Artists Ajay Desar, Raj Man Maharjan, Kishor Nakarmi, Paka Bahadur Thapa Magar, Madan Shrestha and Ramesh Shrestha created the informative paintings to raise awareness about the disease.

Healthy persons holding the hands of leprosy-affected people, their homes, their source of income like cattle rearing were some other subjects painted by the artists. Apt use of green, black and blue colours beautifully reflected the green areas, leaves, sky among others.

The artists had gone to Chandranigahapur and Chitwan to understand the lifestyle of leprosy-affected people. And after their research, they created these artworks, trying to reflect on the problems and sufferings of those people. “We have tried to raise public awareness about leprosy through our artwork,” artist Raj Man informed.

What is Leprosy?

According to WHO

  • Leprosy is a chronic disease caused by a slow multiplying bacillus, Mycobacterium leprae.
  • leprae multiplies slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear.
  • The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and also the eyes.
  • Leprosy is curable with multidrug therapy (MDT).
  • Although not highly infectious, leprosy is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.
  • Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs and eyes.
  • Leprosy is curable and treatment provided in the early stages averts disability.


  • Dry pale or reddish patch on skin
  • Loss of sensation on the patchy skin
  • Numbness or tingling of hand and feet
  • Reddening, thickening, shiny or oily facial skin
  • Thickened, painful or tender nerves
  • Thinning or loss of eyebrows
  • Saddle nose