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HANSEN'S DISEASE: A VANISHING DISEASE?
Autor
Afiliación
Universidade Nilton Lins. Departamento de Dermatologia. Manaus, AM, Brasil.
Governo Estadual de Minas Gerais. Secretaria Estadual de Saúde de Minas Gerais / Fundação Hospitalar do Estado de Minas Gerais. Belo Horizonte, MG, Brasil.
Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Minas Gerais. Departamento de Dermatologia. Belo Horizonte, MG, Brasil
Universidade Nilton Lins. Departamento de Dermatologia. Manaus, AM, Brasil.
Universidade de Brasília. Faculdade de Medicina. Núcleo de Medicina Tropical. Brasília, DF, Brasil.
Governo Estadual de Minas Gerais. Secretaria Estadual de Saúde de Minas Gerais / Fundação Hospitalar do Estado de Minas Gerais. Belo Horizonte, MG, Brasil.
Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Minas Gerais. Departamento de Dermatologia. Belo Horizonte, MG, Brasil
Universidade Nilton Lins. Departamento de Dermatologia. Manaus, AM, Brasil.
Universidade de Brasília. Faculdade de Medicina. Núcleo de Medicina Tropical. Brasília, DF, Brasil.
Resumen en ingles
The introduction, implementation, successes and failures of multidrug therapy (MDT) in all Hansen's disease endemic countries are discussed in this paper. The high efficacy of leprosy treatment with MDT and the global reduction of prevalence led the World Health Organization, in 1991, to establish the goal of elimination of Hansen's disease (less than 1 patient per 10,000 inhabitants) to be accomplished by the year 2000. Brazil, Nepal and East Timor are among the few countries that didn't reach the elimination goal by the year 2000 or even 2005. The implications of these aspects are highlighted in this paper. Current data from endemic and previously endemic countries that carry a regular leprosy control programme show that the important fall in prevalence was not followed by the reduction of the incidence. This means that transmission of Mycobacterium leprae is still an issue. It is reasonable to conclude that we are still far from the most important goal of Hansen's disease control: the interruption of transmission and reduction of incidence. It is necessary to emphasize to health managers the need of keeping Hansen's disease control activities to better develop control programmes in the future. The recent international proposal to interrupt the transmission of leprosy by the year 2020 seems to unrealistic and it is discussed in this paper. The possibility of epidemiological impact related to the human immunodeficiency virus/Hansen's disease coinfection is also considered.
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