People with Leprosy Avoid Treatment Due to Stigma, Discrimination

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In this report, Odimegwu Onwumere reveals that fragile healthcare system culminated to dearth of technical know-how in diagnosis and treatment, sensitisation and high discrimination of people with leprosy in the Nigeria, whereas the last leprosy hospital in Sweden closed in 1948

During the January 29 2017 World Leprosy Day, the World Health Organisation’s Global Health Observatory Data showed that Nigeria had 2,893 new cases of leprosy sufferers in 2015, making the country one of the three countries in Africa the organisation said that had the highest level of victims.

According to the source, no fewer than 212,000 more sufferers were reported across the world in the year in quote. Correspondingly, other African countries that included Democratic Republic of Congo and Ethiopia had 4,237 and 3,970 cases respectively.

Defining leprosy or Hansen’s disease, experts say “leprosy is caused by a type of bacteria otherwise known as mycobacterium leprae and is known to multiply very slowly. Its incubation period is said to be between five years while symptoms can take 20 years to appear and it mainly affects the skin and peripheral nerves.” It was revealed that Nigeria in 10 years recorded 43,179 cases.

However, in early 2016, the Leprosy Mission Nigeria (TLMN) warned that no fewer than 3,000 fresh cases of leprosy were emerging annually in Nigeria and narrow-mindedness against sufferers was skyrocketing. Checks revealed that when this revelation was made, the authorities barely listened nor moved against the malady with the appropriate measure that was required.

Because of lack of awareness and stigmatisation, many of the sufferers were said to hardly show themselves for treatment, thinking that the disease was a death sentence. This was confirmed at a seminar in Abuja, where Mr. Terver Anyor, the Funds Development Manager of TLMN, purportedly told newsmen, “Some sufferers hide due to lack of awareness or fear of stigma and discrimination, resulting in high number of cases of the disease. There is need for awareness. The last leprosy hospital in Sweden closed in 1948. It can also be eradicated in Nigeria.’’

There were data in 2015 showing that Anambra State had 14 cases of leprosy and about 3,800 Nigerians were sufferers. But in April 2014, experts had amplified their fear over stigma attached to sufferers, but the authorities were yet to live to the occasion in creating the much needed awareness in their defense. A chieftain of the Leprosy Mission-Nigeria (TLMN), Dr. Sunday Udo showed apprehension that he didn’t know from where some Nigerians got the information that leprosy was not curable; he however advised them on the contrary, saying, “The last fight against leprosy is the stigma. It is a very deep issue that we need to find a way to break the reign of stigma.”

Notwithstanding, while observing the 64th Anniversary of World Leprosy Day this year dubbed ‘Zero Disability Among Children Affected by Leprosy’ the Minister of Health, Professor Isaac Adewole was befuddled, saying that leprosy still had a dangerous position in 16 states of the country owing to different high “endemicity” in those states.

Such states were given as Jigawa, Kano, Kaduna, Kebbi, Bauchi, Taraba, Niger, Kogi, Ebonyi, Abia, Cross River, Edo, Osun, Ogun and Lagos states. It was revealed that the 2,892 leprosy cases reported in the country, as according to the 2015 calculation, “nine per cent was made up of children, while victims with “grade II disability” accounted for 15 per cent.”

Statistics that was unrestricted by TLMN showed that “Grade-2 disability – the deformities that set in when leprosy is untreated – rose to 14 per cent in 2012, up from 12 per cent in 2010. Also, the proportion of children affected rose to nine out of every 10,” the source said. Despite this, a National Coordinator of the National TB, Leprosy and Buruli Ulcer Control Programme, Dr. Gabriel Akang had said in 2015 that as his agency was the custodian of the country’s data on leprosy, “We are saying that Nigeria was able to meet the target of 1/10,000 cases of leprosy. This is the elimination target.”

Albeit, given the new cases of leprosy patients in Nigeria, the WHO Regional Director for South-East Asia, Dr. Poonam Khetrapal Singh showed uneasiness that synergy between the authorities was supposed to be put in place in order to overcome. His apprehension was hinged on the data, as according him, “Leprosy affected 212, 000 more people globally in 2015. Of them 60 per cent were in India. The other high-burden countries were Brazil and Indonesia. Of the new cases 8.9 per cent were children and 6.7 per cent presented with visible deformities.”

It was however experimental that in 1998, after the beginning of the Multi-Drug Therapy (MDT), Nigeria accomplished WHO’s eradication aim of less than one case per 10,000 population at the national level. But In spite of this, there were indications from some quarters saying that the WHO informed that MDT was “made available free of charge to all patients worldwide since 1995.” Checks further revealed that the new leprosy cases in the country were as a result that many victims never went to health professionals to seek for advise, or that they went late thereby making the matter worse. According to a national director of TLMN, Dr. Moses Onoh in 2016, “The deformities you see on persons affected by leprosy is a result of late treatment but it is not leprosy in itself. Most of them do not come for treatment until they are faced with the deformities. It’s just a deformity which can also occur in other ailments. It is not contagious and can be treated and the treatment is free.”

Based on poor sensitisation of the citizens, pundits were worried that many people believed that leprosy was hereditary or some super-natural powers’ way of punishing some persons. But as according News Agency of Nigeria (NAN), “Adewole said that this is very bad of such beliefs, adding that the Federal Government had launched a five-year National Leprosy and Buruli Ulcer Strategic Plan (2016-2020) as part of its efforts to eliminate the disease in the endemic states.”

The source continued, “This document facilitates the implementation of appropriate strategies to increase case detection, improve treatment outcome, prevent disabilities and provide rehabilitation services to affected persons.” But many stakeholders were worried why the fresh leprosy cases owing to the fact that since 2000, the disease had been defeated headlong with the authorities providing multi-drug therapy, or MDT – which had been affordable in the 80s to date and was formulated to cure leprosy.

According to Onoh, “There are four organisations in Nigeria which oversee leprosy-related diseases and are committed to its total eradication. They are based in Enugu, Enugu State, Jos, in Plateau State, Ibadan in Oyo State and Abuja, the Federal Capital Territory which are situated in the South-east, South-west, North-central and the nation’s capital respectively.”

But Dr. Akang had a contrary view, saying, “The fight is not over especially as we have been able to identify cases of child leprosy and this means, we have transmission of the disease going on in some communities…”

It’s hoped that the authorities would close the last leprosy hospital soon as Sweden did in 1948; some 69 years ago.