An update of the diagnosis, treatment, and prevention of leprosy: A narrative review

Abstract

Leprosy is an infectious disease that remains a public health concern. It is caused by acid-fast Bacillus leprae, which primarily affects the skin and peripheral nerves, potentially leading to long-term disability and stigma. However, current and previous efforts have focused on developing better diagnostic and therapeutic interventions for leprosy, and its prevention needs to be addressed. In this review, we organize the currently published papers and provide updates on the global epidemiology, diagnosis, treatment, and prevention of leprosy. Several online databases, including MEDLINE (National Library of Medicine, Bethesda, MD), PubMed, EMBASE, Web of Science, and Google Scholar, were searched to collect relevant published papers. As a public health issue, the World Health Organization set the goal of leprosy elimination with a prevalence of <1 case per 10,000 people, which was achieved in 2000 and in most countries by 2010, mainly owing to the treatment of leprosy using drugs starting in 1980 and no-cost access for patients since 1995. Although diagnostic and therapeutic techniques have improved, the new occurrence of leprosy remains a critical global disease burden. With continuous technological improvements in diagnosing and treating leprosy, obtaining more relevant healthcare knowledge and preventing leprosy disability are crucial.

Figure 1.

Global distribution of new leprosy cases in 2019 reported by World Health Organization (photograph courtesy of World Health Organization).

Figure 2.

Potential transmission routes of leprosy.

Figure 3.

Leprosy classification and clinical spectrum according to Ridley and Jopling.

Figure 4.

Tuberculoid leprosy: lesion with a single, stable, hairless plaque and well-defined borders (photograph courtesy of Eichelmann K et al).

Figure 5.

Lepromatous leprosy: lesion with diffuse thickening, numerous discrete, and confluent nodules (photograph courtesy of White C et al).

Figure 6.

Type 1 reaction: lesions with erythema, swelling, papules, and plaques. (photograph courtesy of Oliveira MB et al).

Figure 7.

Type 2 reaction: lesions with erythema multiform-like bullous (photograph courtesy of Alemu Belachew W et al).