Leprosy: the ancient disease scientists cannot solve

Leprosy: the ancient disease scientists cannot solve

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If an effective rapid diagnostic test were available – one that was non-invasive and effective, many of these missing leprosy cases and close contacts of patients could be diagnosed, without the need for blanket prescriptions of rifampicin to potentially healthy individuals. The good news is that these diagnostic tests are currently in development – ​​although they may not be available for some time.

To study the disease and its progression and to develop diagnostic tests, scientists often need to inject M. leprosy in armadillostechnique which was first attempted in 1971. “The fact that we cannot culture [grow] this bacterium so readily in the laboratory is another factor impeding the development of these tests,” says Sunkara.

New horizons

Since 2000 Novartis Foundation partners with the WHO, providing free drugs worldwide for multi-drug therapy. In February 2022, they partnered with Fiocruz for survey which uses artificial intelligence (AI) to speed up leprosy diagnosis. “I call it applying state-of-the-art technology to an ancient disease,” says Sunkara.

There are at least 20-30 other skin conditions that manifest as white patches on the skin, says Sunkara. By using the AI ​​algorithm to analyze the way light reflects differently from the surface of each skin disease, it is possible to identify cases of leprosy, distinguishing them from other similar conditions with much greater accuracy. Their study, published in Lancet Regional Health, put the accuracy at 90% – but with 1,229 skin images, the dataset remains small at the moment. If successful on a larger scale, it could one day be a useful tool for speeding up diagnosis and treatment.

A lingering stigma

Although modern advances in the treatment and diagnosis of leprosy have changed the lives of many patients, there is one problem that has never completely disappeared: relentless discrimination.

“Leprosy remains a deep-rooted human rights problem,” says Alice Cruz UN Special Rapporteur on eliminating discrimination against people affected by leprosy, a role she has held since November 2017. There are more than a hundred laws that discriminate against people with leprosy worldwide, creating a strong stigma that can act as a barrier to receiving treatment , she says.

In some countries leprosy is grounds for divorce. In India it was so until the laws were amended in 2019. Many people affected by the disease still struggle to find work, and the disease can prevent them from accessing health care and education.

“States must do everything in their power to eliminate discriminatory laws and introduce policies that can guarantee economic and social rights for people affected by leprosy,” says Cruz. “Moving forward, we must ask ourselves: are our health systems working to provide full access to people affected by leprosy?” This is because leprosy is much more than a disease, it has become a label that dehumanizes the people who are affected by it. “

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