Santillan.leprosy

8/8/2019 Santillan.leprosy

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LEPROSYHANSENS DISEASE


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Is a chronic mildly communicable

disease that mainly affects the

skin, the peripheral nerves, theeyes and the mucosa of the upper

respiratory tract

disease caused by the bacteriaMycobacterium leprae


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When a person becomes infected with the

bacteria that cause the disease, the bacteriabegin to multiply within the body. After three to

five years, symptoms can begin.

Incubation Period


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SIGNS AND SYMPTOMS

A. EARLYSIGNS AND SYMPTOMS

Change in skin color- either reddish or white

Loss of sensation on the skin lesion

Decreased/ loss of sweating and hair growth over the

lesion

Thickened and painful nerves

Muscle weakness or paralysis of extremities

Pain and redness of the eyes

Nasal obstruction or bleeding

Ulcers that do not heal


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B. LATE SIGNS AND SYMPTOMS

Loss of eyebrow madarosis

Inability to close eyelids- lagophtalmos

Clawing of fingers and toes

Contractures

Sinking of the nose bridge

Enlargement of the breast in males orgynecomastia

Chronic ulcers


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Causative agent:

Mycobacterium leprae

-It is an intracellular, acid-fast bacterium

-an aerobic, rod-shaped (bacillus) surrounded by

the characteristic waxy coating unique

tomycobacteria.


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Slit Skin Smear (SSS)

It is done when the diagnosis is doubtful

The main objective is to preventmisclassification and wrong treatment


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Management/ treatment:

Ambulatory chemotherapy through use of

Multi- drug therapy

Domiciliary treatment as embodied in R.A4073 which advocates home treatment


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Multi-drug therapy:

Is the use of 2 or more drugs for the

treatment of leprosy. It is proven effective

cure for leprosy and renders patientss

non- infectious a week after treatment.

MDT makes home treatment of leprosy

patients possible


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WHO classification of Leprosy

which in the basis ofMulti- drug

Therapy

A. Paucibacillary

(tuberculoid and intermediate)-Non- infectious type

-Duration of treatment 6-9 months


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B. Multibacillary (lepramatous and

borderline)

Infectious types Duration of treatment is 24- 30

months


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For paucibacillary leprosy cases:

shall be treated with PB regimen as

follows:Drugs/

duration

Adult Child(10-14

years)

Rifampicin 600mg once amonth

450mg once amonth

Dapsone 100mg daily 50mg daily

Duration oftreatment

6 blister packsto be taken

monthly

6 blister packsto be taken

monthly


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For multi-bacillary leprosy cases:

shall be treated with PB regimen as

followsDrugs/

duration

Adult Child(10-14

years)

Rifampicin 600mg once a

month

450mg once

a month

Clofazimine 300mg once a

month and 50mg

daily

150mg once

a month and

50mg everyother day

Dapsone 100mg daily 50mg daily


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Duration oftreatment

12 blisterpacks to be

taken monthly

12 blisterpacks to be

taken monthly


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Public health nursing

responsibilities Health education to patients, families and

the community on the nature of thedisease, symptomatology, and its

transmission. Advocate healthful living through proper

nutrition, adequate rest, sleep and good

personal hygiene. BCG vaccination especially of infants and

children


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PREVENTION:

Avoidance of prolonged skin-to skin

contact specially with a lepramatous case

Children must avoid close contact withactive, untreated leprosy case

BCG vaccination

Good personal hygiene

Adequate nutrition

Health eduction


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Management and treatment

Rehabilitation

-To help him/ her attain this, the nurse:

Helps create a congenial atmosphereessential to progressive recovery

Must e kind and maintain attitude ofprofessional concern and interest

Encourage patients participation inoccupational activities suited to hisinterest, experience and capacity


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Refers patient to other persons/ agencies

who can help in his/ her physical, mental

and social rehabilitation


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Promotes family health by:

Providing information to the patient and

his/her family on family planning and

nutrition

Encouraging utilization of available family

planning and nutrition service

Providing counseling and guidance aimed

at improving health of every member of

the family


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For community health:

Participates assemblies and shares

information on leprosy and its

management

Participates in seminars/ workshops/

consultative meeting of other GOs and

NGOs on leprosy control

Participates in tri-media dissemination of

leprosy


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Training, Supervision, and Research:

Conducts orientation of student nurses,

midwives and other students on leprosy

and control program

Participates in orientation of new

RHU/BHS staff on leprosy and its control

Participates in studies on leprosy and its

mnagement


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