|
'''[[Leprosy]]''' was said to be first recognized in the [[ancient civilization]]s of '''[[China]]''', [[Egypt]], and [[India]], according to the [[World Health Organization]] (WHO).<ref>[httphttps://www.who.int/mediacentre/factsheets/fs101/en/ WHO | Leprosy Factsheet]</ref> Leprosy, also known as '''Hansen's disease''', was officially eliminated at the national level in China by 1982, meaning prevalence is lower than 1 in 100,000. There are 3,510 active cases today. Though leprosy has been brought under control in general, the situation in some areas is worsening, according to China’sChina's [[Ministry of Health (China)|Ministry of Health]]. In the past, leprosy sufferers were ostracized by their communities as the disease was incurable, disfiguring, and wrongly thought to be highly infectious.
==Epidemiology==
===Numbers===
500,000 cases of leprosy were registered in China between 1950 and 2002.<ref>[{{cite journal |vauthors=Chen XS, Li WZ, Jiang C, Ye GY |title=Leprosy in China: epidemiological trends between 1949 and 1998 |journal=Bull. World Health Organ. |volume=79 |issue=4 |pages=306–12 |year=2001 |pmid=11357209 |pmc=2566398 |url=http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862001000400007&lng=en&nrm=iso&tlng=en Leprosy in China: epidemiological trends between 1949 and 1998], Xiang|issn=0042-Sheng9686 Chen, Wen-Zhong Li, Cheng Jiang, & Gan-Yun Ye, Bull World Health Organ vol.79 no.4 Genebra 2001}}</ref> Most of these sufferers have been cured but approximately 6,000 active cases remain today and about 2,000 new cases are detected and registered every year. Many more cases are not registered, partly through ignorance, but also because of the stigma associated with the disease. The number of cases reported has varied over time, with the number of cases declining between 1985 and 1993 but staying flat between 1994 and 2001.<ref>{{cite journal|vauthors=Shen JP, Gupte MD, Jiang C, Manickam P, Yu MW, Li WZ|date=June 2005|title=Trends of case detection and other indicators of leprosy in China during 1985–2002|journal=Chin. Med. Sci. J.|volume=20|issue=2|pages=77–82|pmid=16075742}}</ref>
There are estimates that show that there are 200,000 people in China today who have recovered from the disease but more than half (110,000) are disabled due to the disease, with conditions ranging from blindness to disfigurement. Although these former leprosy sufferers were cured in the last 50 years, many of them still suffer serious pain and difficulties because of these disabilities/deformities and the stigma. This social stigma has become the main problem in leprosy diagnosis and treatment, today.{{cn|date=April 2023}}
===Areas affected===
Mostly, cases of infection remain in impoverished parts in the southwestern provinces of [[Yunnan]], [[Guizhou]], and [[Sichuan]], and [[Tibet]] in the west and [[Hunan]] in the Southsouth. Other provinces/municipalities affected on a smaller scale, are [[Anhui]], [[Qinghai]], [[Chongqing]], [[Guangdong]], and [[Shaanxi]].{{cn|date=April 2023}}
===Transmission and pathology===
Contrary to popular belief, leprosy ranks lowlylow in terms of infectiousness and is not congenital. It is passed via [[respiratory]] droplets among people in close and prolonged contact. The transmission rate is low and 95 percent of people are naturally [[immune]] to it. Caused by the bacterium ''[[Mycobacterium leprae]]'', leprosy affects the skin, mucous membranes, peripheral nerves, and eyes. As nerve damage is permanent, even those who have recovered can notcannot feel pain. Minor cuts and abrasions on fingers and toes often turn into gaping, inflamed ulcers because of unsanitary living conditions. These open sores overrun the digits, which slowly shrink and many sufferers end up with stumps. Some have legs amputated.{{cn|date=April 2023}}
==Treatment==
In China, [[dapsone]] was used from 1946 to treat leprosy, but treatment of the disease took a leap in 1982 with the introduction of a largely successful [[multidrug therapy]] (MDT) using dapsone, [[rifampicin]], and [[clofazimine]]. Today, therapy takes six months to a year. MDT treatment has been made available by the WHO free of charge to all [[patient]]s worldwide since 1995, and provides a simple yet highly effective cure for all types of leprosy.<ref>[httphttps://www.who.int/lep/en/ WHO | Leprosy Today]</ref> If diagnosed and treated early, the disease leaves no traces. But in some places such asin China, stigma still surrounds the disease and victims do not seek treatment until it is too late.{{cn|date=April 2023}}
==Stigma==
{{see also|Leprosy stigma#China}}
China officially stopped sending lepers to colonies from the mid-1980s and the majority are now treated at home. But there is still existence of hundreds of "[[leper colony|leper colonies]]" in China because of the deep-rooted ignorance and prejudice in society about the disease, medical experts and aid workers say, despite the proven advances in treatment.
In current-day China, leprosy is strongly associated with poverty and stigma remains a significant barrier to effective treatment.<ref>{{Cite web|url=https://www.scmp.com/news/china/article/1136867/discrimination-still-plagues-leprosy-victims-mainland-china|title = Discrimination still plagues leprosy victims in mainland China| date=27 January 2013 }}</ref>
===Isolation===
Many of those people affected by leprosy have been isolated in remote villages since the 1950s, and they and their offspring - most of whom have never been infected - have little chance of rejoining society because of the strong prejudice, and their own fears. Due to strong stigma of the disease, many children have been abandoned, while others are deprived of proper care because their parents/families are concerned that their extended family may be ostracised. There have been many cases of people that have recovered from leprosy who have been permanently spurned by their family after being sent away by parents for medical help. They instead have been told (by their families) to remain in the leper colony. These cases include those who have lived in leper colonies for over 40 years.
===Deterioration===
Ignorance and fear of the disease prevent sufferers and their families from seeking medical help because the social stigma is very serious. Stigma therefore prolongs the disease. As many people try to hide the disease, families rarely publicly admit to having any sufferers in their households, because of the fear that the entire village will cut them off. This leads to extreme complications. Those who are afflicted tend to seek help only when their illness - which can permanently damage the [[skin]] and [[nerves]], particularly in the [[Limb (anatomy)|limbs]] and around the [[eyes]] - is at an advanced stage and unbearable.
==See also==
*[[Public healthHealth in mainland China]]
*[[Leprosy]]
*[[Leper colony]]
==External links==
*[http://www.ncstdlc.org/english/ National Center for STD and Leprosy Control] — Institute of Dermatology, Chinese Academy of Medical Sciences
*Shen JP, Gupte MD, Jiang C, Manickam P, Yu MW, Li WZ (2005) [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16075742&dopt=Abstract Trends of case detection and other indicators of leprosy in China during 1985-2002]. ''China Med Sci J.'' June; 20(2): 77-82
*[http://www.erenlai.com/index.php?aid=391&lan=3 Leprosy and the Buddhist Tradition] — eRENLAIMAGAZINE
*[https://web.archive.org/web/20080225102905/http://afpnews.googlexinhuanet.com/articleenglish/ALeqM5j_sV3OesAUxybMnKbeOCeBQphI7A2008-01/26/content_7500087.htm LeprosyFeature: downLone butgood notsamaritan outopens inup China:'s lost stateleprosy mediavillage] AFPXinhua. 26 January 2008.
*[http://news.xinhuanet.com/english/2008-01/26/content_7500087.htm Feature: Lone good samaritan opens up China's lost leprosy village] Xinhua. 26 January 2008.
{{Health in the People's Republic of China}}
{{Asia topic|Leprosy in}}
[[Category:HealthLeprosy in theChina| People's Republic of China]]
[[Category:Health in China]]
[[Category:Leprosy by country|China]]
| 