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Volume - 81, Issue - 1

Editorial
Pages 3 - 4
Review
Pages 5 - 16
  • Hansen’s disease recoverers as agents of change: a case study in Japan

    • Miwako Hosoda
    Volume 81, Issue 1

    | Published on March 2010

    This manuscript addresses the role and contribution of people affected by Hansens disease (leprosy), especially through the efforts of Zen-Ryo-Kyo, the National Hansen’s Disease Sanatoria Residents’ Association, in changing laws and attitudes in Japan since the 1950s. Health social movements are discussed in the Japanese context and more broadly. An important contribution of this manuscript is the explanatory description of the activities of Zen-Ryo-Kyo in achieving change through addressing issues related to social stigma and discrimination. The argument is made for expanding the scope of social movements to include all stigmatised illnesses and disabilities. Another significant point discussed is the need to move beyond defining Hansen’s disease in medical and legal terms, and to redefine it as a public health and social issue to be solved.

Review
Pages 17 - 26
  • Déjà Vu: Leprosy and Immigration Discourse in the Twenty-First Century United States

    • Cassandra White
    Volume 81, Issue 1

    | Published on March 2010

    Leprosy, or Hansen’s disease, continues to be feared and poorly understood in the United States, where knowledge of the disease is limited and prevalence is low. The presence of leprosy among immigrants, however, provides fuel for those with an anti-immigration agenda. In recent years, there have been several examples of popular media distortions of statistics and of information on leprosy’s properties and contagiousness. As in previous eras of U.S. history, public fears about leprosy seem to be related to anti-immigration or nativist sentiment, which often mask underlying concerns about the potential economic threat of immigrant populations. In this article, I analyse the role of the U.S. media and other stakeholders who may have an interest in generating public fear associated with leprosy, in presenting and at times manipulating data about the disease to create an association between leprosy and undocumented immigration

Original Papers
Pages 27 - 33
  • The efficacy of a four-week, ofloxacin-containing regimen compared with standard WHO-MDT in PB leprosy

    • Marivic F. Balagon
    • Roland V. Cellona
    • Rodolfo M. Abalos
    • Robert H. Gelber
    • Paul R. Saunderson
    Volume 81, Issue 1

    | Published on March 2010

    Objectives:

    To compare the efficacy of a 4-week ofloxacin-containing regimen and the standard WHO-MDT regimen for PB leprosy, in terms of the rate and timing of relapse after treatment completion.

    Design:

    124 PB patients were enrolled in a randomised, double-blind trial. Of these, 66 received the standard 6-month WHO-MDT regimen, whereas 58 received 28 daily supervised doses of rifampicin 600 mg + ofloxacin 400 mg, plus 5 months of placebo. Patients were regularly monitored for clinical response and for signs of relapse after treatment completion.

    Results:

    Patients enrolled in the ofloxacin group had a mean follow-up of 10.8 years (628 patient-years) with 1 early relapse at 3 years after treatment completion. On relapse, this patient remained smear negative but was reclassified by current WHO criteria (≥6 skin lesions) as multibacillary (MB). Patients on the WHO-MDT regimen had a mean follow-up of 11.3 years (749 patient-years) with two late relapses at 8 and 12 years, both still classified as PB on relapse.

    Conclusion:

    In conclusion, both regimens appeared generally efficacious, and, in particular, resulted in few relapses.

Original Papers
Pages 34 - 40
  • Assessment of needs and quality care issues of women with leprosy

    • Annamma Succhanda John
    • Pamidipani Samuel Sundar Rao
    • Sonali Das
    Volume 81, Issue 1

    | Published on March 2010

    Objectives:

    Leprosy causes not just physical but psychosocial and economic problems which are further magnified in women due to gender disadvantages especially in developing countries. In order to determine the needs and quality care issues of women leprosy patients attending a hospital/health care facility, a research project was done.

    Design:

    All women leprosy patients attending a Leprosy Referral Hospital in Kolkata, India during 2006 were interviewed in depth and clinically assessed, using a standardised proforma.

    Findings:

    Of 104 women studied, half below 40 years of age and 70% above 40 years, had visible disability, and some had diabetes, low back pain etc. Nearly 60% preferred to hide their disease but even so, some had social problems. Most women delayed going to hospital, until their husband/guardian felt it was necessary. They had to complete their household chores before setting out for the hospital, and after their return. A considerable amount of time was spent waiting at various service points which conflicted with their domestic work, and lowered their social worth if they were away too long. This de-motivated them from visiting hospitals, even for follow up visits. Medical advice given – such as avoiding prolonged walking and standing, working with hot utensils etc., was not practical.

    Conclusion:

    Hospitals can do much to address the needs of women leprosy patients and. provide quality services. National programmes should give a higher priority to offering culturally acceptable health education to promote early reporting.

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