If an effective rapid diagnostic test were available – a non-invasive and effective test, many of these missing leprosy cases and close contacts of patients could be diagnosed, without the need for blanket prescriptions of rifampin to potentially healthy people . 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. leprae into armadillos, a technique that was first attempted in 1971. “The fact that we cannot cultivate [grow] this bacterium so easily in the laboratory is another factor that hinders the progress of the development of these tests, ”explains Sunkara.
Since 2000, the Novartis Foundation has partnered with the WHO, providing free drugs worldwide for multidrug therapy. In February 2022, they partnered with Fiocruz for a study that uses artificial intelligence (AI) to speed up the diagnosis of leprosy. “I call it applying cutting-edge technology to an ancient disease,” says Sunkara.
There are at least 20 to 30 other skin diseases that present as white patches on the skin, Sunkara says. By using the AI algorithm to analyze how light reflects off the surface of each skin disease differently, it is possible to identify leprosy cases, distinguishing them from other similar conditions with much more precision. Their study, published in Lancet Regional Health, pegged the accuracy at 90% – but at 1,229 skin images, the data set remains small at this time. If successful on a larger scale, it could one day be a useful tool to speed up diagnosis and treatment.
While modern advances in the treatment and diagnosis of leprosy have changed the lives of many patients, there is one problem that has never quite gone away: relentless discrimination.
“Leprosy remains a deep-rooted human rights issue,” says Alice Cruz, the UN special rapporteur on the elimination of discrimination against people affected by leprosy, a role she has held since November 2017 There are over a hundred laws that discriminate against people. with leprosy around the world, creating a strong stigma that can be a barrier to getting treatment, she says.
In some countries, leprosy is grounds for divorce. In India, this was the case until the laws were changed in 2019. Many people affected by the disease still find it difficult to find employment, and the disease can hinder their access to health care and ‘education.
“Countries must do everything in their power to get discriminatory laws abolished and put in place a policy that can guarantee economic and social rights to people affected by leprosy,” says Cruz. “Going forward, we should ask ourselves the question: are our health systems functioning to provide full accessibility to people affected by leprosy? This is because leprosy is more than a disease, it has become a label that dehumanizes those affected. “
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. Leprosy the ancient disease the scientists can not solve