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Leprosy: training of health workers on skin-NTDs

via OpenWHO

Overview

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Leprosy occurs worldwide. The prevalence of leprosy has decreased from more than 5 million cases in the 1980s to a little over 170 000 in 2019 due to the introduction of Multi-drug therapy. Even though the prevalence has decreased, the new cases continue occurring which are around 208 000 annually and out of which 8% are children and 5% are detected with deformities (grade 2 disabilities). If leprosy is not diagnosed early, it may lead to deformities which affect socio-economic and psychological conditions of the persons affected. It is common in communities where overcrowding and poverty coexist. Leprosy is associated with certain stereotypes in the community often resulting in discrimination of the persons affected.

This course addresses the epidemiology of leprosy, suspect and refer, diagnosis and treatment, lepra reactions, prevention of disabilities and public health interventions.

Photo credit: Stephanie Roberts - The Leprosy Mission International

Syllabus

Course information

Overview: Leprosy can be suspected or diagnosed at the peripheral health level. Effective treatment exists for individuals diagnosed with leprosy. Treatment of lepra reactions and management of disabilities are in place. Chemoprophylaxis to prevent leprosy for contacts of persons affected by leprosy is also available.

The aim of the course is to provide information about leprosy to increase knowledge and skills of front-line health workers in national programmes to manage this disease and its complications.

Learning objectives: By the end of this course, you should be able to:

  • explain the epidemiology of leprosy
  • describe how to suspect and refer
  • identify how to diagnose and classify leprosy
  • explain how to treat leprosy
  • describe how to diagnose lepra reactions and manage
  • describe how to prevent and manage disabilities du toe leprosy
  • explain the self-care (hands, feet, and eyes)
  • identify how to take slit skin smear (SSS) and report
  • describe the post-exposure prophylaxis (PEP) with single dose of rifampicin
  • explain the public health interventions to reduce disease burden and essential indicators

Course duration: Approximately two hours.

Certificates: A Record of Achievement certificate will be available to participants who score at least 80% in the final assessment. Participants who receive a Record of Achievement can also download an Open Badge for this course. Click here to learn how.

Course contents

  • Module 1: Introduction:

    This introductory module gives an overview of leprosy and the basic epidemiology of the disease. By the end of this module, you should be able to: explain the causative organism and how it is transmitted; describe age and gender distribution; explain disabilities and stigma associated with leprosy; describe geographical distribution of leprosy and its new case detection.
  • Module 2: Suspect and refer:

    By the end of this module, you should be able to: identify when to suspect leprosy; differentiate between leprosy and non-leprosy skin patches; explain the action to be taken when a person presents with lesions suggestive of leprosy.
  • Module 3: Diagnosis and treatment:

    By the end of this module, you should be able to: know the cardinal signs of leprosy and the importance of early diagnosis; know different methods to diagnose leprosy and confirm leprosy cases; understand classifying leprosy into paucibacillary and multibacillary; understand treatment regimens.
  • Module 4: Nerve Function Assessment (NFA):

    By the end of this module, you should be able to: know the importance of nerve function assessment in leprosy; know sensory and voluntary muscle testing of peripheral nerves involved in leprosy and documenting the findings and know the WHO Grading of Disability for leprosy.
  • Module 5: Lepra reactions :

    By the end of this module, you should be able to: explain lepra reactions and neuritis; describe the signs and symptoms of Type 1 and Type 2 lepra reactions, as well as explain the management of lepra reactions.
  • Module 6: Prevention and management of disabilities due to leprosy :

    By the end of this module, you should be able to: explain the consequences of nerve damage in hands, feet and eyes; the mechanisms of impairments of hands, feet and eyes due to nerve damage; describe the consequences of nerve damage in eyes and of loss of vision due to leprosy, and explain the management of disabilities of hands, feet and eyes.
  • Module 7: Self-care of disabilities:

    By the end of this module, you should be able to: identify basic principles and practices of self-care, describe the activities to be carried out to limit disabilities through self-care, demonstrate self-care habits to patients, explain how to monitor the “self-care” activities, describe the principles in formation of a “self-care” group.
  • Module 8: Laboratory diagnosis in field settings:

    By the end of this module, you should be able to: describe the importance of slit skin smear (SSS) in diagnosing and classifying leprosy, and in the follow-up of treatment with MDT, identify the technique of taking, staining, reading the SSS and documenting the results.
  • Module 9: Post Exposure Prophylaxis (PEP):

    By the end of this module, you should be able to: understand post exposure prophylaxis with single dose of rifampicin (Exclusion and Inclusion Criteria and Side effects of Rifampicin and mitigation plan); know the contact tracing and screening.
  • Module 10: Public health interventions:

    By the end of this module, you will be able to: understand public health interventions to reduce the disease burden due to leprosy.
  • Final Assessment

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