Chemoprophylaxis was carried out on high risk group of extended contacts of new leprosy cases in Nyaungdon Township, Ayeyarwaddy Division, Myanmar and serological response was followed up for two years. In September 2003, blood samples were collected from 829 contacts after getting informed consent and sera were tested for immunoglobulin M antibodies using NTP-BSA ELISA test. These 300 seropositives were randomized to treated and non-treated groups. In each group 102 each were enrolled in adults and 48 each in children. A single dose of ROM (rifampicin, ofloxacin and minocycline) and RMP (rifampicin) by body weight was administered to treated group of above 15 years and those below 15 years respectively. The vitamins were administered to non-treated group. The blood samples of all contacts were collected again in September 2004 and September 2005 and ELISA was carried out on paired samples on one plate. The mean optical density (OD) titers before vs after chemoprophylaxis were 0.24 vs 0.10 and 0.20 vs 0.09 in treated and non-treated group respectively in adults and 0.25 vs 0.11 and 0.22 vs 0.11 respectively in children after one year. These were 0.24 vs 0.17 and 0.20 vs 0.19 respectively in adults and 0.25 vs 0.19 and 0.22 vs 0.20 respectively in children after two years. The difference of mean antibody titers before and after chemoprophylaxis in treated group was significantly reduced compared to non-treated group in adults but was not significant in children. The findings show that there is a significant role of chemoprophylaxis on serological response in the form of decreasing antibody titer among the adult group of extended contacts.
Leprosy is a chronic bacterial disease that has many clinical presentations. We are reporting a patient who presented with an erythematous plaque over the nose, which was proved to be due to leprosy. We think that this type of clinical feature is not a common presentation for leprosy.
The typical leprosy doctor is disappearing in Japan. One of the reasons for this is that no more new cases arise among people of Japanese nationality. Furthermore, among people of other nationality living in Japan, occurrence of the cases has become rare. At the same time, it has become difficult to get a new medical person for leprosy field because the interest for the overseas medical cooperation has become diversified and there is a misunderstanding that the problem of leprosy in the world has been resolved. However we need to keep speaking out that there are still much more to be done. When we fortunately have someone who wishes to become a leprologist, his/her training is only possible in the very site of NGO in developing countries. One may start his/her work by passionate motivation of “living together”, but actually he/she needs to be nurtured by people there. Another way to get involved is to first become a specialist of some sort, and then get in a medical system of a developing country as a narrow range specialist, and while serving them there, one can deepen his/her experiences as a whole leprosy. It is also important for us to think how we accept people who have worked overseas. We need to investigate and construct the supporting system for them. As long as leprosy patients exist in the world who are still suffering, we, as Japanese, need to make efforts in continuously sending people who live with them.