Leprosy (Hansen’s Disease) презентация

Содержание

What is Leprosy? It is a disease of Historical importamce Worlds oldest recorded disease Stigmatized disease

Слайд 1Leprosy (Hansen’s Disease)
The topic of the lecture:
Professor Kutmanova A.Z.


Слайд 2What is Leprosy?
It is a disease of Historical importamce
Worlds oldest recorded

disease
Stigmatized disease

Слайд 3Introduction
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an

acid-fast, rod-shaped bacillus.
The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract and the eyes.
Leprosy is curable and treatment provided in the early stages averts disability.

Слайд 4Introduction
Multidrug therapy (MDT) treatment has been made available by WHO

free of charge to all patients worldwide since 1995.
It provides a simple yet highly effective cure for all types of leprosy.
Elimination of leprosy as public health problem (with a prevalence less than 1 case per 10 000 persons) was achieved globally in the year 2000.
More than 16 million leprosy patients have been treated with MDT over the past 20 years.

Слайд 6Gerhard Armauer Hansen
Global Project on the History of Leprosy
http://www.leprosyhistory.org/graphics/gallery/hansen.jpg
1868 - Identifies

First microorganism

Слайд 7Leprosy is caused by Mycobacterium leprae
Scollard, DM et al. 2006.

“The continuing challenges of leprosy.”
Clinical microbiology reviews 19, no. 2: 338-81.

Bacilli may present in singles, can be intracellular.
Agglomerates.
• Bacilli bound by lipid like substance (Glia)
• Masses are Globi
• Appear cigar bundles.


Слайд 8Cultivation
Not possible
Can be propagated in Foot pads of Mice
Granulomas develop at

the site of inoculation.
Nine banded armadillo highly susceptible.
Chimpanzees
Generation time 12 -13 days.
Average may be 8- 42 days

Слайд 9Important Experimental Animal


Слайд 10Most Important experimental Animal


Слайд 11Transmission
Nasal/oral Droplets
Dermal Inoculations


Слайд 12Classification (Madrid)


Слайд 13Symptoms


Слайд 14Types of Leprosy
Depending on clinical features, leprosy is classified as:
Indeterminate Leprosy

(IL)
Paucibacillary Leprosy (PB)
Borderline Tuberculoid Leprosy (BT)
Borderline borderline Leprosy (BB)
Borderline lepromatous Leprosy (BL)
Multibacillary Leprosy (MB) 

Слайд 15WHO classification
Two Groups:
1 Paucibacillary
2 Multibacillary
Paucibacillary (PB): the number of M.

leprae in the body is small (less than 1 million) and a skin smear test is negative. The patient presents five or fewer skin lesions. Most cases of leprosy are PB.

Слайд 16WHO classification
2 Multibacillary
M. leprae can multiple in the body almost without

any check and is thus present in high numbers. The bacillus has likely spread to almost all areas of skin and peripheral nerves. A skin smear test is positive and the patient presents more than five skin lesions. 

Слайд 17Bacteria Resides in Cooler Parts of the Body
http://www.nlm.nih.gov

Skin
Peripheral Nerves


Слайд 18Symptoms & Diagnosis: (1) Skin Lesions
Worobec, Sophie M. 2009. “Treatment of

leprosy/Hansen's disease in the early 21st century.” Dermatologic therapy 22, no. 6: 518-37.

Слайд 19Immunocompromised individuals are more susceptible to disease


Слайд 20Mechanism of Nerve Damage
Scollard, DM et al. 2006. “The continuing challenges

of leprosy.”
Clinical microbiology reviews 19, no. 2: 338-81.

Entry Through Blood Vessels

2. Inflammatory Response

3. Demyelination


Слайд 21Sensory Loss

Paralysis

Deformities
Outcomes of Nerve Damage
Leprosy: eMedicine Infectious Diseases
http://emedicine.medscape.com/article/220455-overview


Слайд 22Sensory Loss Can Lead to Secondary Infections and Severe Deformities
International Federation

of Anti-Leprosy Associations (ILEP)
http://www.ilep.org.uk/en/

Слайд 251941: Discovery of Dapsone
Targets dihydropteroate synthase (DHPS)

Inhibits nucleic acid synthesis



Слайд 261964: Dapsone Resistance from Missense Mutations in DHPS
Matsuoka, Masanori M. 2010. “Drug

Resistance in Leprosy.” Japanese journal of infectious diseases 63, no. 1: 1-7.

DHPS - dihydropteroate synthases


Слайд 271960’s: Rifampicin and Clofazimine Discovered
Rifampicin (Rifampin): Inhibit RNA synthesis



Clofazimine:
Anti-inflammatory


Слайд 281981: WHO Proposes Multi-Drug Therapy (MDT)
Combination of DAPSONE, RIFAMPICIN, and CLOFAZIMINE
+
+


Слайд 29The Nippon Foundation
http://www.nippon-foundation.or.jp/eng/


Слайд 301995: WHO Distributes MDT Drugs for Free to Worldwide Patients


Слайд 311999: Global Alliance to Eliminate Leprosy As a Public Health Problem


Слайд 32Obstacles to Eliminating Leprosy in Endemic Countries
World Health Organization. 2001. “Leprosy:

Learning from Success.”
WHO Publications on Leprosy.

STIGMA




Слайд 33 Overcoming Stigma
Mass Media

Integrated Primary Health Services

Education & Training


Слайд 34Worobec, Sophie M. 2009. “Treatment of leprosy/Hansen's disease in the early

21st century.”
Dermatologic therapy 22, no. 6: 518-37.

Слайд 35In 2016 WHO has launched a new global strategy – “The

Global Leprosy Strategy 2016–2020: Accelerating towards a leprosy-free world” 

The targets of the new global strategy to be met by 2020 are:
Zero disabilities among new paediatric patients.
A grade-2 disability rate of less than 1 case per 1 million people.
Zero countries with legislation allowing discrimination on basis of leprosy.


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