Leprosy tertiary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
After leprosy has been diagnosed and treatment has been initiated, other measures may be taken, in order to minimize further damage to the patient. These include: education of the patient and family members to monitor and treat skin ulcers and other lesions, primary care facilities to provide help to the populations and to direct patients to a specialist, whenever needed.[1]
Tertiary Prevention
Once an individual is infected with leprosy and symptoms start to develop, the longer the period taken to establish a correct diagnosis and until treatment is started, greater the chance of developing lifelong damage. It is important to emphasize this time frame because, even after the diagnosis has been reached and adequate therapy has been started, significant nerve damage will continue to develop, particularly in multibacillary cases. This damage will then decline throughout the following 3 years. Education of the population to prevent further damage, monitor and provide basic treatment should be emphasized. Once the damage has been established, it is important to minimize its impact on the lives of the populations. For this, important measures may be applied, including:[1]
- Home self-care - the activities that individuals may perform at their homes, individually or with assistance of family members, such as wound dressing of the hands or feet, thereby minimizing further damage.
- Interventions and education at the local clinic.
- Direct education of patients to treat their lesions, prevent further damages and identify early symptoms, that should direct them to seek medical attention.
- Educate about protective footwear and orthotics.
- Identify problems that may need specialist intervention.
- Provide basic care and monitoring of skin ulcers and sequelae of the disease.
- Specialist intervention, such as:
- Assist patients with acute eye problems.
- Debridement of infected areas.
- Surgery in required cases.