Leprosy in Latin America and the Caribbean: Burden of Disease and Approaches for Elimination

Abstract

Leprosy is a highly treatable chronic bacterial NTD with multidrug therapy (MDT), which has a high cure rate. Early initiation of treatment in leprosy is important for limiting transmission and disability. Proper treatment decreases bacterial burden and thus likely decreases transmissibility considerably, though the degree of transmission risk reduction remains unknown due to lack of exact knowledge of transmission mode and mechanism. In order to eliminate leprosy in the Americas or elsewhere, concerted efforts need to target the stigma and discrimination legacy of this disease. Furthermore, monitoring, treatment, and rehabilitation of those who have important disability among new cases and among those individuals who have completed treatment will remain a challenge, even if the elimination goals are achieved. Finally, the statistics presented in this chapter and reported from WHO/PAHO do not capture the burden of disease associated with long-term disability even after completing MDT, as well as the potential occurrence of late leprosy reactions among many individuals classified as microbiologically cured. Setting realistic goals for elimination of leprosy in Latin America and other regions is crucial.