Past disease? No way. This infectious pathology, caused by the Bacille MyCobacterium Leprae, continues to receive at least 200,000 people worldwide (minimized figures), a new case every three minutes, recalls the Raoul Follereau Foundation, which has been acting for 60 years with sick.
With more than 100,000 cases declared on average each year, India concentrates the majority of world cases. Next come Indonesia, Brazil and the African continent. France remains free from indigenous cases, but some imported cases can be detected sporadically overseas.
If it is treated and only rarely kills, leprosy continues to suffer from poor repetition, linked to the stereotypes of history, often leading to the exclusion of the patients. And this “Despite its very weak contagiosity”which is done “Essentially in the family sphere”recalls the foundation.
“It is a neurological disease with a dermatological expression”summarizes Dr. Bertrand Cauchoix, infectious scientist who worked all his life in Africa, especially on AIDS and tuberculosis, before engaging alongside the Foundation. “It is commonly said that the bacillus licks the skin and bites the nerve”which can lead to desensitization and damage to motor skills, translated in particular by paralysis (claw hand and falling foot) and amyotrophies.
Climate change
Claiming 16 million patients treated in 30 years, the Raoul Foullereau Foundation, named after its creator, intervenes mainly in French -speaking Africa, and in particular in four so -called countries “Priority” (Madagascar, Cote d’Ivoire, Chad and Benin).
On this last country, “We hope to win the battle in a short time”explains Bertrand Cauchoix, Benin now with less than one hundred patients.
“The scandal today is that we know how to diagnose leprosy, we know how to cure it, but unfortunately, poverty acts as an obstacle”adds the doctor. “If we could multiply the exams, it would make it possible to detect in perhaps infraclinical stages”.
Thus, the activity of the foundation aims to « Pallor the difficulties of access to the health system poor populations ”, Through screening actions with residents, logistical support and staff training in the countries concerned. In addition to the medical aspect, it also acts with patients excluded to promote their social reintegration.
In developed countries, it also supports research programs to find effective treatments.
So, for Bertrand Cauchoix, the interest of a world day is also an opportunity to educate public opinion and mobilize donors.
« Today, activities on leprosy are only funded by charitable foundations, which themselves live only in generosity ”he explains. Like Raoul Foullereau in France, or in the order of Malta, which also works in the fight against illness.
-The Foundation also warns on the impact of climate change on the detection and monitoring of patients; which acts both on “The impoverishment of states” (and its consequences in terms of health budgeting), and on the displacement of populations, “Treatment stop vector”.
New treatment tracks
Because the current treatment against leprosy – an association of several antibiotics (rifampicin, clofazimine and dapsone) – is “Very long and restrictive” (Six to twelve months) Recalls Alexandra Aubry, microbiology professor at Paris-Sorbonne University and member of the Foundation Medical Commission. The downside is that patients “Apparently improved or healed”can be encouraged to stop.
“The risk is that we relapse with a bacteria which has become resistant to at least one of the antibiotics used”she says.
In addition, clofazimine has a particular side effect, which gives the skin a coloring-yellow-orange to brown-black-helping to amplify the “Stigmatization” which already surrounds this disease.
Recently, Bedaquiline, an already effective antibiotic against tuberculosis has shown “Spectacular results” on leprosy, according to two parallel studies published and to be published in the New England Journal Of Medicine.
Carried out respectively on 8 and 30 patients, they showed that Bedaquiline had a “Effect almost never observed vis-à-vis the leprosy agent” which therefore makes a treatment “Really promising”rejoices Alexandra Aubry.
Betaquidine having a long half-life, “We can very well imagine giving treatment to patients only one or twice a month”she adds.
Concerning a potential vaccine, however, “It is probably not to this solution that you have to go to priority”with regard to the financial means allocated to the disease that remains “Unfortunately limited”.
https://www.whatsupdoc-lemag.fr/article/10-millions-de-vaccins-antipaludiques-distribues-en-afrique-en-un-et-les-resultats-sont
“It doesn’t interest the private sector. We are not going to vaccinate the West, we are not going to vaccinate the United States, so no one will finance it ”concludes Bertrand Cauchoix.
Note from the editorial staff: Raoul Follereau (1903-1977) remains a controversial character in the history of France who, if he devoted the second part of his life to the fight against leprosy, he also posted publicly to The Pétainist and Maurassian extreme right, and has demonstrated its support for European fascist regimes in the interwar period.
In an email at What’s up Docthe foundation wanted to recall that it “Do not deny the controversial facts linked to the political past of Raoul Follereau, but insists on his humanitarian commitment to the patients of leprosy from 1942 (…)”. Elle “Also claims its independence and its apolitical character (…)” And said he was detached “Any political influence [et] religious to focus on the fight against leprosy and neglected diseases ”.
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