Feared and forgotten, leprosy still in Kenya

Leprosy, an antiquated disease so old that people only relate to it through the Bible, affected 109 people in Kenya in 2018 due to ignorance in the public and healthcare workers.

According to annual reports from the National Tuberculosis Leprosy and Lung Disease Programme, the coastal area is the most affected. Kilifi recorded the highest cases (35) with Kwale and Mombasa recording six each.

The western part of the country was not spared either: Siaya had 12 cases, Busia nine and Homa Bay five. 

When not treated, the disease leads to limb deformities. Patients can also go blind and may never be sensitive to pain or heat because their nerves are damaged.

Men and children seem to be the most affected by leprosy, but in terms of severe disability, women have the worst outcomes.

Dr Fatihiyya Wangara, a researcher based in Kwale, said that while it has not been established yet, there seems to be a close association between living near water bodies and the forest to the disease.

Hansen’s disease is a bacterial illness caused by Mycobacterium leprae that is easily cured with a combination of drugs if detected early. Today, research into the disease reports that approximately 95 per cent of the world’s population is naturally immune to the leprosy-causing bacilli and is in no danger of contracting the disease. Dr Wangara said diagnosis is fairly simple.

“There are patches on the skin that look like ringworms but they are not itchy and when pricked, the patient does not feel pain,” she told the Nation. Apart from the patches, patients may also exhibit limb deformities.

Derogatory term

The medical fraternity shifted the name of the disease to its scientific name — Hansen’s disease — in a bid to dismantle the religious and historical stigma attached to it and its affiliation with the derogatory term “leper.”

However, that has not made life easier for those living with the disease, or the scientists working on it. Leprosy was eliminated from Kenya in 1989, a status the country attained when there was just one case in 10,000 people, but it has been reported in 25 counties. 

Data shows that Kenya has reduced the numbers from 6,558 in 1986 to just 109 in 2018. Prof Matilu Mwau, a medical doctor and an infectious disease expert, termed the cases as “very few but nobody should be suffering from Leprosy in this age”.

Studies, including those sponsored by the Ministry of Health, show that the low suspicion in the health workers contributes immensely to spreading of the disease.

Yet literature of the bacterium that causes the disease— Mycobacterium leprae — shows that it is a lethargic microorganism that lost its power in the times of Jesus. Leprosy bacillus is poor at migrating from one person to another and dies so fast outside the body

The shape does not make it strong either. Normally, bacteria’s genome— the arrangement of all its DNA that make it— are aligned in a way that would facilitate the microorganisms to multiply and infect others.

But the recent studies have found that nearly half the DNA in Mycobacterium leprae consists of pseudogenes, genetic material that are now inert and just occupy space. For this reason, Leprosy is very slow in conquering its space: it divides itself just once every 12 to 14 days, against 20 minutes for the Escherichia coli that causes a number of food poisoning.

Be that slow as it may, if not treated, Mycobacterium leprae will multiply into the many trillions, forming thick, scaly nodules on the face and extremities and then destroys the Schwann cells that protect the nerves of the peripheral nervous system such that the patient will never feel any pain when pricked, burnt or hit.