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Infectious diseases frequently affect the peripheral nervous system by direct infiltration or indirect inflammatory response induced by the microorganisms. Peripheral neuropathies are commonly observed in the course of HIV infection and represent the major neurological complication of the disease. The heterogeneous spectrum makes the diagnosis challenging even for the expert neurologist and includes distal symmetric neuropathies, demyelinating neuropathies, mononeuritis multiplex, progressive polyradiculopathies, and diffuse infiltrative lymphocytosis syndrome. Peripheral neuropathy (PN) is one of the most frequently reported extrahepatic complications of HCV chronic infection, occurring in about 10% of HCV-infected patients. PN usually coexists with cryoglobulinemia and may manifest as chronic "length dependent” distal symmetrical sensorimotor or mainly sensory axonal polyneuropathy, "stocking-glove” asymmetric polyneuropathy, subacute mononeuropathy multiplex, or asymmetrical neuropathy involving large or small nerve fibers. Pure motor or demyelinating neuropathies and, rarely, cranial or autonomic neuropathies, have also been reported. Among the rarest causes of infectious neuropathies, leprosy and borreliosis are an important global health concern. The differential diagnosis is often difficult and sometimes, in particular in suspected neuritic form of leprosy, requires nerve biopsy and a detailed neuropathological analysis that can help for personalized therapy. With the COVID-19 pandemic, many cases of patients with peripheral nervous system involvement have been described, in the absence of a direct role of SARS-CoV-2. © Springer Nature Switzerland AG 2022.
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Introduction The COVID-19 pandemic imposed new challenge to the implementation of the National Leprosy Eradication Programme. According to national data, after lockdown due to COVID-19, there was a 29% reduction in total leprosy cases reported in the first quarter (April-June) of 2020 in comparison to 2019. Objectives To explore the difficulties faced by different stakeholders of the National Leprosy Eradication Programme like policy makers, doctors, grass root level health workers as well as leprosy patients during COVID-19 pandemic with respect to programme implementation and access to leprosy care. Materials and Methods Qualitative research was undertaken including two focus-group-discussions held among six leprosy patients diagnosed after lockdown and nine ASHA workers as well as six in-depth interviews of doctors, leprologists, and programme managers. Ethics committee approval was sought and informed consent was obtained from all participants. All focus-group-discussions were electronically recorded and the in-depth interviews telephonically recorded, transcribed and translated from Bengali-to-English. Transcripts were separately coded by researchers and thematically analysed with the help of Visual-Anthropac software version 1.0. Results Solitary focus on COVID-19 control, capacity building and information, education and communication, leprosy case search & surveillance, co-infection among health workers, transportation issues were the themes explored from focus-group-discussions of health workers and ASHA workers. Similarly, the present study identified six themes from in-depth interviews of programme manager, leprologists, programme manager as diagnostic difficulty, operational issues, rehabilitation issues, capacity building & information education and communication activities and way forward. Limitations The research reveals the perceptions of rural population of Eastern India with high leprosy prevalence, which might not be applicable for urban areas or low prevalent districts Conclusion The solitary focus of the administration towards COVID and shifting the infrastructure and human resource only towards the management of COVID can lead to resurgence of the leprosy. Having an organised framework of operations, catering to the need of the front-line workers in rendering services, utilizing the digital platform and social media, and focusing on rehabilitation would be needed to overcome the crisis.
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Background and Aim: Leishmaniasis is a parasitic disease transmitted by sandflies and is one of the endemic diseases of Iran. With the spread of the Covid-19 epidemic worldwide, the virus will interface with endemic infectious diseases in different regions. In this study, coronavirus disease was evaluated in patients with a history of leishmaniasis referred to the Center of Research and Training in Skin Diseases and Leprosy. Methods: A total of 91 patients with a history of leishmaniasis were studied for possible SARS-CoV-2 infection. The number of patients referred to the Center of Research and Training in Skin Diseases and Leprosy during the coronavirus epidemic was also compared with the same period before the epidemic Results: A total of 60% of patients with leishmaniasis did not report coronavirus disease. Twenty-one percent of cases had a mild corona disease, 13% had a moderate and 3% had severe corona disease. Only a single death was reported in corona patients with a history of cutaneous leishmaniasis. The number of referrals before the beginning of the corona epidemic was twice as high as during the epidemic. Conclusion: In these participants, mortality and side effects of COVID-19 were significantly less reported. However, further studies are needed to evaluate the immune system and cutaneous leishmaniasis protection against COVID-19. Various factors can be effective in reducing patients during the epidemic, including not going to medical centers, reducing the number of trips, and observance of health issues.
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In the present pandemic, social distancing for health care calls for special attention. Eversley Childs Sanitarium and General Hospital (ECSGH), originally Eversley Child Sanitarium (ECS) in Metro Cebu/Philippines has been representing for decades a humane health care philosophy and built environment. In this study, the researcher inserts ECS in the typology of leprosy facilities and investigates its transition through time. He follows up the social-medical backgrounds of each spatial developmental phase. Comparing ECS with historical leprosy facilities, the researcher proves that from its foundation on, ECS has been following community-driven medical principles and realized corresponding architectural-urban features. The main finding consists in the resiliency of the Sanitarium's original design philosophy which is in position to give impulse for an incoming heritage conservation and urban rehabilitation. The researcher recommends to update the area to a modern hospital with a cluster of livable new subdivision designs in conformity with ECS' original dynamics.
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Mycobacterium indicus pranii (MIP) earlier known as Mw is a soil-borne, non-pathogenic, saprophytic and rapidly growing strain of mycobacteria. MIP is approved as a vaccine/ immunomodulator for various indications including mycobacterium infections like leprosy in humans. Its administration has resulted in satisfactory clinical improvement, accelerated bacillary clearance, and increased immune responses to Mycobacterium leprae antigens, thereby shortening the full recovery time of the patients. It also shares its antigens with M.tuberculosis. In the last decade, RCTs have been done establishing immunotherapeutic properties of MIP in the treatment of leprosy, tuberculosis, warts and experimently in leishmaniasis. Through its immune inducing and cytotoxic property, it has also proved beneficial for human use especially in treating lung cancer. The beneficial role of it is also being explored in breast, cervical, oral, liver, and bladder cancers. Various studies on MIP have shown that it has immune-modulating properties in humans. The curiosity of the human mind has led to it being tried in Covid treatment trials. The results have shown that administering MIP has lowered inflammatory markers in Covid 19 patients, promising us for it to be a potential treatment option. More RCTs with a larger sample size should be done to establish this. Cytokine storm seen in bacterial sepsis is also decreased with MIP administration. Considering the encouraging results in hastening recovery in various diseases it appears that MIP is perhaps not being exploited to its fullest potential. © 2023, Hind Kusht Nivaran Sangh (Indian Leprosy Association). All rights reserved.
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Jesus' response to the leper's request in Mark 1:40-45 tempers the harsh reality of laid down protocols for the management of leprosy. Against the physical distance of the time, Jesus takes the risk of touching the leper. He restores his battered dignity, heals him, and shows solidarity. The COV-ID-19 pandemic has stigmatized the human person as a weapon of infection. This situation has questioned the nature of man as a social being and impeded inter-human relationships. Using the synchronic approach of the historical critical method for the study of this text of Mark, this work compares the challenges of the leper in the ministry of Jesus with the threats posed by COVID-19. It concludes that both situations stereotype the human person and affect interpersonal relationships. It proposes Jesus' compassionate disposition and sense of solidarity as indices for the management of the COVID-19 crisis. © 2022 Strossmayer University of Osijek, Catholic Faculty of Theology in Djakovo. All rights reserved.
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Hyssopus officinalis is a traditional medicinal plant that belongs to the family Lamiaceae, which has been used for centuries for various purposes like carminative, expectorant, and cough reliever. It has been used for the treatment of numerous diseases in patients such as ulcers, asthma, jaundice, leprosy, dropsy, bronchitis, COPD, diabetes, AIDS, bacterial and fungal infections as an herbal remedy due to its fewer side effects and is more efficacies than other traditional medicine. Major classes of chemical compounds found in H. officinalis essential oil are bicyclic monoter-penes, monoterpenoids, acyclic monoterpenes, phenolic monoterpenoids, monocyclic monoterpenes, monocyclic sesquiterpenes, tricyclic sesquiterpenes, bicyclic sesquiterpenes, tricyclic sesquiterpe-noids, straight chain saturated hydrocarbons. Some of the major chemical constituents present in the H. officinalis are beta-pinene, alpha-pinene, 1, 8-cineole, apigenin, diosmin, caffeic acid, rosmarinic acid, cis-pinocamphone, trans-pinocamphone, iso-pinocamphone, pinocarvone, which are responsible for its various pharmacological activity. Various studies have been performed on the pharmacological activity of its extract, such as antioxidant, antimicrobial, anti-diabetic, anticancer, antiviral, anti-inflammatory, analgesic, anti-leishmanial, anthelmintic, anti-protozoal, and anti-anxiety. Recently, it is used as an anticancer agent and has been demonstrated by studying its cytotoxic and apoptotic effects on breast cancer and colon cancer cells. It is used as a potent antibacterial and antifungal agent being studied on the antibiotic-resistant bacterial and fungal strains recently, which can be further useful in developing herbal medicine against AMR. It is an excellent natural antioxidant due to the presence of polyphenolic compounds, and H. officinalis is used in various food industries as a source of natural antioxidants, which has minimum side effects as compared to artificial antioxi-dants. Furthermore, the pharmacological activity of these individual chemical constituents in H. officinalis extract still needs to be investigated for identifying the effectiveness of this plant in the natural treatment of various diseases. This review aims to collect various data regarding the traditional herbal plant hyssop (Hyssopus officinalis), including its photochemistry, chemical structures of the phyto-constituents and pharmacological profile, along with all the pharmacological models. This plant has significant importance in the health industry, so further studies are required on its effective usage against various emerging health problems, including COVID-19, cancer, diabetes, AMR.Copyright © 2023 Bentham Science Publishers.
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Leprosy is a pathology known to mankind for centuries. The clinical manifestations of leprosy depend on the patient's immune reaction against Mycobacterium leprae, ranging from small hypochromic lesions and hypoesthesia to progressive and diffuse infiltrations of the skin, involvement of upper airway mucosa and involvement of cutaneous as well as nerve trunks. In some cases, and especially during reactions there are several manifestations and signs and symptoms of systemic involvement. The objective of the present study was to analyse the incidence of leprosy and the epidemiological parameters in the period from 2011 to 2021, in the Northeast of Brazil. The Notifiable Diseases Information System-SINAN of Brazil was consulted and is being reported on the detected cases of leprosy. The various parameters being discussed in the present study include sociodemographic aspects, types of injuries, clinical form, treatment regimen, degree of disability and clinical evolution. We were all during a global pandemic in 2020-21. The 2020-21 global pandemic of COVID-19 compromised the monitoring and recording of several diseases, which were left in the background. This fact may have contributed to the drop in the number of leprosy cases registered between 2020 and 2021 in the present study. There were 168,848 reported cases, of which 55.57% were males 62.87% were multiracial, most with low education level, until primary education, 35.63% had multiple skin lesions, 68.51% received treatment for the multibacillary type of disease, 26.83% (24.468) had neuronal impairment and, 71.74%, were considered cured. Despite the drop in the global number of cases observed in the region, several factors are still worrying, these require actions that contribute to the eradication of leprosy in the region, and these include programs that eradicate poverty, implementation of health programs that favour early diagnosis and treatment of leprosy cases, reduction of stigma and social exclusion of affected patients.Copyright © Hind Kusht Nivaran Sangh, New Delhi.
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Objectives: To analyse the effect of using digital health technology on leprosy control programmes. Method: The systematic review comprised search on PubMed, Scopus, ScienceDirect, SAGE and ProQuest databases for interventional studies published in English language from 2013 to 2021 which used digital health technology for leprosy contact tracing, active leprosy detection, monitoring of multi-drug therapy and treatment management during the corona virus disease-2019 pandemic A standard risk of bias tool was used to evaluate bias in the studies, and the Joanna Briggs Institute protocol was used to assess the quality of the studies analysed. RESULTS: Of the 205 studies initially identified, 15(7.3%) were analysed in detail. Quasi-experimental studies had a low risk of bias compared to the rest. The e-leprosy framework was being used along with applications based on smartphones and artificial intelligence Digital health technology was found to be practical, accessible and effective in leprosy control programmes. CONCLUSIONS: Studies reported favourable findings regarding the use of digital health technology in services related to leprosy patients.
Subject(s)
COVID-19 , Leprosy , Humans , Pandemics , Artificial Intelligence , Leprosy/drug therapy , TechnologyABSTRACT
In 2020, there were reports of people with albinism being branded as 'Corona' and 'COVID-19', using individuals as scapegoats and further ostracizing them from communities. People with albinism are vulnerable to human rights' violations and suffer with skin and eye health. Albinism is increasingly recognized in the Pacific Region, particularly in the Polynesian community in Fiji, Samoa, Vanuatu and Tuvalu. A register has been created for Fijians with albinism, with the objective of understanding the scale and health needs of the population. In 2014, The Fiji Albinism Project was established through charity funding in partnership with the Fiji Ministry of Health. The aim is to improve the quality of life of people living with albinism in Fiji. Proformas are completed by Fijians with albinism and their details are collated into an Excel spreadsheet, including name, gender, date of birth, ethnicity, contact details, address, nearest health centre, school, date of entry and additional comments. The database currently holds the details of 172 people with albinism (aged 9 months-77 years), with 161 self-reporting as iTaukei. There are 88 females and 82 males registered (two do not have gender documented). Sixty-four participants are < 18 years of age. Basal and squamous cell carcinomas have been seen among adults, with one incidence of clinical Bowen disease in a child. Similar numbers of people attended the national skin clinic in 2020 vs. nonpandemic times. However, uptake of outreach clinics was reduced and fewer people with albinism are collecting free sunscreen. Owing to the COVID-19 pandemic, the first virtual International Albinism Awareness Day was held in 2020, with participants from Fiji. In 2020, a 5-year National Strategic Plan for Dermatology, Leprosy and Albinism was submitted and reviewed by the Minister of Health and Permanent Secretary of Health in Fiji. The plan includes proposals for continued free sunscreen and formalizing of referral pathways to Tamavua Twomey Hospital and The Pacific Eye Institute. This incorporation of albinism care within the Ministry of Health and Ministry of Education provides a model for other pacific islands and developing countries to follow.
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Leprosy is the oldest disease affecting humankind since ancient times. Despite MDT's availability for disease curability, vast pockets of multi-bacillary (MB) cases persist in the community. We conducted this study to know the clinico-epidemiological trends of leprosy over four years and five months in this era of the COVID-19 pandemic (C19P). A total of 90 cases were registered;59 (65.5%) were males, and 31 (34.5%) were females. The majority (69%) of cases were in the 15-45 age groups. Childhood leprosy was detected in 3(3.3%) cases. A history of contact with leprosy patients could be established in 16 (17.8%) cases. The cases comprised 54.5% local inhabitants and 45.5% were migrants. The MB cases 77 out of 90 (85.6%) were in higher proportion than pauci-bacillary (PB) cases. In the clinical spectrum, BL leprosy was most common in 39% of cases, followed by LL and BT leprosy. Thirty-seven (41%) patients were suffering from lepra reactions (LR), and out of them, 59.4% had type 2 reactions (T2R), and the rest had type 1 reactions (T1R). Disabilities were found in a total of 56 (62.2%) cases, and grade 2 disabilities (G2D) were recorded in 25 (44.6%) patients. Ulnar nerve (UN) was most commonly affected nerve in 64.4% of cases, followed by lateral peroneal (LPN) and posterior tibial nerve (PTN). We observed the impact of Covid 19 infection peak C19P in two ways;firstly, during the C19P peak in 2020, there was a drastic fall in total registered cases (TRC) to 4/year against 22/year in pre-C19P with a relative increase in LRs and disabilities. In post-C19P peak periods, not only was there a marked rise in TRC (20/5 months), but LR (50%) and disabilities (75%) also showed a significant rise. A high proportion of MB cases, LRs and disability rates indicate the need for population-based studies and subsequent public health measures for early diagnosis and treatment. Further large sample-sized, in-depth studies can tell the exact impact of C19P on leprosy.Copyright © Hind Kusht Nivaran Sangh, New Delhi.
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Leprosy is a neglected tropical disease (NTD) that continues to burden low- and middle-income countries (LMICs), despite being eliminated as a public health concern by the World Health Organization (WHO) in 2000. The causative agents, Mycobacterium leprae and Mycobacterium lepromatosis, affect nearly 200,000 individuals globally each year, with over 19,000 new cases detected in the Americas in 2020 alone. Canada has experienced an increasing incidence of leprosy, due to rising levels of travel and migration from endemic areas, reaching over 37,000 individuals with leprosy by the end of 2020. Patients experience a spectrum of signs and symptoms including hypopigmented cutaneous macules alongside peripheral neuropathy including peripheral neuropathic pain (PNP) and disabling sensory neuropathies. Despite the development of effective and curative therapeutics via multidrug therapy (MDT), many barriers to treatment adherence and effective immunological control of the pathogen challenge the care of patients with leprosy. Socioeconomic barriers, such as disability-related social stigma and often undiagnosed nutritional deficiencies, have resulted in heightened disease severity. PNP therapeutics are associated with significant side effects and remain ineffective as the majority of individuals will not experience a greater than 30% reduction of symptoms. Nutrient supplementation is known to be instrumental in reducing host oxidative stress, strengthening the immune system and mitigating comorbidities. Likewise, dietary lifestyle interventions known to be physiologically beneficial have recently emerged as powerful tools conferring neuroprotective effects, potentially mitigating PNP severity. However, a significant knowledge gap concerning the effect of adequate nutrition on host immunological control of leprosy and PNP severity exists. Further evaluation of this relationship will provide key insight into the pathogenesis of leprosy, strengthening the current body of literature.
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The World Health Organization (WHO) recommends multidrug therapy (MDT) for the treatment of paucibacillary and multibacillary forms of leprosy, also known as Hansen's disease (HD). MDT combinations of dapsone, rifampin, and clofazimine have reduced the prevalence of the disease but are not without adverse effects impacting regimen adherence. Hence, an urgent need exists to consider alternative MDT regimens with an improved safety profile that promotes treatment adherence. Herein, we described a case series of 10 patients with HD (nine patients with multibacillary leprosy and one with pure neural leprosy) treated with monthly rifampin, moxifloxacin, and minocycline (RMM). The United States National Hansen's Disease Program (NHDP) diagnosed and treated patients across US institutions. All patients received a regimen of 12-24 months of RMM. We reviewed the clinical outcomes, adherence, rate of completion, and adverse events of patients treated with monthly RMM from January 2019 to August 2022. Nine patients had multibacillary leprosy, with some having type-2 reactions. One patient had pure neural leprosy with a reversal reaction. In this case series, we identified that all patients completed the RMM regimen without treatment interruptions. None of the patients experienced any skin hyperpigmentation or any significant side effects. All patients tolerated the monthly RMM regimen with rapid improvement of skin lesions and without logistic hurdles. Based on previous clinical evidence and the results of this case series, the NHDP and other programs should consider the RMM regimen as first-line therapy.
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Em março de 2020 a Organização Mundial da Saúde decretou estado de pandemia por SARS-Cov-2, o que exigiu importantes medidas médicas e sanitarias, bem como posicionamentos e ações políticas com consequências agudas por parte de todos os países atingidos. Johan Goudsblom aborda as epidemias de lepra, peste, sífilis e cólera, discutindo possíveis transformações civilizatórias. Seguindo na mesma linha do autor e adicionando discussões centradas nos conceitos eliasianos de figuração, interdependência, identidade-eu e identidade-nós, esse ensaio traz algumas reflexoes, elaboradas ainda no calor dos acontecimentos, a respeito da sociedade brasileira.Alternate :In March 2020 the World Health Organization declared a state of pandemic by SARS-Cov-2, which required important medical and health measures as well as political stances and actions with acute consequences on the part of all affected countries. Johan Goudsblom addresses the epidemics of leprosy, plague, syphilis, and cholera, discussing possible civilizational changes. Following the same line and adding discussions centered on the Eliasian concepts of figuration, interdependence, I-identity and We-identity, this essay brings some reflections, still elaborated in the heat of the events, concerning Brazilian society.
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Context: Coronavirus disease 2019 (COVID-19) has shown the potential to affect the life of people all over the world either directly or indirectly. Aim: To assess the impact of lockdown measures on treatment of leprosy among patients who received treatment from a tertiary referral centre. Settings and Design: A retrospective study was conducted at the dermatology department of a tertiary referral centre. Materials and Methods: We did a retrospective analysis of case records of patients with leprosy who received treatment from our tertiary referral centre from 01 March 2020 to 31 May 2021. Results: During the 15-month period, 59 patients received multi-drug therapy (MDT) for leprosy from our centre. Thirty-two patients (54.2%) were already receiving MDT as on March 2020, and 27 others (45.8%) were diagnosed with leprosy and started on MDT during the period from March 2020 to May 2021. Two patients (3.4%) developed COVID-19 while on MDT. When lockdown measures were implemented, 12 patients (12/59, 20.3%) discontinued treatment, citing conveyance difficulties. Three patients (3/59, 5.1%) were lost to follow-up. Limitations: Small sample size and reliance on retrospective data from a single centre were the major limitations of the study. Conclusion: A conscious effort is needed from healthcare professionals and the government to ensure that implementation of national programmes is not adversely affected by the ongoing COVID-19 pandemic.
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Spread of pathogens to the nervous system is a serious complication of infections. In addition to infections with well-known microbes and viruses in the Western world, and the World Health Organization priorities of HIV/AIDS, malaria, and tuberculosis, several neglected tropical infectious diseases target the nervous system and have high mortality rates. Infections can cause cognitive and behavioral disturbances as well as late-onset epilepsy in survivors. The specialized environment in the brain dampens immune responses to avoid harmful effects on the nonrenewable nervous tissue. Some pathogens can therefore evade efficient elimination, persist, and be involved in interactions with nervous tissue that create balances, which, if lost by the host, can result in long-term functional disturbances. Viruses also can be useful tools to study the structure and function of the nervous system. Neuroscience can disclose mechanisms of neurodegeneration and brain dysfunctions from studies of the interplay among pathogens, nervous tissues, and immune responses that could lead to better management of brain disorders. © 2023 Elsevier Inc. All rights reserved.
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Background: Tuberculosis prevails to be the leading cause of deaths from infectious diseases following COVID-19 in 2021. Global MDR/RR-TB cases were estimated at 3.3% and 18% of new and previously treated TB cases in 2019. The 2019 annual National Tuberculosis and Leprosy Programme (NTLP) report estimated an increase in MDR/RR-TB notification from 217 in 2015 to 534 patients in 2019 in Tanzania. The country uses a longer oral MDR/RR-TB regimen of 18 to 20 months as standard of care since November 2019 although the 2018 WHO DR TB guidelines recommended a new shorter all-oral bedaquiline-containing MDR/RR-TB regimen. Given paucity of clinical and programmatic evidence, WHO called upon operational research if pilots of the regimen are to be conducted. In response, NTLP collaborates with the National Institute for Medical Research-Mbeya Centre and Kibong'oto Infectious Diseases Hospital in conducting operational research with acronym RISE project, in 16 MDR/RR-TB facilities since June 2019 to assess the new regimen's clinical effectiveness and feasibility. Objective(s): To describe acceptability, facilitators, and barriers in implementation of a modified shorter all-oral MDR/RR-TB regimen as perceived by healthcare workers and MDR/RR-TB persons. Method(s): A qualitative descriptive study was used that purposively selected 16 MDR/RR-TB persons enrolled in MDR/RR-TB treatment facilities implementing the RISE project and 53 HCWs from respective facilities. A total of 36 IDIs and 8 focus group discussions with 33 HCWs were held at 6 and 15 months timepoints. Data were analyzed by thematic analysis using ATLAS ti. Result(s): Four themes emerged namely;preference for shorter MDR/RR TB treatment, inaccessible laboratory tests, persistent infrastructural limitations and enhanced programmatic support. Conclusion(s): The shorter all-oral bedaquilline containing regimen is acceptable by MDR/RR TB persons and providers however, financial support for patient access to safety tests and strengthening facility laboratory infrastructure is crucial for the clinical effectiveness of the regimen.
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Since the onset of the COVID-19 pandemic, the priorities of leprosy affected patients in seeking anti-leprosy treatment have been affected. This study was initiated at a tertiary leprosy hospital in India to understand the health seeking behaviour of leprosy affected patients who delayed their treatment. A total of 164 patients who delayed their treatment during the COVID-19 lockdown were recruited. The health seeking behaviour and treatment methods adopted by the patients during the lockdown were retrospectively analysed through an exploratory study. Lockdown prevented travel in many cases, but stigma was not an important factor in those who delayed. Of the 164 subjects, 17 developed new leprosy-related impairments. Of those who delayed, patients with plantar ulcers carried out self-care that had been taught to them earlier and they could continue treatment in spite of the lockdown. Reinforcing the patients regularly through health education and self-care teaching helped them to manage and prevent worsening of leprosy related impairments. © The author(s).