LEPROSY IS EVADING ERADICATION - A REVIEW ARTICLE EVALUATING MISSED DIAGNOSIS AND CLINICAL SENSITISATION

• DOI: 10.37572/EdArt_3006260555

• Palavras-chave: Leprosy M. Leprae M. Lepromatosis Misdiagnosis Delayed diagnosis.

• Keywords: Leprosy M. Leprae M. Lepromatosis Misdiagnosis Delayed diagnosis.

• Abstract:

  Leprosy remains prevalent in 2026 and continues to cause irreversible disability. This is despite efforts to increase detection rate of M. Leprae and M. lepromatosis, reduce the social stigma of leprosy, and provide afflicted patients with appropriate therapy at the earliest opportunity. Improvements in the accessibility of technology augmenting our ability to detect pathogens goes some way to improve detection rates. However, clinical suspicion remains the most important factor in increasing the rate of accurate and timely detection. Misdiagnosis of leprosy results from its ability to mimic many disease states and due to the lack of suspicion held by the examining clinician on first and repeated presentations. This project considers the case reports published either side of the start of the most recent leprosy elimination campaign to evaluate the factors which impede progress in reducing the prevalence and burden of leprosy globally. Through a systematic literature review, it is demonstrated that the average duration of disease prior to classic cardinal symptoms is over 18 months, and to accurate diagnosis over 2 years, these are significant results. Not only does this period of disease impact the patient themselves, but this time duration is also a period in which they pose a potential infective reservoir. In addition to this, environmental exposure is a factor which is poorly evaluated and requires additional exploration in the immediate future if we are to reduce the risk of exposure through this route. A gap in the literature exists to convincingly explain autochthonous cases of leprosy in non-endemic regions. A high level of clinical suspicion is required in all territories to better develop our control over leprosy pathogens. Presented within is a novel pre-diagnosis disease timeline, developed through the analysis of included case reports. This timeline will help sensitise clinical suspicion in endemic and non-endemic regions alike.