Nigeria
History of leprosy in Nigeria
Leprosy colonies were established around the country in the late 1920s and early care was provided by Christian missionaries.
By the 1940s and 50s Nigeria was ahead of many countries in its leprosy control activities. C M Ross pioneered outpatient treatment and was involved in pioneering the use of dapsone as a new drug for leprosy care.
The programme faced setbacks in the 1960s and 1970s due to the impact of the Nigerian civil war.
The Federal Government of Nigeria launched the National Tuberculosis and Leprosy Control Programme to control the increasing prevalence of leprosy and tuberculosis.
At the start of 1992 the World Health Organisation thought there were 360,000 people with leprosy in Nigeria. By July 1993, the WHO had revised their estimate to 63,000 following a cleaning of the registers when it was discovered that some patients had been taking treatment for ten, 15 and even 20 years.
Nigeria adopted multi-drug therapy as the means to treat persons affected by leprosy in 1993.
Around 1996 approximately 30% of past or present people affected by leprosy in Nigeria were affected by a disability or impairment.
Leprosaria abolished in Nigeria with the long-term plan of providing community-based treatment programmes. Of those who have left colonies, some are living in roadside huts and begging from passing motorists.
In the post-leprosaria abolition years, default and irregular clinic attendance by patients with leprosy were many and complicated control of leprosy.
A study conducted in 2002 in Nigeria revealed health workers knowledge of leprosy to be inadequate and identified the need for suitable training programmes on leprosy.
Nigeria achieved less than one case of leprosy per ten thousand people in 2003. However, since then it has been struggling to overcome discrimination against people with obvious signs of the disease and to address the disability it causes. Many find it hard to seek help because they fear being stigmatised.
In 2006 Nigeria was one of seven countries in Africa reporting more than 1,000 new cases a year (the other six being Angola, the Democratic Republic of Congo, Ethiopia, Madagascar, Mozambique, Nigeria and Tanzania).
Today there are plans to integrate HIV/AIDS control measures into the tuberculosis and leprosy program so as to facilitate early case detection of tuberculosis among persons living with HIV/AIDS. Benue, Cross River, Ebonyi and Gombe States have the highest levels of leprosy infection in the country, closely followed by Adamawa, Kano, Taraba, Yobe and Zamfara.
Nigeria: leading role in advances in treatment of leprosy
Dr Lykle Hogerzeil went out to eastern Nigeria in 1955. After working in leprosy hospitals at Itu and Uburu, he became Medical Superintendent of Uzuakoli Leprosy Settlement. Attached to the hospital was the Research Unit, well-known for its trials in anti-leprosy medicines. During 1947 Dr John Lowe had studied there the effect on leprosy patients of Dapsone taken by mouth (until then most treatment was given by injection). There, too, Dr Frank Davey had done much work on thiambutosine (DPT), at that time a useful medicine for patients who were intolerant of Dapsone.
Dr Stanley Browne (see RDC page) became senior leprologist at the Leprosy Research Unit of Uzuakoli in 1959. In 1962 Dr Browne, then head of the Research Unit, and Dr Lykle Hogerzeil published the first report on the use of Clofazimine in leprosy patients. This drug superseded DPT and later became part of the MDT of multi-bacillary patients. Dr Hogerzil wrote of it: “I still remember our excitement during the Clofazimine trials when we noticed that ‘B 663’, as it was then called, not only reduced bacterial index of positive patients but also diminished the frequency and sensitivity of their ENL reactions.”
Opo
Opo is the native term for leprosy in southern Nigeria. It is seldom used for fear that repetition could cause the speaker to contract this disease.