Japanese Journal of Leprosy最新文献

In Japan people affected by leprosy who were forced to admit to national leprosy sanatoria under leprosy prevention/segregation law (1953) have ever been promoted to return to live in community, after destruction of the law in 1996. In this paper two cases are shown with some comments who had already been discharged from leprosy sanatoria and came late to OPD of National Suruga Sanatorium for consultations of their leprosy related conditions. One case is a 60 year-old male who developed squamous cell carcinoma (SCC) from chronic planter ulcer. The other is a 69 year-old female who developed relapse after more than 20 years BI negativity. In these cases, periods until consultation to our clinic were one year and five months, and five years and five months respectively. One reason is that there is no follow-up system of leprosy related conditions for ex-patients in current medical service of Japan. Another reason may be that patients hesitated to consult local doctors for their leprosy related conditions. Since national leprosy sanatoria will come to be closed in near future, services should be available for leprosy related conditions, such as prevention of disability (POD), prevention of worsening disability (POWD), early detection of relapse and leprosy reaction, in general medical service of Japan.

The tenth meeting of the WHO Technical Advisory Group (TAG) on Leprosy Control was held in New Delhi, India on 23rd April 2009. The meeting was chaired by Professor WCS Smith and attended by TAG members, several experts, WHO secretariat, and members of the technical bodies of International Leprosy Association (ILA) and the International Federation of Anti-Leprosy Associations (ILEP) also attended the meeting.

The epidemiological situation of leprosy is reported by the health division of each country to WHO. The reported data is collected by WHO and is immediately run on the Weekly Epidemiological Record. On this latest edition, data from the beginning of 2009 was reported. In almost all of the highly endemic countries, control activities have been integrated within the general healthcare system. However, early case detection and prompt treatment with MDT remain the cornerstone of leprosy. In order to reduce the physical, mental and socioeconomic burded of leprosy, much remains to be done.

The main principles of leprosy control, based on timely detection of new cases and their treatment with effective chemotherapy in the form of multidrug therapy, will not change over the coming years. The emphasis will remain on sustaining the provisions for quality patient care that are equitably distributed, affordable and easily accessible. The Enhanced Global Strategy for Further Reducing the Disease Burden due to Leprosy: 2011-2015 together with the updated Operational Guidelines of the Enhanced Global Strategy. The Strategy will require endorsement and commitment from everyone working towards the common goal of reducing the disease burden due to leprosy and its detrimental physical, social and economic consequences in order to move closer to achieving the common dream of "world without leprosy".

This year is the centennial anniversary of the five national leprosaria in Japan. It means that the official accommodation of leprosy patients who were wandering on the streets started in 1909. At that time, the existence of these leprosy patients on the streets was considered as a national shame and also an evidence of falling behind the Western cultured countries. Japanese people and the government were hypersensitive of such notoriety, especially from the Western countries. Some doctors, politicians and bureaucrats were really concerned about the situation and made great efforts to establish the leprosy separation law. It was implemented in 1907, but it took two more years for the preparation of the sanatoria for accommodation. The leprosy separation law has persisted until 1996. It has been revised to the leprosy segregation law in 1931, and to the leprosy isolation law in 1953. Although the law underwent two revisions, the main ideology of isolation has been abundant for almost ninety years. This law has been infamous for its misery and pointed out to be abolished by the WHO. This paper will focus attention on the doctors, politicians and bureaucrats who have worked for the institution of this cruel law, and also discuss the reason why this law had prevailed.