26 January - World Day of Assistance to Leprosy Patients

January 20, 2025

Since 1954, on the initiative of WHO, the World Day of Assistance to Leprosy Patients has been celebrated annually on the last Sunday of January all over the world. Within the framework of this day, various educational and charitable events are organised in our country by the efforts of the society of dermatovenerologists, dermatocosmetologists and leprosy patients in order to draw the attention of the general public and medical workers to the problem of social protection of leprosy patients, their rehabilitation and readaptation, and assistance to low-income families of leprosy patients.

       WHO classifies leprosy as one of the twenty neglected tropical diseases (NTDs). Like other NTDs, its emergence is often associated with poor socio-economic conditions.

Lepra is an infectious disease with a long incubation period and is caused by Mycobacterium leprae. Leprais transmitted through droplets from the nose and mouth, through prolonged and close contact with untreated infected people. The disease affects the skin and peripheral nerves, and without treatment it can progress to irreversible lesions of the skin, nerves, face, hands and feet, and lead to profound disability and social isolation. For millennia, stigma and discrimination have played a major role in relation to leprosy, overcoming which is important to achieve leprosy zero.

        Since the successful introduction of combination drug therapy (CDT) in 1981, WHO strategies have focused on reducing the prevalence of the disease, first to below 1 per 10 000 population, and then to further reduce the rate of new cases (especially among children). Some countries have already achieved very low numbers of cases, and may have ensured that sustained community transmission has been interrupted.

     In 2022, more than 174 087 cases of leprosy were identified in 182 countries. About 5% of cases (9 554 cases) had visible deformities at the time of diagnosis, a rate of 1.2 cases per million population - a 28% decrease from 2013 (13 305 cases-1,9 per million population). Globally, the rate of new cases among children was 10.302 cases-5,1 per million children, a significant improvement on the 2013 rate of 19.799 cases-10,4 per million children.

Detection of new cases (by age, sex and disability) by WHO region, 2022

           At the same time, in the European Region, which includes Kazakhstan, the number of detected cases for 2022 is 55 new cases, per million population 0,1.

          The WHO Global Leprosy Strategy 2021-2030, which was developed through a consultative process with all key stakeholders, reflects these epidemiological changes. Whereas previous strategies focused on ‘elimination of leprosy as a public health problem’, the new strategy focuses on interruption of transmission and achieving zero autochthonous (local) cases. Thus, the Strategy aims to encourage countries with a high burden of disease to step up their activities, and countries with a low burden to fulfil the unfinished task of making sure that leprosy remains only history. The Strategy is aligned with broader global health trends, including the movement towards integration of services across a wide range of diseases, digitalisation and accountability, and addresses key challenges such as human capacity, epidemiological surveillance and antimicrobial resistance. The strategy promotes innovative approaches, including targeted active case detection and the eventual introduction of a safe and effective vaccine. Encourages country efforts to develop ‘roadmaps to achieve zero leprosy’ and to provide chemoprophylaxis to all people who have been in contact with confirmed cases.

The implementation of the Global Strategy for Leprosy Control 2021-2030 will facilitate rapid and sustained progress in all leprosy-endemic countries, contributing to the successful implementation of the WHO Roadmap for the Control of Neglected Tropical Diseases 2021-2030 and meeting the targets of the Sustainable Development Goals.

       A world with zero leprosy infection and disease, without disability, and without stigma and discrimination associated with leprosy is possible.

     In the Republic of Kazakhstan, leprosy has been virtually eliminated to date. Kazakhstan is one of the countries with a low burden of the disease, but sporadic cases persist.

     For the first time information about leprosy on the territory of Kazakhstan, among the Ural Cossacks, was described by P.S.Pallas in 1769.

       In Kazakhstan leprosy began to be dealt with since 1929, when by the Decree of the Council of People's Commissars of the USSR it was decided to organise a leprosarium in the Kazakh SSR.

      Annual mass surveys of lepra foci made it possible to register practically all patients. The number of registered patients reached its maximum in the 1950s. Since the mid-50s, the number of patients discharged from the leprosarium for outpatient treatment has increased sharply, which is associated with the introduction of sulfone therapy. In total on the territory of Kazakhstan since 1929 3612 patients with leprosy were found.

        Since 60th years of the last century the total number of patients is decreasing. Decrease in the number of registered patients is caused by predominance of natural loss over morbidity. At the beginning of 2025 there are only 224 patients and 222 contact persons. 

  It should be noted that the achieved decrease in morbidity in Kazakhstan is sustainable. In recent years, the registration of single, sporadic cases of leprosy continues, for 10 years newly detected - 2, with relapse of the disease -0. The last patient was detected in 2017.

Data on newly registered and relapsed patients in the last 10 years.

There are no children or adolescents among the identified leprosy patients. Today, leprae affects only the elderly population, which, according to scientists, is characteristic of fading foci of this infection.  

       The low level of M.leprae infection in the population of Kazakhstan also corresponds to the relatively low proportion of patients with tuberculoid type of leprae (TT) in the structure of morbidity. It means that leprae in Kazakhstan today affects, first of all, the population predisposed to the disease rather than the stable population, which is also characteristic of fading foci. Thus, the current situation on leprosy morbidity in Kazakhstan as a whole remains favourable.

           The centre of treatment of patients and anti-epidemic measures is the Kazakh Republican Leprosarium. The leprosarium is located in Kyzylorda city, designed for 50 beds, as well as there are 2 dispensary departments in Aralsk city and in Kyzylorda city (Tasbuget settlement). Leprozorium is a modern medical organisation providing qualified, specialised medical care and some social services to leprosy patients.

          Currently, the leprosarium is not a place for isolation of leprosy patients. Patients registered for leprosy have the opportunity to receive medical care in other medical organisations in the country, as indicated.

       Successful fight against leprosy is impossible without the involvement of local health authorities. Our leprosarium has based its activities on dispensary methods of work and has established co-operation with skin and venereological institutions. This allowed us to establish permanent epidemiological control of leprosy and to conduct joint preventive examinations of the population.

Lepra is a social disease, therefore, in addition to specific prophylaxis great attention is paid to social prophylaxis. Improving working and living conditions, increasing the material well-being and sanitary culture of the population is the key to reducing the incidence of leprosy.

M.Seitaliyev, J.Sarsenbayev, T.Abubakir, S.Eginshibayev

State Institution ‘Kazakh Republican Leprosarium’ of the Ministry of Health of the Republic of Kazakhstan.

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