Better prevention could cut leprosy complication's high cost for Indian families - study

By Kieran Guilbert LONDON (Thomson Reuters Foundation) - The loss of earnings and cost of treatment for a common complication of leprosy can seriously damage the finances of Indian households with a leprosy patient, and better prevention could help, a study said on Thursday. More than one third of households affected by the leprosy complication Erythema Nodosum Leprosum (ENL) face "catastrophic" costs exceeding 40 percent of their income, the study in the journal PLOS Neglected Tropical Diseases said. The study, based on interviews with 91 leprosy patients in Purulia, West Bengal, said ENL, which causes swollen skin and inflamed organs, costs patients one third of their income, compared with five percent for people with leprosy alone. India is home to 60 percent of the 200,000 new cases of leprosy registered worldwide each year, and one in six leprosy patients are at risk of developing ENL, according to the study. It revealed the crippling financial burden placed upon some of the "most marginalized people in Indian society", senior author Professor Diana Lockwood said. "This is a problem for the whole of the country. Families are sucked into a downward spiral of poverty which has a knock-on effect for health systems in India," Lockwood, a researcher from the London School of Hygiene and Tropical Medicine, said. Although the government offers financial support for leprosy, the schemes have a poor understanding of the problems. "Some of the worst affected lack bank accounts and simply fall through the cracks," she said. LOSS OF INCOME The study found that of the income lost, 65 percent was due to reduced productivity and hiring extra labour to minimise farming losses and 35 percent was the cost of private treatment. As the financial costs of ENL are so high, better measures to prevent the complication occurring could be highly cost-effective, the study said. "If the skills of leprosy workers are improved to recognise ENL, and efforts are made to shorten these episodes, we would expect to see an increase in productivity," Lockwood said. "This can only provide a positive impact on the Indian economy.” In response to the study, Swapan Kumar Jhariat, deputy director of Health Services, Leprosy, in West Bengal, said there was no shortage of funds from central and state government to support families affected by the disease. Free rice is distributed to families with leprosy patients, and relevant non governmental organisations are being funded based on their work, Jhariat said. "I think there is quite a big emphasis now to support leprosy families." Leprosy is a chronic infectious disease causing disfiguring skin ulcers and nerve damage in the arms and legs. Over time, it can cause inability to feel pain and the loss of parts of the extremities. In the past the disease, also known as Hansen's disease, was regarded as incurable, and patients often became social outcasts, but it can now be treated with antibiotics. (Reporting by Kieran Guilbert; Additional reporting by Sujoy Dhar in Kolkata; Editing by Tim Pearce)