KUALA LUMPUR: IN 1994, the World Health Organisation announced that leprosy had been eliminated in Malaysia.
The Health Ministry said this did not mean there were zero cases, but a reduction in the prevalence of leprosy (new and old cases) to less than one case per 10,000 people before 2000.
But, there has been a steady rise in the number of cases in recent years.
Deputy director-general of health (public health) Datuk Dr Lokman Hakim Sulaiman said the prevalence rate had been declining since 1994 and was at 0.1 case per 10,000 people last year.
However, he said, the ministry’s data showed that the number of new cases had risen from 244 cases in 2004 to 308 last year.
The incidence rate (new cases only) of leprosy was 0.9 cases for every 100,000 people in 2004, and 1.02 cases for every 100,000 people last year.
Last year, Sabah recorded the highest number of 104 cases, followed by Pahang (45), Selangor (41) and Sarawak (31).
At the district level, Tawau, Sabah, registered the highest of number of cases at 36, followed by Rompin, Pahang (29), Marudi, Sarawak (14) and Gombak, Selangor (14). The lowest number of cases was reported in Labuan (2), followed by Malacca (3) and Terengganu (4).
Dr Lokman said the high number of cases in certain states and districts indicated that leprosy was more common in some remote regions, and areas with a large number of migrants, legal or otherwise.
He said 33.4 per cent (103 cases) of leprosy cases last year were detected among immigrants. In 2001, the figure was 25.8 per cent.
Leprosy, Dr Lokman said, was a chronic disease caused by a slow multiplying bacillus called Mycobacterium leprae and mainly affected the skin and peripheral nerves.
“It is transmitted via droplets from the nose and mouth during close and frequent contact with untreated people.
“But the disease is curable with proper treatment.
“Leprosy among migrants contributed more than 50 per cent of cases in Kuala Lumpur, Sabah, Johor and Labuan.”
Dr Lokman also attributed the rise in the number of cases to improved detection.
“In 1995, leprosy services were integrated into the general health services to make it more accessible to patients, and was also made available at rural health clinics. Hence, people can easily reach out to healthcare facilities to screen for leprosy. Our health staff are also searching for untreated cases.”
Dr Lokman said new reported cases were also due to leprosy patients treated with dapsone monotherapy relapsing. Dapsone monotherapy was used to treat leprosy before WHO provided Multi-Drug Therapy (MDT) free to all patients in 1995.
He said employers should hire foreign workers legally, as illegal migrants could lead to the spread of infectious diseases.
He urged them to cooperate with the authorities if their foreign workers were found to have infectious diseases, by supporting them during the course of treatment or sending them back to their country of origin if proven unfit to work.
The ministry’s tuberculosis and leprosy sector senior chief assistant director, Dr Muhamad Ismail, said the now defunct leprosy control programme was launched in 1969 to find all patients and segregate them from the public, as there weren’t effective treatments at the time.
“In 2012, we used WHO MDT as our first line of treatment. For more than four decades, we experienced many changes in our control and prevention measures, and we acted accordingly to achieve our target — firstly to eliminate and now to eradicate leprosy.” He said there was a need to locate all cases to break the chain of transmission.