02766nas a2200313   4500000000100000008004100001260001700042653001500059653001000074653001000084653002000094653001100114653002100125653001100146653001200157653000900169653001600178653001600194100001600210700001800226700001300244700001800257245009200275856005900367300001100426490000700437520199400444022001402438       2012                            d  c2012 Oct-Dec10aAdolescent10aAdult10aChild10aEarly Diagnosis10aFemale10aHealth Personnel10aHumans10aleprosy10aMale10aMiddle Aged10aYoung Adult1 aOjinmah U R1 aOnyekonwu C L1 aOzoh G A1 aOnyekonwu G C00aHansen's disease: the need for increased healthcare provider awareness and re-training.  uhttps://www.ajol.info/index.php/njm/article/view/86656  a427-310 v213 a<p><strong>CONTEXT: </strong>Leprosy continues to be a challenge worldwide. In 2009, the World Health Organisation (WHO) reported 244,796 new cases worldwide. Of this, South East Asia, South Americas and Africa have the highest number of new cases.</p>

<p><strong>OBJECTIVE: </strong>To highlight misdiagnosis of Hansen's disease as a drawback to eradication of leprosy.</p>

<p><strong>MATERIALS: </strong>A retrospective study of cases of Hansen's disease misdiagnosed by clinicians who were seen in the skin clinics of two tertiary institutions in South-East Nigeria over a one year period.</p>

<p><strong>RESULTS: </strong>Of the nine misdiagnosed cases, three were females while six were males. Apart from one child of six years old, the rest of the patients were adults. Referring diagnoses included chronic osteomyelitis, acromegaly, dermatitis and depression. One of the patients presented with a reversal reaction (erythema nodosum leprosum) following treatment in a peripheral health facility. Confirmation of the diagnosis was based on slit skin smears for Acid Fast Bacilli carried out in the side laboratory of skin clinic UNTH, Ituku-Ozalla, Enugu state (four patients) and mile four hospital, Abakaliki, Ebonyi State( three patients). All the smears were positive. Patients were commenced on multi drug therapy and all showed marked clinical improvement following drug therapy.</p>

<p><strong>CONCLUSION: </strong>Eradication of leprosy may not be feasible if health care providers are ignorant of the different presentations of the disease. A high index of suspicion for leprosy is needed among health care workers in endemic areas. Development of tools for early diagnosis and detection of infection, improvement in existing tools for data collection, provision of guidelines and training materials on vital information for leprosy control will all contribute to the continued success of the National Tuberculosis and Leprosy Control Programme in Nigeria.</p>
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