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Biomedical subjects

Ruth Leekassa

Publications and source records attributed to Ruth Leekassa.

4 recordsLinked to original sources
PubMed2005

Challenges presented by nerve damage in leprosy.

The basis of nerve damage in leprosy is the unique tendency of Mycobacterium leprae to invade Schwann cells. alphaBeta-Dystroglycan on the basement membrane of Schwann cells binds to laminin alpha2, in turn binding to receptors on the M. leprae surface, comprising a histone-like protein and phenoglycolipid-1. When nerve damage during reversal reactions was found to be associated with an abrupt increase in delayed type hypersensitivity against M. leprae antigenic determinants released from Schwann cells, it suggested that the nerve is damaged as an innocent bystander during the immune response. This strongly influenced the introduction of therapy based on immunosuppression combined with continued anti-mycobacterial medication. Lysis of Schwann cells presenting M. leprae antigenic determinants by activated CD4+ T cells and interaction of M. leprae with Toll-like receptors on Schwann cells are additional mechanisms implicated in nerve damage. Persistence of M. leprae antigen in local lesions after regular multiple drug therapy (MDT) is an important risk factor for late reactions. In spite of significant advances in the provision of MDT globally, early diagnosis, together with effective treatment of the disease and associated nerve damage at initial presentation remains a major challenge for the health services. Reduced prevalence as a result of MDT should not be taken to indicate that the challenges of leprosy control are diminished as long as nerve damage is not controlled and new case detection rates are not declining.

Drug Therapy, Combination↗
PubMed2005

Community diagnosis of common skin diseases in the Zay community of the Zeway Islands, Ethiopia.

BACKGROUND: Skin diseases are common public health problems throughout the world. Studies on skin problems are rare in Ethiopia. Easy and cheap methods of identifying skin conditions in the community are poorly developed in the country. OBJECTIVES: (1) To assess whether the newly developed Dermatological Screening Questionnaire (DSQ) can be used to effectively screen for common skin diseases and (2) to estimate the prevalence of skin diseases in a rural community. METHODS: A cross-sectional survey was conducted in the rural community residing on the islands of Lake Zeway. A locally prepared nine-item questionnaire (the DSQ) was used by lay-interviewers to screen for common skin diseases. Any respondent giving one or more positive responses, and a further 104 people who had replied negatively, underwent confirmatory diagnosis by specialist dermatologists. RESULTS: A total of 4697 people were included in the survey. Of these, 992 (20.0%) respondents screened positive on the DSQ. Out of 62.5% (N = 620) examined by dermatologists, 98.6% (n = 611) were found to have one or more skin conditions. Amongst screen negatives, 10.6% had skin diseases. Sensitivity and specificity of the DSQ was found to be 98% and 91%, respectively. The weighted prevalence of clinically-confirmed skin disease was 22.5%. Scabies was the most common of all skin conditions, followed by fungal infections. CONCLUSION: Our survey revealed that easily preventable and treatable skin diseases are common in this rural community. Nearly all those who gave a positive response to the DSQ had one or more skin disease confirmed on clinical examination. This finding indicates that the DSQ is a useful instrument for identification of common skin diseases in the community.

Adolescent↗
PubMed2004

Prevalence of mental distress in the outpatient clinic of a specialized leprosy hospital. Addis Ababa, Ethiopia, 2002.

Leprosy is a chronic disease that leads to physical disability as a result of nerve damage. Stigma and associated psychosocial problems are common and may increase the risk of mental disorders. This study was conducted to estimate the prevalence of mental distress amongst people attending a Specialized Leprosy and Dermatology Hospital, ALERT, Addis Ababa. Alternate patients from the daily register of outpatients were interviewed for symptoms of mental distress using the Self Reporting Questionnaire (SRQ). This questionnaire was administered by two specially trained nurses. The study population consisted of 786 people. Of these, 60% had leprosy and the remainder had other skin diseases. The sex distribution of the study population was approximately equal. The overall prevalence of mental distress was found to be 34.6%. Among people with leprosy the prevalence was 52.4%, compared with 7.9% in those with other skin conditions. This represented a 7-fold increased risk of mental distress in people with leprosy, adjusted OR = 7.14 (95% CI; 4.15, 12.35). Physical disability was also strongly associated with mental distress. This study showed that the 1-month prevalence of mental distress was significantly higher in patients with leprosy compared to patients with other dermatological conditions. Such a study allows identification of non-specific mental distress. Thus, future work should be directed at further characterizing the nature and severity of mental disorder in this group. However, our study has indicated a need for the integration of psychosocial care into our current medical treatment of patients with leprosy.

Adolescent↗