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Penyakit kusta

Sumber: Website Wikipedia

Penyakit kusta atau juga dikenali sebagai penyakit Hansen, merupakan penyakit berjangkit yang disebabkan oleh jangkitan Mycobacterium leprae. Nama penyakit Hansen datang daripada orang yang menjumpai Mycobacterium leprae, G. A. Hansen. Pengidap penyakit Hansen biasanya dipanggil pesakit kusta atau dalam bahasa Inggeris lepers, walaupun penggunaan istilah lepers semakin ditinggalkan kerana jumlah pesakit yang berkurangan dan sebagai mengelak stigma buruk yang dikaitkan dengan pesakit kusta.

Kusta dahulunya tidak dapat diubati dan amat mencacatkan. Pesakit kusta akan disingkir dan dikurung di
penempatan kusta. Pada masa kini, kusta mudah dirawat dengan menggunakan terapi pelbagai antibiotik. Cabaran utama bagi usaha menghapuskan penyakit kusta adalah untuk sampai kepada penduduk yang masih belum menerima perkhidmatan terapi pelbagai dadah, memperbaiki pengesanan penyakit, dan membekalkan pesakit dengan perkhidmatan berkualiti tinggi dan dadah yang murah.

Selain manusia, haiwan lain yang diketahui mengidap kusta adalah
armadillo.
 

Sejarah

Penyakit kusta telah dikenali sebagai masalah semenjak permulaan sejarah bertulis. Pesakit kusta sering tinggal dipinggir masyarakat, dan penyakit sering dipercayai disebabkan oleh sumpuhan tuhan (atau shaitan) atau hukuman.
Kitab Injil mengandungi banyak rujukan kepada "pesakit kusta", yang tidak semestinya berkaitan dengan penyakit Hansen. Perkataan ini telah digunakan bagi merangkumi pelbagai masalah kulit yang berlainan etiologi dan keparahan ( severity ).
Di bawah hukum
Yahudi silam, rabai dikehendaki mampu mengenalpasti pesakit kusta. Kaum Yahudi menggunakan kuarantin untuk menghalang penyebarannya.
Minoriti seperti
agote Navarrese sering dituduh sebagai pesakit kusta.

 Clinical features

The disease is caused by a bacillus which multiplies very slowly and mainly affects the skin, nerves, and mucous membranes. The organism has never been grown in bacteriologic media or cell culture, but has been grown in mouse foot pads. It is related to M. tuberculosis, the bacillus that causes tuberculosis.
The mode of transmission of Hansen's disease remains uncertain. Most investigators think that M. leprae is usually spread from person to person in respiratory droplets. What is known is that the transmission rate is very low.
This chronic infectious disease usually affects the skin and peripheral nerves but has a wide range of possible clinical manifestations. Patients are classified as having paucibacillary or multibacillary Hansen's disease. Paucibacillary Hansen's disease is milder and characterized by one or more hypopigmented skin macules. Multibacillary Hansen's disease is associated with symmetric skin lesions, nodules, plaques, thickened dermis, and frequent involvement of the nasal mucosa resulting in nasal congestion and
epistaxis (nose bleeds).

 

Incidence

In 1999, the world incidence of Hansen's disease was estimated to be 640,000; and in 2000, 738,284 cases were identified. In 1999, 108 cases occurred in the United States. In 2000, the World Health Organization (WHO) listed 91 countries in which Hansen's disease is endemic, with India, Myanmar, and Nepal having 70% of cases. In 2002, 763,917 new cases were detected worldwide, and in that year the WHO listed Brazil, Madagascar, Mozambique, Tanzania and Nepal as having 90% of Hansen's disease cases.
Worldwide, 1-2 million persons are permanently disabled because of Hansen's disease. However, persons receiving antibiotic treatment or having completed treatment are considered free of active infection.
Hansen's disease is one of the infectious diseases tracked passively by the
Centers for Disease Control and Prevention. Its prevalence in the United States has remained low and relatively stable. There are decreasing numbers of cases worldwide, though pockets of high prevalence continue in certain areas such as the western Pacific.

 

 Risk groups

Those having close contacts with patients with untreated, active, predominantly multibacillary disease, and persons living in countries with highly endemic disease are at risk for contracting the disease. Recent research suggests that there is genetic variation in susceptibility. The region of DNA responsible for this variability is also involved in Parkinson's disease, giving rise to current speculation that the two disorders may be linked in some way at the biochemical level.

 

Asylums

There are still a few "leper colonies" around the world, in countries such as India and the Philippines. In the United States, the tiny island of Molokai in the Hawaiian chain contains that country's oldest asylum.
In
2001, government-run leper colonies in Japan came under judicial scrutiny, leading to the determination that the Japanese government had mistreated the patients [1].