“In Indonesia, the biggest scope of infection is of the Brugia malayi. I have even discovered patients living in urban areas of Bekasi. Our biggest problem is to get the patients to faithfully take their medication, because they feel no pain from the start, so they don’t feel ‘sick’. People believe that ‘If it doesn’t swell out you’re not sick – you’re only sick if you are swollen’, while swelling indicates such a severity that you can’t go back to normal anymore. These very same patients complain that they do not get better, even though they have taken medications, as their legs remain swollen,” gripes Prof. Dr. Dra. Taniawati Supali, M.Biomed., of the University of Indonesia Faculty of Medicine’s Department of Parasitology.
Initially, patients merely suffer from fevers or chills, that go away by themselves, even without medication. Then normal moving limbs become swollen; then, the swelling goes down by itself. The swell up-swell down cycle repeats itself multiple times over five years, at which point the swelling becomes permanent. “Medication will not repair damage to the lymphatic channels and glands. We implement preventive measures in endemic areas with a prevalence of at least 1%, i.e. where we find 1 case per 100,000 residents. Strict, routine monitoring must be performed in cities and regencies with animals who host filaria worms, in order for us to be able to achieve filariasis elimination by 2030,” Prof. Tania said.
Third Most Leprous Country
In 2021, Indonesia was named the third most leprous country in the world, with 10,976 cases of leprosy discovered in that year, right after India (75,394) and Brazil (18,318) for the same period, followed by Congo (4,148) and Mozambique (3,135) in fourth and fifth spots, respectively. Our leprosy elimination target is “fewer than 1 case per 10,000 residents”.
According to the results of the national leprosy analysis per 2020, no fewer than 111 regencies and municipalities are known to be sources of leprosy. For the year, there were 15,052 registered cases and 12,095 new cases, with the proportion of new cases without disabilities at 82.87%, the proportion of stage two disability at 6.37%, and the proportion of new cases among children at 9.89%. The provinces with the highest number of leprosy cases are West Papua, North Maluku, Papua, Maluku, North Sulawesi, Gorontalo, and West Sulawesi, respectively.
During her exposition at the same event, Dr. dr. Sri Linuwih Susetyo Wardhani Menaldi, Sp.KK(K), dermatology and venereology specialist consultant in tropical skin infections, especially Morbus Hansen (leprosy) from Cipto Mangunkusumo Hospital (RSCM), Jakarta, reported that leprosy is caused by the Mycobacterium leprae bacteria. “Leprosy can be suffered by anyone, from children to the elderly. Even though it is an infectious disease, it has an extremely low infection rate and an extremely long incubation period. Whenever we find a child patient of the disease, we can be certain that there must be an adult sufferer nearby who has infected them. Leprosy is treatable and curable. Medication for it is freely available in community clinics. However, in specific conditions, allergy to the first line of medication may occur. This happens because the patient is already resistant, or they suffer from intolerable side effects of the medication, like severe nausea or vomiting, or if the sufferer is being or nursing. In such cases, the patient must be referred to a hospital to get second-line therapy – and pay for the medication.”