Prevention of disabilities in patients with leprosy: a practical guide.

A practical guide to the many simple things that can be done - by health workers and patients alike - to prevent the development of disabilities in patients with leprosy. Addressed to peripheral health personnel, the manual concentrates on the various conditions leading to disability and deformity that can be arrested if action is taken at an early stage. To this end, readers are given extensive practical information on the signs to look for, the questions to ask, and the tests to perform in order to recognize these conditions at the earliest possible stage and take appropriate action. Preventive measures described consist of simple treatments, devices, exercises, and behavioural changes that are easy and inexpensive as well as highly effective. Details range from step-by-step instructions for preparing a finger splint from rubber or plastic tubing, through simple tests for determining when leg muscles are weakened, to illustrated exercises that patients can perform at home. Throughout the book, numerous tables, charts, checklists, and some 100 illustrations are used to help readers absorb information and acquire the full range of necessary skills. The book has eight chapters. Background information is provided in the first three, which discuss the impairments caused by leprosy, explain nerve trunk involvement and its consequences, and set out a framework for disability prevention which categorizes patients according to level of risk and maps out the precise actions to be taken by health workers and patients. The core of the manual consists of chapters focused on the specific actions needed to prevent disability and deformity in patients with insensitive hands and feet and to preserve nerve function. Although prevention is stressed, measures that can limit or correct deformities are also covered. Each richly illustrated chapter provides detailed information on the assessment of patients, the recognition of normal and abnormal conditions, the assignment of risk status, and the principles and specifics of management. Highly didactic, these chapters also alert readers to common errors and pitfalls, and specify the precise do's and don'ts of effective management. Readers learn how to do such things as dress injuries correctly, construct simple protective devices, recognize cases requiring the most urgent attention, and know when patients should be referred. Readers also receive advice on how to teach patients to perform exercises, care for themselves, be alert to certain symptoms, and report them promptly. Methods of eye care are not included in the book in view of the number of excellent guides covering this subject. In view of the crucial role of the patient and the need for proper motivation and support, the book concludes with chapters offering practical advice on the instruction and training of patients, the monitoring of their performance in disability prevention, and the provision of adequate material and moral support - See more at: http://apps.who.int/iris/handle/10665/41226#sthash.m5ZKv3aV.dpuf