11. Management by community approach

Findings on the meaning of leprosy show confusion about the concept of leprosy and the lack of knowledge about the disease, its causes, and the mode of transmission. In addition, the views and perceptions of leprosy that have been internalized or newly acquired cause fear. The perception that leprosy is a highly contagious disease that can be transmitted by touching the same objects that have been touched by lepers is very worrying. Therefore, increasing knowledge about leprosy in affected people, community members, and health workers remains an important goal for leprosy services, and although that is not the only answer to stigma, it is an important prerequisite. Some challenges arise in relation to seeking care, recognizing the symptoms, making the right diagnosis, and sharing the diagnosis with the patient and the treatment. What is visible is the strength and influence of leprosy workers and therefore the destructive impact of their stigmatization behavior on the people they care for. White calls this the "iatrogenic stigma" or stigma produced by meeting patients with health care workers [30]. Multidrug therapy (MDT) was recommended as the standard treatment. The recommended treatment duration for MB is 12 months; otherwise, the duration for PB is 6 months. In 1997, WHO recommended treating patients with SLPB with single-dose regimen contain of 600 mg rifampicin, 400 mg of ofloxacin, and 100 mg of minocycline [16].

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[7] Wibawa T, Satoto TBT. Magnitude of neglected tropical diseases in Indonesia at postmille-

[8] The World Health Organization (WHO) Regional Office for South East Asia. Updated:

[9] Tempo Co. Leprosy still prevalent in some areas in Indonesia; Wednesday, 22 June 2016

[10] Peters RMH, Dadun LM, Galarza BM, et al. The meaning of leprosy and everyday experiences: An exploration in Cirebon, Indonesia. Journal of Tropical Medicine. 2013;2013:507034.

[11] WHO. Global Leprosy Strategy 2016–2020. Accelerating Towards a Leprosy- Free World. Vol. 2016. World Health Organization, Regional Office for South-East Asia. India. pp. 1-2

[12] van Brakel WH, Sihombing B, Djarir H, et al. Disability in people affected by leprosy: The role of impairment, activity, social participation, stigma and discrimination. Global Health

[13] Gokhale SD, Sohoni N. Human Face of Leprosy. Pune, India: Ameya Prakashan; 1999

[14] Pathogenesis Leprosy. Training Manual for Medical Officers. Nirman Bhawan, New Delhi: National Leprosy Eradication Programme Directorate General of Health Services, Ministry

[15] Anastasiaa P, Walker SL, Lockwood DN. New findings in the pathogenesis of leprosy and implications for the management of leprosy. Current Opinion in Infectious Diseases. 2013;

[16] Pandhi D, Chhabra N. New insights in the pathogenesis of type 1 and type 2 lepra reaction.

[17] Truman RW, Singh P, Sharma R, Busso P, Rougemont J, Paniz Mondolfi A, et al. Probable zoonotic leprosy in the southern United States. The New England Journal of Medicine.

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nium development goals era. Journal of Tropical Medicine. 2016;2016:1-9

Corticosteroids should be given to patients experiencing leprosy reactions due to their ability as anti-inflammatory and immunomodulatory. Duration of treatment >12 weeks is recommended only if the patient is supervised by a specialist. Treatment duration is different for leprosy type 1 and type 2 reactions [31]. The morbidity report becomes very important in epidemiology because it is based on real events and not based on estimates or estimates. In addition, morbidity recording and reporting can be determined from changes in the incidence and prevalence of the disease until the results can be used for the planning and management of health problems. Full support from the Government is needed to carry out continuous activities in preventing the spread of leprosy [10].
