[Leprosy in Amazonas-impressions of the National Leprosy Program]. / Lepra in Amazonien ­ Eindrücke aus einem Kontrollprogramm.

Due to the often late detection and the neurological disability as a consequence of the disease, leprosy plays an important role in the public health system of emerging countries with the highest prevalence such as India and Brazil. The National Leprosy Control Program of the Ministry of Health and the Health Institutions of the Federal States in Brazil has implemented a strategy to ensure successful treatment of people in rural areas both at the preventive and curative level. A successful screening program, timely treatment of patients according to the stage of disease, and the introduction of preventive measures have significantly reduced the prevalence of leprosy in Brazil over the last 20 years. Due to limited medical care and socioeconomic weakness in the Amazon region in Brazil, the early eradication of leprosy does not seem to be currently realistic.

[Tropical dermatology training in the Bundeswehr: Deployment in Manaus, Brazil]. / Tropendermatologische Ausbildung in der Bundeswehr: Einsatz in Manaus/Brasilien.

Training in tropical dermatology at the Fundação de Medicina tropical (FMT-AM) in Manaus, Brazil, offers an ideal opportunity to become familiar with the broad spectrum of tropical skin-diseases which are endemic in the tropical rainforest of the Amazon region. Besides frequently observed cases of cutaneous leishmaniasis of the new world, mucocutaneous forms of leishmaniasis and all entities of the different deep mycoses of South America are also regularly diagnosed. Of special importance in the dermatological care of the population is the early diagnosis of all clinical forms of leprosy and the long-term care of HIV patients. Modern diagnostics, including histopathology and molecular biology analytical methods, enable patients at the FMT-AM to be diagnosed without having to solely rely on clinical presentation and epidemiological data.

Leprosy. Our Southeast Asian refugee experience.

In the past two years, we have diagnosed four cases of leprosy at the St Paul-Ramsey Hospital Dermatology Clinic. This is a markedly increased incidence for the state of Minnesota. All of these cases have been found among recently arrived Southeast Asian refugees not noted to have their disease by previous screening examinations. The purpose of this study is to report these four cases (two tuberculoid, one lepromatous, and one borderline leprosy) and to review the Southeast Asian Refugee Resettlement Program, focusing on medical screening programs. We recommend refugee health education, health personnel training, and refugee medical screening centers as ways to detect leprosy among refugees entering the United States.