الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
leprosy is still one of the most: important disease of developing ’untries as its prevalence in some of these coun tries may be 5/ 1000 persons and it may reach up to 25/1000 persons in some stricts of very high endemici tr . The study was performed wi th the following aims: )To determine the magni tude of the problem of leprosy among the usehold contacts of leprotic patients. in Alexandria. ,.-)To study some of the epidemiologic factors in relation to the currence of leprosy. I leprotic patients residing in Alexandr ia and registered in .e six skin clincs r.amely : Bakos clinic. Moharem bek clinic, m El-Shokafa clinic .Ras El-Teen clinic ,Mina El-Basal clinic. id El Kabar i and the leprosorium ,were included in the study. ere the total number amounted to 125 patients. Their names and addresses were taken ei ther from the records r through a personal interview at the clinic to inform them that .ne researcher will visit them at home :0 have -cheir consent. The required data i.e : basic personal data as age, sex d the socio-economic standard of the family, were collected at questionnaire-interview with the patients and ry was taken from contacts about the suggestive symptoms of i.8 : history of epistaxis, tingling and numbness, of other skin les10n with or without hyposthesia or thsia. Then a complete clinical examination was performed any dermatological or nervous affection. All suspected cases ( 7 cases) among the household contacls referred to the speciallst at the Dermatology Departement, ia University, where they were carefully reexamined and tted to skin biopsy to confirm the diagnosis, where three were diagnosed as leprosy. The three discovered leprotic were referred to the the ski~ clinics for follow up . The study revealed the following main results: *?revalence of leprosy among the household contacts ( which are considered the most important risk group of contracting leprosy) of all ages was 1.2210 , while 1 t was 2.610 among those aged up to 16 years. * Intimacy and closeness of con tact was important for spread of mfection among the household con tacts . This result appeared ~bviously dur ing the study as two of the discovered cases were :nildren of thei r index cases an.d the thi rd case wase in con tac t 1ith her husband. ILeprosy is a disease of those living under low socio-economic Handard . !The highest proportion of cases was in the age group 30”<40 fears, ”fIith no significant difference between the mean age of the tUberculoid and lepromatous leprosy. ;* Face,upper and lower limbs were the most commonUy affected si tes ’by leprotic lesions. ,lOne third of patients were suffering from deformities. commonly i I Iin the hands and feet in the form of plantar ulceration and deformi ties of the hand phalanges. ~ IIA direct positive relation was found between prevalence of i jceformities. duration of the disease and regularity of treatment. i .~ ! t ~ ,I IThe ~llowlng are the main recommendations: 11- Diagnosis of leprosy in I ts ear Iy stages especiallY among high risk groups i. e: household contacts. school children. workers in fKtories and army .This can be acheived through specialized examination SUCll as full neurological and histopathologicaJ examlna t ions. Such examina t ions could be done through different ways of sur veys such as sample surveys. mass surveys and surveys of t~e high risk groups. 2- continuous moni tor ing of the household contacts .wi th per iodic medical examination at 6-12 months interval. It should be continued for at least 10 years for R contact of lepromatous case after the case is bac ter iologically nega ti ve. while the follow up is continued for about five years for a contac~ of a tuberculoid case from the time of diagnosis of index cas~ . 3- Heal theduca tion , aiming at promoting early detection and adequate treatment by enlisting the participation of all concerned public author i ties, the population. the patients and t~ir families and the health personnel .The population should be ~couraged to look at leprosy as one disease among others requires no special measures and to accept patient in the community.Health personnel education is perhaps the most important component for its direct effect on the patients. Skin out-patient clinJcs provide an important setting for educating patients and their families about the nature of the disease. the ~ j modes of transmission and the impotance of ear Ir management and treatment as to avoid the occur rence of deformi ties. 4- BCG vac~ination to contacts especially in areas known to havE’! higrt prevalence of tuberculoid leprosy.^leng