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Topics for Today

Topics for Today. Who am I What is Epidemiology? Research & Politics What is Leprosy? Leprosy Research Disability & Functioning Impact of Leprosy Surgery. Johan Velema. Nutrition & Statistics / Anthropology Bible & Mission Epidemiological Methods Heart Disease Cancer Research

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Topics for Today

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  1. Topics for Today • Who am I • What is Epidemiology? • Research & Politics • What is Leprosy? • Leprosy Research • Disability & Functioning • Impact of Leprosy Surgery

  2. Johan Velema • Nutrition & Statistics / Anthropology • Bible & Mission • Epidemiological Methods • Heart Disease • Cancer Research • Primary Health Care • Tropical Diseases • International Health & Development • Leprosy, Disability, CBR • Theology

  3. God is International!

  4. Epidemiology is medicine at the population level What is Epidemiology?

  5. The Politics of Health Research Does an American die of it?

  6. The Politics of Pharma Research Who will buy the product?

  7. Leprosy: The Disease • Mycobacterium Leprae • Transmission: droplets ? • Incubation: 3-25 years • Virulence: 5% • Affects skin and nerves

  8. Disabilities • peripheral sensory loss • damage (heat / sharp / pressure / friction) • -> ulcer, inflammation, bone resorption • paralysis enhances these processes

  9. Prevention of Disabilities • Early detection! • Teach patient how to prevent damage • Footwear • Self Care • Treat reactions / neuritis promptly

  10. New case detection 1985-2012

  11. Historical Overview • 1874: Hansen discovers M Leprae • 1874: Exclusion, no Treatment • 1948: Lifelong Dapsone • 1982: Multi Drug Therapy (MDT) • 1991: Elimination Goal • 2001: Integration into General Services

  12. Pater Damiaan

  13. Stanley Brown

  14. Paul Brand

  15. Research in Leprosy • Occurrence / Control • Transmission • Chemoprophylaxis • Diagnostic Tests • Vaccine • Impact of Interventions

  16. Int’l Classification of Functioning

  17. ICF framework • Environment factors • Love and friendship • Culture / worldview • Legislation / rights • Perceived stigma (attitudes) • Enacted stigma (behaviour) • Participation • Work/livelihoods • Relationships • Education Condition • Activities • Mobility • Communication • Learning • Personal factors • Spiritual life • Self-esteem / self-efficacy • Anticipated stigma • Internalised stigma • Experienced stigma • Body functions and structure • Vision • Hearing • Mental function

  18. Tendon transfer surgery Introduction (2) Postoperative outcomes one year after tendon transfer surgery for ulnar nerve paralysis in leprosy patients

  19. Postoperative Outcomes Methods (2) Impairment correction Function Postoperative outcomes one year after tendon transfer surgery for ulnar nerve paralysis in leprosy patients

  20. SALSA • 5 Continents • 5 Years • 3 Meetings • 20 Questions • Universal score

  21. Improved Participation after Surgery

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