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Leprosy

麻风

Leprosy is an infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus. The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes. Leprosy is curable and treatment in the early stages can prevent disability.

麻风是一种慢性传染病，由一种杆状耐酸杆菌（即麻风杆菌）引起。该病主要侵犯皮肤、周围神经、上呼吸道粘膜和眼睛。麻风可以治愈，早期施治可避免出现残疾。

Brief history of the disease and treatment

疾病与治疗简史

Leprosy is an age-old disease, described in the literature of ancient civilizations. Throughout history, people afflicted have often been ostracized by their communities and families.

麻风是一种古老的疾病，在古代文献中早有记载。从古至今，患者往往遭到社会和家庭的排斥。

Although leprosy was managed differently in the past, the first breakthrough occurred in the 1940s with the development of the medicine dapsone. The duration of treatment lasted many years, often a lifetime, making compliance difficult. In the 1960s, M.leprae started to develop resistance to dapsone, the only known anti-leprosy medicine at that time. In the early 1960s, rifampicin and clofazimine were discovered and subsequently added to the treatment regimen, which was later labelled as multidrug therapy (MDT).

在过去，麻风病的治疗方式各不相同。第一次决定性的变化发生在上世纪40年代，当时研制出了药物氨苯砜。麻风的治疗期限长达多年，往往是终身，这使患者难以做到始终遵守治疗方案。在上世纪60年代，麻风杆菌开始对当时唯一已知的抗麻风药物氨苯砜产生抗药性。上世纪60年代初发明了利福平和氯法齐明，随后被加到治疗方案之中，后被称为联合化疗。

In 1981, WHO recommended MDT. The currently recommended MDT regimen consists of medicines: dapsone, rifampicin and clofazimine. This treatment lasts for six months for pauci-bacillary and 12 months for multi-bacillary cases. MDT kills the pathogen and cures the patient.

1981年，世卫组织建议使用联合化疗。目前推荐的联合化疗方案由氨苯砜、利福平和氯法齐明几种药物组成。这种治疗对于少菌型病例须持续6个月，对于多菌型病例须持续12个月。联合化疗可杀死病原体并治愈患者。

Since 1995 WHO has provided MDT free of cost. Free MDT was initially funded by The Nippon Foundation, and since 2000 it is donated through an agreement with Novartis until at least 2020.

自1995年起，世卫组织免费提供联合化疗。最初由日本基金会资助，自2000年以来，通过签订协议由诺华公司捐赠至少到2020年。

Elimination of leprosy as public health problem (defined as a registered prevalence of less than 1 case per 10 000 population) was achieved globally in 2000. More than 16 million leprosy patients have been treated with MDT over the past 20 years.

2000年，在全球实现了消灭作为公共卫生问题的麻风病的目标（定义为患病率低于每万人1例）。在过去的20年中，1600多万麻风患者接受了联合化疗治疗。

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