 Leprosy affects people in over 100 countries worldwide |
Brazil has stepped up its efforts to eradicate leprosy. Health chiefs have launched a major public awareness campaign telling people how to spot early signs of the disease.
They are also training doctors and nurses to diagnose the condition early.
Brazil has one of the highest rates of leprosy in the world.
Curable disease
Brazil continues to suffer despite the fact that leprosy can be cured by giving patients a powerful cocktail of antibiotics.
Brazil is not alone. Figures from the World Health Organization show that 524,000 people in 103 countries were diagnosed with leprosy last year.
Leprosy is caused by a germ similar to that which causes tuberculosis.
 The problem is early diagnosis  |
It attacks the nerves of the hands, feet and face and, if left untreated, can deaden movement in fingers, toes and eyelids. It can also destroy the ability to feel pain, so those affected are prone to injuries and burns which can result in serious infections, and can ultimately lead to the loss of fingers, toes and sight.
The longer the disease is left undetected, the more likely it is that the deformities, so often associated with leprosy, will occur.
For that reason, health chiefs in Brazil have stepped up their efforts to spot the disease early on.
"The earlier it is diagnosed, the easier the treatment," said Dr Mauricio Nobre, a skin specialist in Rio Grande.
"The main thing we have to do is diagnose the disease in the early stages so that the nerves are not damaged.
"A big part of our work is running education campaigns telling people about the signs of leprosy. It is a silent disease."
Health chiefs are also targeting those with advanced leprosy, not least because they believe they are the source of many new infections.
"If we can diagnose every case then we can stop the spread of leprosy," said Dr Nobre.
City slums
He believes living conditions in Brazil are contributing to the spread of the disease.
"We have a lot of people living in slums in and around the big cities. They live in crowded situations. They don't have a lot of food and their immune systems do not develop as they should.
"These are things we think are contributing to the high prevalence rates in Brazil," he said.
"It is more common to diagnose the disease in people who live in crowded situations.
"If you have one person with the disease and 10 people living in the same house, the chances of them getting the disease are quite high."
Experts believe that leprosy can be eradicated.
"We have the drugs to do it," said Professor Terence Ryan, chairman of the International Foundation for Dermatology. "The problem is early diagnosis."
He maintains that training doctors and nurses to spot the disease is the key.
"We can't afford to have specialists looking at every patient in the world. Therefore, we have to rely on generalists and increase their knowledge and ability to look at skin and make the diagnoses."
The problem is that early signs of leprosy are sometimes difficult to diagnose.
"In many of these countries, poor people have a lot of skin disease," said Professor Ryan.
"It is one of the main reasons they go to a health centre or tradition healer. Therefore, the ability to sort out various skin diseases is very important."
This story is featured in the radio programme Health Matters on the BBC World Service.
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