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Yohannes Negesse

Centre Hospitalier Universitaire de la Guadeloupe, France

Title: The importance of defining hanseniasis according its pathophysiological nature as a noncurable chronic autoimmune and autoinflammatory disease. Bridging the gap between individual and collective medicines based on the principle of complementarity of deep contradictory truths

Biography

Biography: Yohannes Negesse

Abstract

Regarding hanseniasis the prevailing population medicine approach is more and more difficult being understood. Indeed, we see that important epidemiologic parameters are uncertain, confusing, non-contagiousness with cure, mode of transmission, duration of disease, incubation period, random incidence estimation and disease elimination concept. On individual medicine perspective it has been established that the bacillary load in the nerve (not in the skin) is an essential factor determining the cycle and spectrum of the disease. The disease may, therefore, be classified as paucibacillary (tuberculoid pole) and multibacillary (lepromatous pole) neural hanseniasis. This pathophysiological approach will allow for instance seeing immunological similarities between paucibacillary neural hanseniasis and sarcoidosis. We can also observe parallelism between the lepromatous neural hanseniasis with whipple disease. For instance, the erythema nodosum like lesions of Whipple disease have more in common clinically, pathologically and immunologically with type 2 reactions during hanseniasis. Thus, the information extracted from immunological study of hanseniasis compared to that obtained from the well-established autoimmune and auto inflammatory diseases might possibly be mutually useful in elucidating the basic pathophysiological mechanisms and treatment regimen. This immunological approach will serve reducing the stigma linked with hanseniasis and constitute as stepping stones to the way of integrating hanseniasis control activities into the general health services as any neurological illness (multiple sclerosis, polyneuritis) or any autoimmune disease.