Ans: C (In paucibaciliary leprosy > 2 nerves are involved] [Ref: Park 23rd/322, 21st/292-299;20th/275-88, 19th/264-277; Harrison ISthfl365-66,17th/1022j" Paucibacillary leprosy: A person having 1-5 skin lesions &for only one nerve involvement"- Park 21st/292"Multibacillary leprosy: A person having 6 or more skin lesions &/or more than one nerve involvement" Park 21stf 292Grouping of Leprosy style="font-size: 1.04761904761905em; font-family: Times New Roman, Times, serif; margin: 0 0 0 8px; text-indent: 0">"To assign the correct regimen for treatment of a Leprosy patient, they are grouped into either Paucibaciliary or Muitibaciliary types of Leprosy, based on the number of skin and nerve lesion and bacteriological status. This is important because it helps in selecting the correct combination of drugs (regimen) for a given person.Table (KDT 7th/784): National Leprosy Eradication Pro- gramme(2009) Classification of leprosyPauclbacillary(PB)Multibaciliary (MB) 1-5 skin lesions Ho nerve/only one nerve involvement +-1-5 skin lesions Skin smear negative at all sites 6 or more skin lesions > 1 nerve involved irrespective of number of skin lesions Skin smear positive at any one siteNote: if skin smear is positive irrespective of number of skin and nerve lesions, the disease is classified as MB leprosy but if skin smear is negative it is classified on the basis of the number of skin and nerve lesions."Regular treatment: A patient may be considered to have regular treatment if he/she has received MDT for atleast two-thirds of the months in any interval of time. E.g regular treatment for 12 months, implies that the patient has had at least 8 full months of combined therapy during the 12-month period"- Park21st/296LEPROSY OR HANSEN S DISEASE OR SOCIAL DISEASE: SHORT REVIEW# "Leprosy is not particularly a disease of children as was once believed. However, the presence of leprosy in child population is of considerable epidemiological importance. A high prevalence of infection among children13 means that the disease is active & spreading'''"- Park20th/278Lepra bacilli can survive for long periods of time in soiP under favourable environmental conditions. There is now evidence that natural infection with M. leprae are present in wild animals e.g. armadillos,, mangabey monkeys & chimpanzeesThe tuberculoid type of lesions are bacteriological!)- negatives The role of inviduals with tuberculoid forms of the disease as sources of infection is not yet clear."Bacilli may also be transmitted by insect vectorsQ or by tattoing needles. However, there is no evidence that any of these transmission route is important in nature-" Park 20th/279Relapse ratef is one of the best indicators of the efficacy of the drug regimenQtr- Park 20thf288The bacterial load is the highest in the lepromatousf casesLeprosy is a highly infections disease but of low pathogenicity^'Both the incidence & prevalence of leprosy appear to be higher in males'1 than in femalesLeprosy may be transmitted via aerosols containing M.leprae (droplet infection1')Bacterial index (BI) is the only objective way of monitoring the benefit of treatment."The most commonly affected nerve are the ulnad3, posterior auricular, peroneal & posterior tibial nerves"- H17/1022The histamine test is a very reliable method for detecting at an early stage peripheral nerve damage due to leprosy-park 20th/281"During the course of leprosy, immunologically mediated episodes of acute or subacute inflammation known as lepra reaction may occur. Because peripheral nerve trunks are often involved, unless reaction are promptly & adequately treated, such episode can result in permanent deformities"- Park21st/297"Immunoprophylaxis: Trial in different population group with BCG vaccine either alone or in combination with other vaccines (from killed mucobacterium leprae or atypical mucobacterium), have shown protective efficacy ranging bfw 28% & 60%. High BCG coverage remains an important contribution to reducing the disease burden due to leprosy"- Park 21st/292