PETALING JAYA: Genetic factors, weakened immune systems due to malnutrition and poor sanitation can make a person vulnerable to leprosy.
Those living in poverty and staying in close quarters, like the Orang Asli, are also more susceptible to the disease.
Thus, early check-ups are vital, say health experts.
Late diagnosis can lead to irreversible nerve damage and deformities.
The good news is that leprosy is curable and there are effective treatments.
Officially, Malaysia eliminated leprosy as a public health issue in 1994, but cases continue to emerge with 142 in 2021, 183 in 2022 and 256 in 2023.
Experts clarified that these figures do not indicate a surge in cases but are instead the result of intensified detection efforts.
Health Minister Datuk Seri Dr Dzulkefly Ahmad has described the leprosy outbreak in two Orang Asli villages in Kuala Pilah, Negri Sembilan, as an isolated case.
Epidemiology and biostatistics expert Assoc Prof Dr Malina Osman explained that leprosy spreads through prolonged, close contact, making household transmission more likely than in the general community.
“Those living under the same roof have a higher risk of contracting it, compared to the wider community,” she said yesterday, adding that Orang Asli communities were usually tightly-knit.
However, she said there was no need for panic as leprosy, although a chronic infectious disease, is both curable and manageable.
Dzulkefly has given an assurance that the outbreak was not widespread.
Health expert Prof Dr Zaleha Md Isa, who has conducted health-related research on Orang Asli communities, outlined several risk factors that make them more vulnerable to leprosy.
She said limited healthcare access, communal living conditions and poor sanitation contribute to the spread of the disease.
“Orang Asli communities in rural and remote areas often have limited access to healthcare facilities.
“Late diagnosis and treatment can lead to prolonged infectious periods, increasing transmission within villages,” she said.
She added that poverty and marginalisation often prevented people from seeking medical help.
“The stigma surrounding leprosy also discourages people from coming forward, allowing silent spread within communities,” she said.
Dr Zaleha explained that malnutrition weakens the immune system, making the patient more susceptible to infectious diseases like leprosy.
She said migration and movement patterns among Orang Asli groups, particularly those who relocate frequently, could contribute to the difficulty in tracking and containing outbreaks.
There are also other challenges in diagnosing and treating leprosy in remote areas.
“One major issue is the delayed recognition of symptoms due to the slow progression of the disease, which can take months or even years to manifest,” she said.
Misdiagnosis was also common, as early symptoms resemble fungal infections, eczema or other skin conditions.
With a lack of trained healthcare workers in rural clinics, delayed or missed diagnoses were likely to happen, she said.
Then there are logistical challenges in delivering multidrug therapy to remote villages.
Another significant barrier is the long treatment duration, which can range from six to 12 months or more.
Consistent follow-ups are difficult for patients living in isolated areas.
Health expert Datuk Dr NKS Tharmaseelan agreed that the current situation did not indicate a larger health crisis.
“This is certainly an isolated case. So, there’s nothing really to be alarmed about,” he said.
Dr Tharmaseelan said that while cases have been detected annually, the Health Ministry aims to achieve zero local cases by 2030 through continuous monitoring, early detection and treatment strategies.
He also assured the public that leprosy was not highly contagious.
“People with leprosy can live with their families, go to school and work if they are already receiving treatment,” he said.
He stressed that stronger public health interventions, improved healthcare access and increased awareness were crucial to preventing future outbreaks.
Authorities have quarantined Kampung Chergun and Kampung Guntur in Negri Sembilan after an outbreak which saw nine people infected, while an 18-year-old Orang Asli girl has died.
Health officials are continuing to conduct screenings, contact tracing and public awareness campaigns.
