LEPROSY IN WOMEN - CHARACTERISTICS AND REPERCUSSIONS

Health is often measured in terms of low mortality; nevertheless, mere ly being alive is not a measure of the quality of life'' H. Mendez Cas tellanos. Physiological, socioeconomic and cultural factors play impor tant roles in the response of women to Mycobacterium leprae and in the impact of leprosy on their lives. They appear to develop stronger imm unological responses to M. leprae than men, as suggested by lower inci dence and less severe clinical forms of disease in most areas of the w orld, as well as stronger reactions of cell-mediated immunity after pr ophylactic vaccination. Genetic factors and physiological status inclu ding pregnancy, intercurrent infection and malnutrition might be among the factors which modulate this response. Women in leprosy-endemic ar eas of the world, with few exceptions, suffer from marked economic and social dependency and inferiority which can only be heightened by the social stigma associated with leprosy. Nevertheless, they bear an eno rmous responsibility for the health of their families, often as head o f the household, and they often possess a unique capacity to influence community opinion. With the introduction of multidrug therapy, lepros y control throughout the world is no longer an unrealistic goal. Activ e vaccination may constitute the other factor necessary for eventual e radication of the disease. The incorporation of women at all levels in to active roles in health care programs may constitute one of the deci sive factors in the success or failure of leprosy control.