On 29 January 2019, WHO’s disease surveillance focal point in north-east Syria informed the WHO country office (WCO) in Damascus of a suspected case of leprosy in Al-Hol camp, Al-Hasakeh governorate. The patient, an eight-year old girl, had recently arrived at the camp and had no history of treatment for the disease. Her symptoms included loss of sensation in both palms, resorption of fingers and early collapse of nose. WHO immediately shared its leprosy guidelines with the physicians investigating the case. The diagnosis was confirmed.
The patient and her family had been displaced several times in the
area near the Iraq-Syria border. Al-Hol camp has admitted approximately
27 000 people over the past two months. Most new arrivals have been
from areas controlled by the Islamic State of Iraq and the Levant.
Following advice from the Global Leprosy Programme and the Regional
Office for the Eastern Mediterranean, the WCO coordinated the response
with the Syrian Ministry of Health. A full course of multidrug therapy
was delivered to the camp and the patient started treatment on 3
February 2019. She was also given ancillary treatment for a secondary
infection in the thumb. A health care worker was given responsibility
for ensuring close follow-up of the patient.
This situation, though not unique, has its own difficulties.
Establishing the patient’s case history has been challenging due to the
remote location of the camp, its overcrowding and the continuous
movement of families within the camp. Efforts are underway to screen the
child’s family contacts.
Although leprosy is a relatively rare disease in this part of the world,
cases may occur sporadically. This emphasizes the need to link remote
health service units with centers of excellence through tele-medicine to
ensure patients in hard-to-reach areas receive proper diagnosis and
treatment.