Self-Assessment Questions (SAQs) for Study Session 19

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 19.1 (tests Learning Outcomes 19.1 and 19.2)

How would you classify the following leprosy patients?

  • a.Tesfaye with four skin lesions and weakness of both hands.
  • b.Hiwot has three skin lesions with loss of sensation.
  • c.Getachew reported with five skin lesions and inability to close his eyelids.


First, count the number of skin patches and check whether a peripheral nerve is involved in order to classify the type of leprosy into PB or MB (Section 19.1). If in doubt, classify as MB.

  • a.Tesfaye is MB because he has four skin lesions and weakness in both hands, which is a sign of nerve involvement.
  • b.Hiwot is PB because she has only three skin lesions.
  • c.Getachew is MB because he has five skin lesions and eyelid gap, an indication of involvement of the nerves serving both eyes.

SAQ 19.2 (tests Learning Outcome 19.3)

What is the correct treatment for each of the following leprosy patients? Classify each person for either PB-MDT or MB-MDT and explain why you reached your decision.

  • a.Bizuwork has four skin patches located on the right upper arm.
  • b.Ato Mesele complains of weakness in both hands and there is also a big skin patch on his back.
  • c.Yohanes has three skin lesions on his back and two lesions on his face, but no muscle weakness.


First determine the classification of the leprosy patient, then decide whether to give PB- or MB-MDT.

  • a.Bizuwork is a PB patient because she has four skin lesions. She should be given PB-MDT.
  • b.Ato Mesele is an MB patient because although he has only one skin patch he also has weakness in both hands (an indication that the nerves responsible for movements of both hands are involved). He should receive MB-MDT treatment.
  • c.Yohanes has a total of five skin lesions and no muscle weakness. He is a PB patient and should receive PB-MDT.

SAQ 19.3 (tests Learning Outcome 19.3)

What would you do when a leprosy patient on treatment comes to you for a monthly visit and why?


You should ask the patient how she/he feels and whether she/he has any complaint since the last visit. Then carry out VMT/ST and record your findings. Then inform the patient about treatment, looking for feedback to check what you say has been understood and clarify any issues the patient may raise. Finally, give/supervise and record the first dose of MDT for the new month, give the patient the blister pack, and remind the patient to inform you about any complaints during the month.

SAQ 19.4 (tests Learning Outcome 19.4)

Briefly describe all the actions and attitudes of healthworkers like you that will help to prevent your leprosy patients from defaulting.


You can prevent patients from defaulting by giving medicines regularly and informing the patient about what is required. In addition, make drug collection accessible and flexible, identify and refer patients with complications promptly. It is also important that you trace patients who miss a drug collection date or clinic day, carry out regular patient reviews and discuss any findings or concerns during clinic visits. Overall, you need to display an encouraging and positive attitude, to help motivate patients.

SAQ 19.5 (tests Learning Outcome 19.4)

Hailemariam started MB-MDT treatment eight months ago under your care but has not collected his MDT drugs in the last three months due to illness. He returns to see you today. What should you have done before now? What will you do today?


Before now, you should have visited him at home to find out why he has been absent from treatment and discuss how to prevent future treatment interruption. You should have reminded him about the need to keep treatment appointments to avoid worsening of illness and possible resistance of the bacteria to treatment.

On his return today, you should ask him about the progress of treatment and carry out a physical examination. Remind him that he has to complete the remaining seven blister packs within 11 months without fail. Tell him to always inform you in advance if he needs to be away from home so that you can give him his medicines for self-administration for the anticipated period of absence.

SAQ 19.6 (tests Learning Outcomes 19.1 and 19.5)

How would you educate a leprosy patient who is about to commence MDT?


Look back at Section 19.1 to check your recall of what to do; see how many of the following points you have remembered. You need to:

  • Educate patients about leprosy treatment to ensure that she/he adheres to the treatment plan.
  • Tell patients that leprosy is curable, and the drugs stop the disease from spreading.
  • Remind patients to keep the drugs in a safe, dry, shady place, out of the reach of children.
  • Mention that if the drugs are spoiled (change colour or broken), they will be replaced, as MDT drugs are free of charge.
  • Tell your patients that leprosy drugs can turn their urine red or skin darker, but they should not worry because this will go away when treatment is completed.
  • Make sure your patients know that MDT is safe during pregnancy, for patients being treated for tuberculosis (TB) as well as those who are HIV-positive.
  • Ask your patient to inform you when they notice any problem and that she/he will be seeing you monthly for a check-up and to collect MDT.

SAQ 19.7 (tests Learning Outcome 19.6)

What should you do before discharging a leprosy patient from MDT treatment?


Prior to discharge from MDT you should examine the patient and record all clinical findings.

SAQ 19.8 (tests Learning Outcomes 19.1 and 19.7)

John has been on MB-MDT treatment for six months. He has come to you today to complain of redness and pain in his skin lesions. He feels unwell and has not been able to go to the farm for four days. What is wrong with John? What would you do and why?


Redness and pain in skin lesions of a leprosy patient are signs/symptoms of a leprosy reaction. So, in John’s case you should inform him about his sickness, as you learnt in Section 19.3, then give him some aspirin or paracetamol tablets to relieve his pain, before referring him to a clinician for immediate management. John must continue to take MDT. If possible, you should accompany him to the clinic.

Summary of Study Session 19