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Combating leprosy, a success story
Then and now
In 1981, when the presence of the disease was considered to be at
its peak in India, the Prevalence
Rate (PR) was 57 per ten thousand population. In March 2007 it had fallen to 0.72.
The number of patients under treatment was about four million then, it is
about eighty three thousand now. In 1991 the World Health Assembly
passed a resolution to Eliminate Leprosy as a Public Health Problem,
defined as reaching a prevalence of less than one per ten thousand population. India achieved this goal at the
end of the year 2005. Presently only six states/UTs (three major states and three smaller states and UTs)
out of 35 have a prevalence of over one, the other
states have achieved elimination. No state has a PR over two. At the
district level, 487 districts out of 611 have achieved the goal.
Strategies
This substantial reduction in disease load can be attributed mainly to
the use of WHO recommended Multi Drug Therapy (MDT). The
original National Leprosy Control Program, which started in 1955, had been re
launched in 1983 as the National Leprosy Eradication Program and MDT was the
mainstay of treatment instead of dapsone
alone. Initially a separate cadre of health workers conducted surveys,
diagnosed cases and provided MDT. Since 2000-01, the separate vertical
system was changed and the program was integrated into the general health
care system. Leprosy services are available at every Public Health
Institution through general health care workers now. The Modified
Leprosy Elimination Campaigns (MLEC)s and
Special Action Projects for Elimination of Leprosy (SAPELS), besides
the meticulous implementation of the program were instrumental in reaching
out to the patients all over India
and curing them. Lately, reducing operational factors like case re
registration and wrong over-diagnosis has helped substantially.
During post elimination, the stress is on sustaining the services for the
lesser number of patients, improving service quality of services and
providing special care to the persons deformed by the disease like Reconstructive
Surgery.
WHO Support
Besides support and guidance at the
policy and implementation levels by means of technical human resources such
as placing NLEP Coordinators, the organization has provided the required MDT
free of charge and has financially supported various components of the
program like information technology since the inception of NLEP.
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Leprosy messages on the back of a bus
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A new patient with his medicines (MDT)
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[ Click for Larger View
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Epidemiological
Situation March 2007
NLEP
Indicators as on 31.03.07
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Prevalence Rate
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0.72 per ten
thousand population
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Cases on
Record
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82,800
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MB Proportion (As
percentage of new cases)
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44.99%
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Female Proportion
(As percentage of new cases)
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34.25%
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Child Proportion
(As percentage of new cases)
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10.13%
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Visible Deformity
(As percentage of new cases)
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2.25%
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Number of states
which have achieved elimination
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29 (Out of 35)
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Annual New Case
Detection Rate (2005-2006)
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1.21 per ten
thousand population
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Number of cases
detected during 2005-06
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139,252
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Epidemiological indicators
of June 2007 Epidemiological indicators
of March 2007 Epidemiological indicators
of December 2006 Epidemiological indicators
of September 2006 Epidemiological indicators
of March 2006
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