Why Brazil is doing this? – Leprosy in Colombia

Leprosy Mailing List – December 8^th, 2011

Ref.:   Why Brazil is doing this? – Leprosy in Colombia
From: N. Cardona Castro, Sabaneta, Colombia

---

Dear Dr. Noto,

Thank you for your message “Why Brazil is doing this?” dated LML Dec. 4^th, 2011. Your words about “elimination” of leprosy are remarkable important.

I would like to share some information about the leprosy situation in Colombia, a country with prevalence of leprosy less than 1/10,000 since 2000 year.  Colombia is still considered an endemic country where leprosy is not a public health problem because its prevalence, but there are about 200-400 new cases per year.  This means that the transmission continues, which has not been impacted by the multi-drug therapy (MDT) as expected.

Nevertheless, the reduction in prevalence is not a real reflection of the problem with respect to population distribution.  For instance, Colombia has some regions where the actual prevalence is 1 to 3/10,000 and other regions where prevalence is 0 to 0, 5/10,000.

When Colombia reached the prevalence of <1/10,000, the leprosy control programme suffered devastating consequences.  After reaching this figure health officials let down their guard and control programmes and control activities were under budget because "leprosy in Colombia is in the post-elimination phase."

I am MD and work in leprosy research, fact that is considering by my colleges as foolishness, because leprosy in Colombia does not exist, this is the interpretation of ELIMINATION, not only for general people, this is the interpretation for scientific and health authorities that have the responsibility to budget the public health policies.

Every week at least one patient with disability 2 or 3 is diagnosed as a NEW patient in Colombia.  The devastating consequences of “elimination” were not only for budget or leprosy control measures, these consequences affected the medicine school programmes, and leprosy is studied in Colombia as other mycobacterial diseases in a class that is forgot very easy for medical students.

I attach some epidemiological studies that we have performed to improve the early diagnosis in household contacts of leprosy patients, but where are the non-diagnosed patients and their household contacts?

What can we do Dr. Noto?

Nora Cardona Castro | MD MSc Investigadora Prof Asociada

Instituto Colombiano de Medicina Tropical - Universidad CES

Carrera 43A # 52 Sur 99  Sabaneta

Colombia

Tel: (57) (4) 3053500 ext 2297 | Fax: (57) (4) 3014258

ncardona@ces.edu.co | www.ces.edu.co

Leprosy in Colombia (PDF): Attachment 1 Attachment 2  Attachment 3