Leprosy Mailing List – September 26, 2013
Ref.: (LML) inTouch magazin The Leprosy Mission New Zealand
From: Brent Morgan, Auckland, New Zealand
Dear readers,
Enclosed a message from the Director The Leprosy Mission New Zealand.
Kind regards,
Pieter AM Schreuder
Editor LML
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 26, 2013
From: Premanshu Bhushan, New Delhi, India
Dear Dr Schreuder,
Thank you for your efforts regarding our objections to the recent WHO epidemiological data. I am happy to inform you; and through you all the leprologists around the world that in response to our objections the reported new case detection rate has been corrected to 4.0 from 0.4 in the prior version. The new corrected version is available at : http://www.who.int/wer/2013/wer8835.pdf.
Regards,
Premanshu Bhushan
New Delhi
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 15, 2013
Ref.: (LML) Leprosy training at Medical Colleges worldwide is lacking?
From: Charles Mang'ombe, Zambia
Dear Dr. Schreuder,
I want to agree with other peoples' concern on inadequate knowledge on Leprosy among Health workers. We can't blame the Health Workers themselves. Most Health Training Institutions in the world are not offering training in Leprosy and if they do it's just a topic among so many topics and inadequately covered. It's just a by-the-way Topic! Patients therefore, are forced to cover long distances for diagnosis and management of Leprosy. Again only those with money for transport can manage to travel and so this causes delay and more Leprosy complications (disabilities).
Are there better ways of handling this situation otherwise the gains we have made in Leprosy control will be in vain?
Regards,
Charles Mang'ombe
Leprosy Control Officer
Zambia (In Central Africa).
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 15, 2013
Ref.: (LML) Leprosy training at Medical Colleges worldwide is lacking?
From: Dr.Maneesha Godbole, Karnataka, India
Dear Dr. Schreuder,
This is regarding the dialogue on lack of leprosy training in medical colleges. I worked in the leprosy program with an NGO for 21 years and have now joined the medical college as faculty in the department of community medicine.
While I was there at the NGO, students from various medical colleges(MBBS as well as ayurvedic and homeopathic) and nursing schools would visit our centre and I would take a theory class for them on leprosy for about 1 and 1/2 hours and then take them around the ward for practical demonstration of cases including various aids and appliances, followed by a visit to the rehabilitation center. It used to be a half day program.
Now that I have joined the medical college, I see that the students have one theory class, one case discussion during their entire UG program. As interns they are posted for 15 days to the urban leprosy center of the college. If the concerned medical officer takes interest, he/she can teach them a lot about leprosy. Considering the burden of syllabus on the undergraduate students, this is all the time that can be devoted to leprosy. It is upto the teachers to drill into the students about the importance of leprosy during this time available to us.
Dr.Maneesha Godbole
Assistant Professor
Karnataka Institute of Medical Sciences
Hubli, Karnataka
India
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 10 , 2013
Ref.: (LML) Pressure Specified Sensory Device sensory testing in leprosy
From: James Wilton, Portland, Maine, USA
Dear Dr. Schreuder,
I direct a surgical team that performs upper and lower extremity peripheral nerve decompression and neurolysis procedures on Hansen’s patients in Ecuador. Our team has been going to South America since 2002. We will be coming out with 3 papers on our medical diagnosis and surgical management of these patients. One of our previous publications has been: Seiler DK, Wilton J, Dellon AL. Detection of neuropathy due to Mycobacterium leprae using non-invasive neurosensory testing of susceptible peripheral nerves. Ann Plast Surg 2005 Dec;55(6):633-7.
In addition to clinical neurological examination we use Pressure Specified Sensory Device (PSSD) sensory testing. We identified 25 patients in the field who have Hansen’s disease but were not identified by the local medical systems as being positive. This non invasive technology may be promising in the very early detection of Hansen’s disease in the field.
Sincerely,
James Wilton
Dr. James P. Wilton
Lower Extremity Peripheral Nerve Surgery
New England Foot and Ankle Specialists
A Division of Mercy Hospital, 195 Fore River Parkway, Suite #210,
Portland, ME, 04102
207-553-6681-Work
207-553-6682-Fax
JPWilton@gmail.com
WiltonJ@MercyMe.com
p/s Note editor:
Neurosensory testing is a non-invasive technique for assessing nerve damage by measuring the pressure threshold felt in the skin. By testing an area of the skin that corresponds to a specific nerve, the extent of nerve damage can be determined by the amount of pressure needed for a person to feel the touch of the testing device. The Pressure Specified Sensory Device (PSSD), is used to make these measure-ments of pressure threshold. This device consists of two blunt probes and sensitive transducers to measure pressure without causing pain to the person being tested (Copyright 2011 Bone and Joint Medical Center, P.C)
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 10, 2013
Ref.: (LML) ILC Pre-congress workshop on 'Community based approaches to patient detection and improving patient services'
From: Ernst Hisch, Würzburg, Germany
Dear Dr. Schreuder,
Greetings from Würzburg. Kindly have the enclosure distributed to all subscribers of LML. The ILC Pre-congress workshop on 'Community based approaches to patient detection and improving patient services' touches exciting topics. Although the great majority of LML readers will not be able to attend he workshop, we look forward to receive comments and proposals.
Best wishes also on behalf of Dr. York Lunau, Novartis Foundation for Sustainable Development
Ernst Hisch
Deutsche Lepra- und Tuberkulosehilfe e.V.
German Leprosy and TB Relief Association
ernst.hisch@DAHW.de
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 8, 2013
Ref.: (LML) BIKASH training calendar 2014
From: Gopal Gurung, Pokhara, Nepal
Dear Pieter,
Could you be so kind to circulate the attached BIKASH training calendar to LML readers?
Thank you in advance,
Gopal
--------
Gopal Gurung
Program Manager
BIKASH Nepal
Pokhara
Nepal
P: 00977 61 430562
F: 00977 61 430940
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 8, 2013
Ref.: (LML) Leprosy training at Medical Colleges worldwide is lacking?
From: Shaikh Abdul Hadi, Dhaka, Bangladesh
Dear Friends,
May I refer to the letter by Dr. Grace Warren “Leprosy training at Medical Colleges worldwide is lacking” of LML September 3, 2013? However, in Bangladesh we have a different experience.
In Bangladesh, National Leprosy Elimination Programme (NLEP) as well as Leprosy Control Institute & Hospital, Mohakhaki, Dhaka, Bangladesh are regularly conducting training programme on clinical leprosy by senior & junior consultant of leprosy hospital. We from the programme site conducting training programme on leprosy all over the Bangladesh for medical officers & field level health workers, key community groups at field level for development of awareness creation for leprosy for awareness in the community.
Regards,
Dr. Shaikh Abdul Hadi
Consultant, (NLEP)
DGHS, Mohakhali,Dhaka
Bangladesh
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 3, 2013
Ref.: (LML) Leprosy training at Medical Colleges worldwide is lacking
From: Grace Warren, Sidney, Australia
Dear Pieter,
Very interested to read the letter from Dr. Sunil Deepak about the WHO Epidemiological Records of September 1, 2013.
It brings up the constant messages that I get, of cases who are not diagnosed. Often because they do not have loss of sensation in patches so do not fit the official WHO definition. It would be very interesting if we could find out how many e.g. Indeterminate cases are found in India as I heard there are many cases officially undiagnosed. My concern is do they still get treated? The situation in many countries is also that early lepromatous may not show definite patches, they have a diffuse infiltration and no sensory loss for many years (often 10-20) so according to WHO do not have leprosy. I could not count the number of early LL I have diagnosed ( via a slit skin smear) and treated over the years. Can such patients still benefit from free MDT?
My concern is that in Medical Colleges worldwide, leprosy is still virtually neglected even in highly endemic countries. Is there anything that can be done at the upcoming ILA conference to get this corrected? The article you mentioned in a previous LML letter (some months ago) sums this up. An article in the March edition of the Australian Medical journal shows an aboriginal who obviously had nodular lepromatous leprosy, who had been treated for years for ulcers on feet and legs but the fact he had nodular leprosy was not recognised till a Srilankan experienced doctor saw him! Here is Australia I am afraid very little is taught about leprosy -- one wonders how many mild cases are missed, till they are gross.
I would love to see the diagnosis figure going up as I would think students were being better trained.
Grace Warren
Previously Adviser for The Leprosy Misison in Asia in ( 1975-1995).
Now living in Australia - still consulting re leprosy.
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
Leprosy Mailing List – September 1, 2013
Ref.: (LML) WHO Epidemiological Record
From: Sunil Deepak, Bologna, Italy
Dear Pieter,
According to WHO Epidemiological Record (WER 35, 30 August 2013), there were 20,213 new cases of leprosy in Africa in 2011, and it specifies that this is updated data from that presented in 2012 (WER 34, 24 August 2012). In fact in WER 34, the number of new cases in Africa in 2011 was 12,673.
However, in “The WHO Africa Region Strategic Plan for Further Reducing the Burden of Leprosy 2013-15” (updated in February 2013), the number of new cases of leprosy in 2011 was 25,231.
May I ask our colleagues from AFRO office of WHO to throw some light on these figures?
Sunil
Dr. Sunil Deepak
Head, Scientific Department
AIFO
Via Borselli 4-6
40135 Bologna
Italy
Webpage: www.aifo.it/english/
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com