Leprosy Mailing List – February 3, 2015
Ref.: (LML) How Efficacious is MDT
From: Maneesha Godbole, Karnataka, India
Dear Pieter,
Have been following the discussions on MDT efficacy. It is true that a there are a lot of relapses, sometimes even after a decade or two of completing MDT.
It is suggested that close monitoring be done of treated cases to detect relapse at the earliest stage. Close monitoring will require the services of personnel well trained in leprosy and thus having a sharp eye to detect signs and symptoms at the earliest. However, the situation in the post elimination era in India is such that the leprosy services have become truncated. The funding for leprosy has come down, post integration the pool of expertise in leprosy has come down Laboratory services are rudimentary even at the district level. I think even slit skin smears are not being done routinely and even that expertise is getting lost. The priority for the disease on the whole has been pushed down. In such circumstances, is it going to be possible to monitor closely for relapses? The result will be that relapses will transmit disease to many contacts before they are identifies and treated again.
What can be done in such circumstances? Apart from continuous sensitisation of the medical people in the diagnosis of leprosy, the patients cured of leprosy should be well educated regarding recognition of relapse. It is not only enough to educated them, but frequent communication should be established with these people to re-educate them. Empowering them will help in their early reporting.
Regards,
Dr.Maneesha Godbole
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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