(LML) Trend in the incidence rate of leprosy in India

Leprosy Mailing List – August 29,  2015

Ref.:  (LML)  Trend in the incidence rate of leprosy in India

From:  Joey Almeida, India and UK

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Dear Pieter,

 

 

With greater delay in detection of leprosy, more of the incident cases self-heal and fewer new cases are detected. However, undetected cases who fail to self-heal develop visible deformities at a steady rate.

 

Let:

NDDt be the annual number of newly detected cases with visible deformity at diagnosis in year t in a given geographical area,

 

PDANt be the proportion with visible deformity among the newly detected cases in year t in that area,

 

It be the incidence rate of leprosy cases in year t in that area.

 

Then,

 

NDDt is directly proportional to It and PDANt, respectively.

 

That is,

NDDt = k x It x PDANt

Where k is a constant

 

Therefore taking years a and b:

 

NDDa/NDDb = (k x Ia x PDANa)/(k x Ib x PDANb)

 

Rearranging and simplifying:

Ib/Ia = (NDDb/PDANb) / (NDDa/PDANa)

 

This equation can be used to determine whether the underlying incidence rate of leprosy in a given geographical area is changing over time.

 

Taking the reports from the Indian leprosy programme, between the years of 2008-9 and 2013-14, it can be shown that the incidence rate of leprosy in India is very unlikely to be declining, and could even be increasing.

 

Claims of a declining incidence rate of leprosy appear inconsistent with the evidence. Indians require earlier detection of leprosy and intensified anti-inflammatory protection against the avoidable nerve damage: during and after MDT.

 

 

Regards,

 

Joel Almeida

almeidafam@aol.com

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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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(LML) Ten Steps: A guide for health promotion and empowerment of people affected by Neglected Tropical

Leprosy Mailing List – August 29,  2015

Ref.: (LML)   Ten Steps: A guide for health promotion and empowerment of people affected by Neglected Tropical Diseases 

From:  Jim Oehrig, Greenville, USA

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Dear Pieter, 

On behalf of American Leprosy Missions I'm pleased to announce the launch of  Ten Steps: A guide for health promotion and empowerment of people affected by Neglected Tropical Diseases. 

The package contains three sets of materials: Ten Steps: A guide for health promotion and empowerment of people affected by Neglected Tropical Diseases, the Ten Steps Executive Summary and Ten Steps Summary Card.

All are available to download for free at www.leprosy.org/ten-steps.

These user-friendly materials will facilitate community-level, cross-cutting approaches across NTDs with the overall goal of improving health outcomes.

Those interested in partnering with American Leprosy Missions to pilot the implementation of Ten Steps should contact us at tensteps@leprosy.org

Regards,

Jim Oehrig

Chief Programme Officer 

 American Leprosy Missions
One ALM Way Greenville, SC 29601

Skype: jsoehrig
Direct:  +1 864.241.1712 | Toll-free:  800.543.3135

Mobile  +1 864.420.6033

joehrig@leprosy.org | www.leprosy.org

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) Criteria for leprosy reactions/treatment?

Leprosy Mailing List – August 27,  2015

Ref.: (LML)  Criteria for leprosy reactions/treatment?

 

From:  Jingquan Wang, Zhejiang Province, China

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Dear Pieter,

Greetings from China.

 

I want to evaluate the curative effect of leprosy reaction,I  wonder if there is a uniform criteria for leprosy reaction treatment .How can we rate the effect  excellent ,good, mean or poor? Any assessment method suggested from LML readers?

Thanks in advance.
Look forward to your response as soon as possible.

Yours sincerely,


Jingquan Wang,Bachelor of Medicine
Chief Physician and Deputy Director
Inpatient Department

Institute of Dermatology of Zhejiang Province,
China,313200
No. 61,Wuyuan Street,Wukang,Deqing,313200，Zhejiang,China.

Academic Secretary of China Leprosy Association since 2010
Science Communication Expert of Leprology of China Association for Science and Technology  since 2013

Deputy Secretary-General of China Leprosy Association since 2015  

Phone:86-572-8296002

Fax:86-572-8078115

E-mail:Jingquanwang.cn@hotmail.com, wjingquan@126.com

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

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(LML) LML Blog: Attached files with LML messages

Leprosy Mailing List – August 27,  2015

Ref.: (LML)  LML Blog: Attached files with LML messages

From:  Sunil Deepak, Guwahati, Assam, India

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Dear LML friends,

 

We have started adding the files sent as attachments with the LML messages, so that these can also be accessed from the LML Blog http://leprosymailinglist.blogspot.in/ . Most attachments from 2015 have already been added.

 

However, this work has brought out the following 2 issues:

 

(1) Messages that have very big files as attachments are automatically excluded from the blog. During 2015 this happened to a couple of messages that had some very big image files. Therefore, if you are sharing pictures with LML members, remember to reduce the size of your files before sending them.

 

This will avoid that your messages do not get stored on the LML blog. This will also help those LML members who live in places where internet speed is not high.

 

(2) Files in Microsoft Word format may not open properly with different internet browsers. Converting your Word files to PDF before sending it to LML will be helpful to avoid this problem.

 

 

Best wishes,

 

Dr Sunil Deepak

Guwahati, Assam, India

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) plantar ulcers - survey new events

Leprosy Mailing List – August 11,  2015

Ref.:    (LML) plantar ulcers – survey new events

From:  Wim Theuvenet,  Apeldoorn, the Netherlands

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Dear Pieter,

 

Thanks to  Dr Jingquan Wang (LML, July 16, 2015)  for bringing up the issue again!!

 

A lot of energy is spent on the classification of plantar ulcers while our understanding of the causative factors still seems incomplete when one dares to look beyond the loss of protective sensation. Biomechanics and socioeconomic factors are often also involved! It may therefore be far too simplistic to speak of simple or complicated ulcers and effective measures to prevent most recurrences are still lacking.

 

Whatever intervention is planned, it should be based upon a more complete understanding of the problem, and evaluation including the ulcer-free interval, is in general recommendable.

 

Wishing Dr Jingquan all success,

 

Willem Theuvenet

Plastic Reconstructive and Hand Surgeon

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

Leprosy Mailing List – August 6,  2015

Ref.:    (LML)  WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

From:  Joel Almeida, India

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Dear Pieter,

 

The WHO Goodwill Ambassador's statement (LML, August 3, 2015) about the need to actively seek out new cases seems very realistic, honest and bold.

 

This statement will help encourage and inspire all health workers to do their best against leprosy, putting people's health ahead of all other considerations.  It also paves the way for everyone fighting leprosy to pull together.

 

M.leprae is an old foe, which has repeatedly shown up at its own funerals. It thrives on complacency and confusion among those fighting it. This statement issues a warning to M.leprae: we mean business.

 

Regards,

 

Joel Almeida

 

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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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(LML) WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

Leprosy Mailing List – August 6,  2015

Ref.:    (LML)  WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

From:  Joel Almeida, India

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Dear Pieter,

 

The WHO Goodwill Ambassador's statement (LML, August 3, 2015) about the need to actively seek out new cases seems very realistic, honest and bold.

 

This statement will help encourage and inspire all health workers to do their best against leprosy, putting people's health ahead of all other considerations.  It also paves the way for everyone fighting leprosy to pull together.

 

M.leprae is an old foe, which has repeatedly shown up at its own funerals. It thrives on complacency and confusion among those fighting it. This statement issues a warning to M.leprae: we mean business.

 

Regards,

 

Joel Almeida

 

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

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(LML) WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

Leprosy Mailing List – August 6,  2015

Ref.:    (LML)  WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

From:  PK Gopal, Erode, India

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Dear Dr.Pieter Schreuder,

Thanks to Ms. Hiroe Soyagimi for posting the WHO Goodwill Ambassador's Newsletter No:74 in the Leprosy Mailing List (August 3, 2015), which gives a lot of information on the activities of Mr. Sasakawa on  leprosy control and elimination of discriminations.

 I am happy to inform that a new resolution introduced by the Japanese Government has been unanimously passed by the United Nations Human Rights Council.  I have attached herewith the copy of the resolution as information to LML readers.

With regards,

Dr.P.K.Gopal    

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) Smoking and leprosy

Leprosy Mailing List – August 5,  2015

Ref.:    (LML)  Smoking and leprosy

From:  PK Das, Birmingham, UK

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Dear Pieter,

 
Please refer to the useful evidence based note by Prof. Terrence Ryan on "the smoking and leprosy" (LML, August 5, 2015). His comment "the best evidence is for delay in the healing of wounds for which there is much evidence today and was so even at the time I wrote my article", makes sense. As in my note on this subject I pointed out that the science of patho-mechanistic of wound healing or aggravating wounds or ulcers, however  is not that simple rather complex. Effect of smoking in relation to  the susceptibility of leprosy per se, due to immune suppression is an overstretched speculation.

I thank Terence for this journal. I shall encourage our Intercalating students of Population Science/International Health to publish their successful elective period research in this journal.

Regards,

Pran(ab).

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

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(LML) Smoking and leprosy

Leprosy Mailing List – August 5,  2015

Ref.:    (LML)  Smoking and leprosy

From:  Terence Ryan, Oxford, UK

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Dear Pieter,

 

This topic (Cairns Smith, LML July 31, 2015) reminded me that readers may not know of the Journal of Community Dermatology freely down-loadable from the website of the International Foundation of Dermatology, I once wrote about the importance of stopping smoking in Community Dermatology N°6 / April, 2007). Or you can just google Community Dermatology Journals. We also post them if required).

It may not say much about Leprosy (unlikely the immediately preceding article on Stigma) but it might stop readers who still indulge!  I have googled the topic and find the lack of an association with leprosy is blamed on small numbers studied. Whereas for Tuberculosis there is a quite strong association. The best evidence is for delay in the healing of wounds for which there is much evidence today and was so even at the time I wrote my article.

 

Terence Ryan 

Emeritus Professor of Dermatology Oxford University.

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) Smoking and leprosy

Leprosy Mailing List – August 4,  2015

Ref.:    (LML)  Smoking and leprosy

From:  PK Das, Birmingham, 2015

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Dear Pieter,

Referring to the LML letter by Joydeepa Darlong of August 1, 2015, there some reports which state that Nicotine does affect the delayed healing of traumatised muscle. Since healthy neuromuscular cross talk together with blood supply is a pre-requisite for healing. The right thing is by advising the patients not to smoke.

Regards,

Pran.

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

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(LML) WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

Leprosy Mailing List – August 3,  2015

Ref.:    (LML)  WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue

From:  Hiroe Soyagimi, Tokyo, Japan

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Dear Dr Schreuder and Friends,

 

Warm greetings from Sasakawa Memorial Health Foundation in Tokyo. 

We have uploaded our latest edition of "WHO Goodwill Ambassador's Newsletter No.74, June 2015 Issue" to our website. 

Please visit 

http://www.smhf.or.jp/e/ambassador/index.html 

to obtain electronic version of this issue. 

In this issue we feature articles about ...

Message : No Shame in Increased Case Numbers

Leprosy and Human Rights: Ending Discrimination: Next Steps - Symposium series concludes with recommendations of International Working Group.

Speech:  Leprosy and the Law - The position in international law could not be clearer : no discrimination. 

Interview:  Going the 'Last Mile' - Dr.Ann Aerts outlines Novartis Foundation's evolving strategy against leprosy.

 Ambassador's Journal:  Visits to Africa, Europe and the U.S. - Field visits to Ethiopia and DR Congo, meetings with ministers at the World Health Assembly in Geneva and awareness-raising in New York. 

News: An Audience with the Pope - People affected by leprosy from Brazil meet Pope Francis, discuss terminology.

From the Editors:  A New resolution

We hope you enjoy our latest Newsletter!

 

Hiroe Soyagimi

Sasakawa Memorial Health Foundation

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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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(LML) Socio-economic rehabilitation: habitat for people affected by leprosy

Leprosy Mailing List – August 3,  2015

Ref.:    (LML) Socio-economic rehabilitation: habitat for people affected by leprosy

From:  Arry Pongtiku, Irian Jaya, Indonesia

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Dear Pieter,

 

Thank you for sharing and updating  all comments of social-economic rehabilitation issue which was first raised by Dr Harun. I also could not avoid myself not to give comments. I would like to add an old quotation regarding empowerment,  the  quotation on the tombstone, partly from Lao Tsu in 500 BC (from a book written David Morley and Herminone Lovel, 1986 “My name is to day, that said.......”):

 

Go in search of your people

Love them

Learn from them

Plan with them

Serve them

Begin with what they know

Build on what they have

But of the best of leaders

When their task is accomplished

Their work is done

The people all remark

"We have done it ourselves"

 

About leprosy settlements

My limited experience about habitat of people affected by leprosy, anyway, we have been trying to convince the local government for the old leprosarium (settlement of Mangurai, in Teluk Wondama)  to be a cultural heritage (not yet finished). The medical history in the land of Papua started from this place Mangurai. The old buildings of the leprosy hospital and houses are still there and a small church with nice decoration made by leprosy carpenters. Mangurai was the first leprosarium in Papua, built by Dr Leiker (founder of NLR). Now the biggest church in Wondama has been built in the settlement, what means that stigma of leprosy is not an issue anymore. I hope and dream people there (still few leprosy patients and their families/ offspring are living there) can be empowered and the place can be a part of tourism (holy tour) because Wondama and Manokwari have an  historical background  of Christianity.

 

Regarding another leprosy settlement in Papua in Sorong, named Km12: because of expansion of the town, the land of the leprosy settlement is being used for developing new buildings and houses. People Affected by Leprosy and their families complain about this situation, which will be hard on them.

 

I hope any leprosy settlement/habitat of people affected by leprosy is not treated exclusively but inclusively to reduce stigma. Probably making SWOT analysis, planning with people and local government, and stakeholders may be helpful.  Empowerment is also a challenge.

 

Regards,

ARRY PONGTIKU

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) Socio-economic rehabilitation: habitat for people affected by leprosy

Leprosy Mailing List – August 3,  2015

Ref.:    (LML) Socio-economic rehabilitation: habitat for people affected by leprosy

From:  HOSHINO Nao, Tokyo, Japan

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Dear Pieter,

 

Thanks to Dr Harun for sharing about his initiative "Superb Habitat for People with Leprosy".

 

Much concerns have been raised as the project proposes to provide housing and means to make a living for people and families of those affected by leprosy not  where they live, but it seems to suggest bringing the 100 families together to start a settlement.

 

The fear is that the new land with the 100 families would be recognised by others as 'the land where 100 families of those affected by leprosy gather and live', which may cause stigma and discrimination, as self-settled colonies or (former) leprosy settlements throughout the world face to date.

 

We, Sasakawa Memorial Health Foundation, have worked with the Ethiopian National Association of Persons Affected by Leprosy (ENAPAL), a national network of persons affected by leprosy in Ethiopia, in the past.

 

Habitat for Humanity planned a housing project in North Ethiopia some years ago. The HfH was to select some tens of families in the city who needed safe and adequate housing. The beneficiaries were to pay back for the raw materials, after certain period of time. Hearing of the project, the local branch of ENAPAL negotiated with HfH that people affected by leprosy in the city be included as the beneficiaries. The discussion did not go smooth at first. One of the criteria set by the HfH was that the beneficiaries had some means to make a living, and that the cost of raw materials be paid back (for the HfH to be able to continue their housing projects in new areas).

 

After much negotiation between ENAPAL and HfH, and later with ENAPAL and SMHF, we came up with a project that SMHF was to support a micro-credit project for people affected by leprosy in the city, and with that, the people who acquired a means of living, would then apply for the housing project of HfH.

 

The HfH and the local government prepared a new residential area where people who had nothing to do with leprosy could find a residence as well. The new residential area accommodates people and families affected by, and NOT affected by leprosy, living as neighbours.

 

The people/families affected by leprosy in new houses have a strong ownership of their house, as they feel that they have earned the house. Though the number was very limited at first, soon, many more people affected by the disease became very interested and hopeful that they could change their life. The new residential area has no division between families of those affected by the disease and those who are not.

 

After the big success in this particular city, HfH and ENAPAL collaborated further to help people affected by leprosy to have a new and decent housing in a few other cities in Ethiopia.

 

I am rather uncertain whether this would help you in any way, but if you need any information, let us know.

 

 

Yours sincerely,

 

 

HOSHINO, Nao

Sasakawa Memorial Health Foundation

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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(LML) plantar ulcers - survey new events

Leprosy Mailing List – August 2,  2015

Ref.:    (LML) plantar ulcers – survey new events

From:  Erik Post, Amsterdam, the Netherlands

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Dear Pieter,

Please find below some feedback to the question of Dr Jingquan Wang (LML, July 16, 2015) about wound assessment. This feedback is based on a large multi-country study that I was involved with on the efficacy of self-care groups with regard to multiple outcomes, including wound healing (the INNI study).

We measured wound healing by longest diameter and 90 degrees axis, outcomes defined as improved when smaller, healed when closed, and deteriorated when bigger. We did not look at other characteristics of the wounds. For the overall picture this approach worked. The diameter as the only parameter was described by Kantor, the article from 1998 is the interesting one. We considered the Bates-Johnson tool, but it became too complicated for the field level we did the assessment for, and was not within reach of the INNI assessment.

 

Hope this helps,

 

Erik Post

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