Leprosy Mailing List – January 13, 2017
Ref.: (LML) Silent neuritis. Nerve damage. Disability and deformity. Prevention and management.
From: Jannine Ebenso, Middlesex, UK
Dear Pieter,
Thank Dr. Francesca for her input into this fascinating dicussion. (LML, January 7, 2017)
Although no longer on the field, during my 16 years managing leprosy and reaction in Nigeria, I never had access to monofilaments, so always carried my ballpoint pens everywhere with me.
Thanks for reminding us of the basics of monitoring nerve function. Being from Lancashire (UK folk will understand), I seek to be practical and like to ensure that what we recommend is actually feasible on the field.
With that in mind, you have stated that “The importance of Nerve Function Assessment during the first visit and monthly till completion of treatment or every two weeks should there be an impairment noted must be recorded. Thereafter, yearly evaluation for three years among PB cases and for five years among MB cases should be a part of the Posttreatment Standard to determine leprosy complications particularly leprosy reactions including examination of household contacts. Most of the time, the latter, is no longer considered.”
The Nigerian programme is managed by the government supported by ILEP members. Although we were successful in ensuring monthly nerve function assessment (NFA) during MDT, to my knowledge we never achieved the annual NFA post-treatment. The exception would be among members of self-care groups
I would be very interested to hear from Philippines and other countries how they have managed to achieve this. We can learn from one another’s success stories.
Warm regards
Jannine
Jannine Ebenso
Head of Quality Assurance
The Leprosy Mission International, 80 Windmill Road, Brentford, Middlesex, TW8 0QH
T: +44 (0)208 326 6767 M: +44 (0)7879647895 E: jannine.ebenso@leprosymission.org S: jannine.ebenso2008 W: www.leprosymission.org
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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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