Saturday, January 5, 2019

(LML) Early detection is the critical part

Leprosy Mailing List – January 5,  2019
Ref.:    (LML) Early detection is the critical part
From:  Arry Pongtiku, Papua, Indonesia

Dear Pieter,
Firstly, wishing all of you the best in the new of 2019 with healthy, prosperous, happy, miraculous life and more for help people.

Thank you very much for Prof. Cairns Smith posting LML on 4 January 2019 about early detection is the critical part. I would like to add. It is indeed the propose of leprosy program not only to cure patients but also to cut transmission and to reduce stigma. It is the essence of early case detection. Treatment is significant/the best for prevention of leprosy.

In order to get the world free of leprosy, active case finding should be done and more health promotion to increase awareness. Our experience with role model leadership to go for surveys and in remote areas we detected more new cases of leprosy. If we are active we find more cases, if we are quiet we harvest a fake elimination. Health education campaigns used social media/technology to increase awareness people to come to health centres voluntary (passive case detection)

I once supported a study proactive health seeking behaviour for detection HIV in Paniai, Papua. We used promotion/campaign with local wisdom/cultural approach to the community, and the health provider went to community, and closer to them we detected more HIV patients (53 times increase in detection). Indonesia, in one hand are introducing an innovation for Knock Door; knock people houses for proactively detecting TB cases and on the other hand combined with TOSS (detection, treatment, and ensure finishing therapy).

Early case detection and treatment are cost effective strategies for leprosy. Some struggles are faced among which not infrequently limitation of MDT supply or out-of-stock altogether. We also need training and on the job training for leprosy health workers and to start introducing leprosy during their study. Early cases of leprosy may be more difficult to diagnose than the late stages. Leprosy is a great imitator. We need to give the health workers a handy book (atlas, illustrative book for those people in front lines). Some people ignore about patch/painless patches in his or her body because it does not disturb their daily life. DDS allergy must be aware after one- or two-months treatment.

Bio molecular studies for early case detection of leprosy/without symptoms are done. Furthermore, prevention through BCG immunization is cheap and applicable tool.

Leprosy should be a part of poverty alleviating strategies and human rights. More commitments including budget are needed. Integrated programs should be done where limited budget, limited staff and geographical constraints are faced. Motivation and inspiration should be tirelessly always in place. It is probably easier working in high endemic areas of leprosy, rather than low endemic areas where leprosy maybe forgotten.

Thank you so much,


Arry PongtikuMD, MHM, PhD
Papua, Indonesia

LML - S Deepak, B Naafs, S Noto and P Schreuder
Contact: Dr Pieter Schreuder <<

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