Terminology

Leprosy Mailing List, March 17^th, 2009

 

Ref.:    Terminology

From:  Frankel R. I., Honolulu, Hawaii, USA

---

 

 

Dear Dr. Noto,

 

The WHO choice of a prevalence of less than 1 leprosy case per 10,000 population as a target was described not as elimination of the disease but elimination of the disease as a public health problem.  While one can argue with the choice of that specific prevalence rate, I believe that this is a valid epidemiologic concept.  I also belive, however, that it should only be used by those who are knowledgeable about leprosy and the epidemiology of this disease. 

 

As pointed out by Ms. Poorman (LML 2 March 2009), reaching the WHO target goal does not mean elimination of the disease for those who have chronic impairment.  Likewise those who are newly diagnosed with leprosy do not have any reason to think that the disease has been eliminated.  I think one can discuss 'control' of leprosy with any audience but that the use of the term 'elimination' should be restricted as I indicated above.

 

I applaud Ms. Poorman for raising this issue.  Aside from her making an astute observation, I think it takes courage for a medical student to express her or his opinion to a group of people with years of knowledge and experience in the field.  Anyone can certainly disagree with her, but I think it is inappropriate to assail her for expressing her concern.

 

Sincerely,

 

Richard I. Frankel, M.D., M.P.H., F.A.C.P.

Emeritus Professor of Medicine

University of Hawai'i