Leprosy detection rate in Rio de Janeiro State, Brazil

Ref.:   Leprosy detection rate in Rio de Janeiro State, Brazil
From: M Leide W. de Oliveira, Rio de Janeiro, Brazil

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Dear Dr Theuvenet,

Thank you for your interest [LML June 4th, 2012].  Our main intention was to correlate case finding activities and early diagnosis of Hansen´s Disease (HD).  In fact there are probably many factors influencing the reduction shown:

1.
When we started with local campaigns in all 4 districts, the strategic objective was to decentralize diagnose and treatment to family health level (each family health area covers about 1000 families) in Duque de Caxias municipality.  Certainly at that time there was a hidden prevalence of HD.  The family health program did not improve significantly since 2005.  However, the Municipal Control Program assumed diagnosis and treatment as well as better contact examination in those covered areas, which includes second dose of BCG.

2.
Since 2010 we organize again local campaigns in Duque de Caxias with almost the same strategy as done in 2003.  Next year, in 2013, the campaigns will be evaluated to see if there still is evidence of hidden prevalence or not.  One preliminary observation is that new cases diagnosed in the current campaigns are mainly adults and the numbers are much less than the 1º intervention.

Since I am not an epidemiologist, there may be some exhaustion of infected persons in this region, alongside those operational factors mentioned above and besides MDT effectiveness.

MLeide W. de Oliveira

Medical School/Federal University of Rio de Janeiro.