(LML) The leprosy Burden: Gabon part I.

 

Leprosy Mailing List – June 12^th, 2012

 

Ref.:   The leprosy Burden: Gabon part I. [see attachments]

From: Annick Mondjo, Libreville, Gabon

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Dear Salvatore Noto,

 

Congratulations for the opportunity that the leprosy mailing list (LML) is providing about publishing the update and the trends of the leprosy epidemiological situation in Gabon.  It is a pleasure to collaborate.  I would like to share with the LML readers the followings points:

 

1.

The 2011 leprosy situation in Gabon [PDF file in attachment - 01];

2.

Trends [PDF files in attachment – 02 and 03]

New cases (NCD) and new case detection rate (NCDR) of leprosy from 1991 to 2011 at Country level;

NCD and NCDR of leprosy from 2006 to 2011 at Regional level;

Prevalence, prevalence rate, detection and detection rate at Country level from 1960 to 2005 [from the beginning up to the end of the "elimination" strategy].

3.

Comments about the leprosy situation in Gabon

 

 

Comments about the leprosy situation in Gabon

 

Detection

In 2011 in Gabon were detected 32 new cases of leprosy [1.7 per 100.000 population].  On average, detection was about thirty (30) new cases every year during the last decade.  Detection was mostly via passive case finding since the 1990's.

 

Proportion of multibacillary (MB) cases among the new cases

The proportion of MB cases is actually very high in Gabon.  It was 100% in 2011. This indicator was much lower, only on-third in Libreville between 1985 and 2000. This increase is not a sign of misclassification or of a declining endemy but, in my opinion, it is mainly due to an increasing delay in diagnosis; a misdiagnose of paucibacillary (PB) cases; and to the WHO classification in use: most of new cases have more than five patches and/or many nerves involved. 

 

Grade-2 disability among new cases

The absolute number of new cases with grade 2 disability and their % (percentage) are monitored.  Also this indicator is high; it was 31.3% in 2011; and 42.5% in 2010.  This is a consequence of delay in diagnosis.  Unfortunately two or three years of delay are often reported.  Sometimes even more.  According to the global Enhanced (new) strategy 2011-2015, the new WHO proposed indicator of new cases with grade 2 disability per 100.000 population is also used.  In 2010 it was 0,93 per 100.000; one of the highest of the whole WHO African Region (and may be of the world?).

 

People living with leprosy related disability

People "affected" by leprosy disabilities (grade 2) are about one thousand.  This was the official estimated number in the year 2000.  Not possible to update this estimation.  Because disability is a "problem of public health" the information relating to the eye-hand-foot (EHF) score was systematically collected particularly in new cases, since the end of the 1990's, mainly in Libreville, and now, since the 2010 workshop for regional leprosy workers, is was extended to the other health areas. 

 

With my next paper I will send you some more comments about the new leprosy National strategy (2011-2015) in Gabon.

 

Best regards.

 

Annick Mondjo

 

Dr Annick MONDJO, MD

Directeur
Programme de Lutte contre les Maladies Infectieuses

Ministère de la Santé

BP 50

Libreville, Gabon

 

 

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LML - S Deepak, B Naafs, S Noto, P A M Schreuder
LML Archives: http://www.aifo.it/english/resources/online/lml-archives/index.htm
Dr Salvatore Noto
Padiglione Dermatologia Sociale
Ospedale San Martino
Largo R. Benzi, 10
16132 Genoa, Italy
Tel: (+39) 010 555 27 83  -  Fax: (+39) 010 555 66 41  -  E-mail: salvatore.noto@hsanmartino.it