Leprosy Mailing List – November 9, 2015
Ref.: (LML) Increasing number of newly detected cases with disability
From: Joel Almeida, Mumbai and London
Dear Pieter,
The incidence rate of newly detected leprosy cases with disability, in India, has increased steadily: from 3.133 per million population per year in 2008-9 to 4.486 in 2014-15.
This reflects not only a delay in diagnosis, but also a probable increase in the underlying incidence rate of leprosy.
Further, the proportion of cases with visible deformity increases from under 5% at diagnosis to between 15% and 30% of all cases released from MDT (as reported from population-based sampling surveys in UP, India).
The second WHO NTD report (2013) clarified that elimination means no new cases in a defined geographical area.
Migration of leprosy patients within India means that we cannot count on the bacterium being confined to geographical pockets.
The best hope to protect the people of India against the deformities of leprosy is to have:
1) Active case finding to reduce the delay in diagnosis
2) MDT for anti-microbial chemotherapy
3) Monthly monitoring of nerve function among MB patients, by skilled leprosy workers, with prompt anti-inflammatory treatment where necessary.
The finishing line is receding, and the last mile is steadily becoming the first mile in a new marathon. If we plan and act accordingly, people will thank us: for our leprosy control efforts, our workforce planning, our research and our advocacy on behalf of populations at risk of deformity from leprosy.
Regards,
Joel
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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