Leprosy Mailing List – December 3, 2015
Ref.: (LML) Draft WHO Leprosy Strategy 2016-2020
From: Chandrakant Revankar, New Jersey, USA
Dear Pieter,
I am following up ongoing interesting discussion on the draft WHO Leprosy Strategy 2016-2020. One of the main concerns of many experts is on Uniform MDT (U-MDT) and its possible consequences. This is well appreciated.
We have travelled from lifelong treatment with DDS (monotherapy) to fixed duration MDT 12 and 6 months for MB and PB leprosy respectively and many of us have made long term observations in terms of success and failures with many reservations. A similar approach may be needed to make further critical observations on U-MDT. The following tips may be considered.
1. While adapting U-MDT ( may be some with concerns/fear), let us work on strengthening clinical and community based surveillance of post-U-MDT follow up to detect relapses, neuritis ,nerve function impairment(NFI) etc.
2.Clinicians(including dermatologists) at their clinic level ( public or private) maintain minimum essential records of leprosy cases on U-MDT to keep an eye to detect and manage morbidity and disability management may be with the support of the leprosy programme.
3. Leprosy programmes should aim at strengthening community based surveillance system for each post-U-MDT patient for early detection and management of problems.
4. Diagnostic facilities centers should provide skin smear services and increase their capacity to diagnose relapses and resistance.
5. Capacity should be built up and sustained by the programme/institutions/partners to detect, diagnose and manage relapse, neuritis, NFI, etc.
6. Research organizations to promote related research.
A simple but good clinical/programme recording system is essential to make long term observations which is really lacking today.
Regards,
Dr. CR Revankar
Consultant
Neglected Tropical Diseases
NewJersey.USA
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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