(LML) What is the actual situation of leprosy and its elimination

Leprosy Mailing List – February 12 ,  2016

Ref.:    (LML) What is the actual situation of leprosy and its elimination

From:  Rajeev Dudhalkar, Mumbai, India

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Dear Sir,

 I would like thank Dr. Arry Pongtiku for discussing on ‘What is the actual situation of leprosy and its elimination’ and making some valid following points:

1.       ‘In the last 10 years, mode of leprosy case detection was mostly passive only.’ When onset on leprosy symptoms are trouble free, we can expect voluntary reporting of cases.

2.        ‘Some surveys in remote areas showed huge number of backlog cases.’ Shared example makes the point very clear and matter of concern.

3.       ‘Integrated programs will be great for cost effectiveness.’ It has to very systematic and accepted by the general health care system.

4.        ‘Strengthening health center level, involving doctors and dermatologist, as well as investing through putting leprosy knowledge as local inputs/curricula for medical students, nurses, and midwife and public health students will ensure sustainability.’ It will be successful only when there is proper task oriented leprosy training of all cadre of health personnel.

5.       ‘In implementation, availability of MDT must go together’ MDT distribution in integrated setup is a problem when numbers of cases is reduced at the peripheral health unit level to the extent which can be counted on fingertip. So for better compliance total number of MDT blister packs should be insured as soon as case is registered, on the line of DOTS treatment for Tuberculosis which is a good practice followed in India under RNTCP.  Loss due to the wastage/misuse of MDT at all if any will be negligible in the interest of the PALs on account of the amount of money spend on the infrastructure and system to deliver leprosy services.

6.       I would like to share a flow chart published by ALERT-INDIA ‘A simple guide to diagnose Leprosy’ for the application of cardinal sings to diagnose leprosy with reference to Dr. Dr. Arry Pongtiku’s suggestion ‘regarding to symptoms not mentioned clearly in Cardinal Signs such as thickening earlobes and nodules these symptoms were not infrequently cases of leprosy. These should consider in cardinal signs method.’ So please refer the attached file. Hope it will clear the doubts.

With best regards,

Rajeev B. Dudhalkar

Mumbai- India

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LML - S Deepak, B Naafs, S Noto and P Schreuder

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