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Explained: Why is Himachal testing residents for leprosy?

How prevalent is leprosy in Himachal Pradesh? What have been the results of the latest surveillance campaign? We explain.

Written by Gagandeep Singh Dhillon , Edited by Explained Desk | Shimla | December 22, 2020 11:32:42 am
There are currently around 80-82 patients with leprosy in Himachal, mostly adults. (Express Photo/File)

Health workers in Himachal Pradesh are screening the state’s entire population for symptoms of leprosy, in a door-to-door surveillance campaign launched last month. We explain how prevalent leprosy is in Himachal, and what the latest campaign means.

How many active cases of leprosy does Himachal have?

There are currently around 80-82 patients with leprosy in Himachal, mostly adults. Half of these patients were diagnosed in 2020, and the rest have been under treatment since last year.

For the first time in years, none of the new cases detected this year had visible impairments/deformity or ‘Grade 2 disability’, as the World Health Organization (WHO) calls it. This indicates the earlier a patient is diagnosed, the fewer the impairments (claw hands, drop foot, eye damage, skin nodules, lesions and ulcers are some of the visible impairments associated with leprosy).

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How prevalent is leprosy in Himachal Pradesh?

With advances in leprosy treatment in the 1980s, the WHO resolved to globally “eliminate leprosy as a public health problem”, that is, bring down the number of cases to less than one per 10,000 by the year 2000. India declared this elimination status in 2005. Himachal attained the status in 2002, and since then, the prevalence rate has been less than one in 10,000.

For the last five years, the leprosy prevalence rate in Himachal has hovered around 0.2 per 10,000 (see table below).

Year New Cases Patients with visible impairments/deformity

(Grade 2 disability)

Prevalence Rate
2016-17 146 23 0.21
2017-18 129 22 0.17
2018-19 150 10 0.20
2019-20 141 13 0.21
2020-21 (till October) 41 0 — (NA)

How is leprosy being eradicated in Himachal?

The national leprosy eradication programme is being implemented in Himachal under the National Health Mission. According to state mission director Dr Nipun Jindal, ASHA workers try to detect new cases at an early stage by screening people from house-to-house and referring suspected cases to a medical officer.

Diagnosis is generally done after confirming a definite loss of sensation in a pale or reddish skin patch on the body, or in some cases by using the slit-skin smear examination, said state leprosy officer Dr Gopal Beri.

Based on the number of skin lesions and other symptoms, leprosy is classified as paucibacillary and multibacillary, the latter being more severe. The disease is cured by multi-drug therapy, which consists of a three-drug regimen and is provided to patients in blister packs. The treatment is six months long in case of paucibacillary and lasts a year in case of multibacillary leprosy. Dr Beri said patients with anaesthetic feet are also given multi-cellular polyurethane (MCP) footwear which help in preventing foot injuries.

Of the 182 leprosy cases detected in Himachal in the last two years, only six were paucibacillary and the rest were multibacillary.

What have been the results of the latest surveillance campaign?

The ‘Him Suraksha Abhiyan’ was launched on November 24 to screen the population for Covid-19, tuberculosis and leprosy. Other health parameters such as blood sugar level and high blood pressure are also being recorded.

By December 8, around 21.5 lakh people, or 29 per cent of the state’s population, had been screened, out of which 688 people showed presumptive signs of leprosy. But none of them was found to be suffering from the disease. The high number of referrals is because the surveillance is being carried out by untrained workers from various departments, and any type of skin lesion or pale skin patch is being recorded as a symptom of leprosy, an official said.

According to the WHO, leprosy, also known as Hansen’s Disease, is a chronic infectious disease caused by Mycobacterium leprae. The disease mainly affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract and the eyes. Symptoms may occur within a year but can also take as long as 20 years or more to occur.

Leprosy is known to occur at all ages and is curable. Treatment in the early stages can prevent disability. Its mode of transmission has never been fully understood, and its likely transmitted via droplets, from the nose and mouth, during close and frequent contact. Around two lakh new cases were reported globally in 2019, of which 1.14 lakh were reported from India.

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